Limited List Prescribing

HC Deb 11 February 1985 vol 73 cc1-3

1. Mr. Raffan

asked the Secretary of State for Wales if he will make a statement on the proposals to limit the range of drugs prescribed under the National Health Service.

The Parliamentary Under-Secretary of State for Wales (Mr. Wyn Roberts)

The proposals for limited list prescribing announced on 8 November 1984 by my right hon. Friend the Secretary of State for Social Services have been the subject of consultation with the medical, dental and pharmaceutical professions and the pharmaceutical industry. The consultation period ended on 31 January and the many responses received are now being considered.

Mr. Raffan

Will my hon. Friend give the most serious consideration to the introduction of an over-rule that drugs not on the list may be prescribed under the NHS subject to accountability to the local general medical committee? Would that not ensure not only that doctors could meet all clinical needs, but that they would be less likely to trade up, which could dramatically reduce savings?

Mr. Roberts

I appreciate my hon. Friend's comment. He will know that it is our intention that the list of NHS drugs should meet all clinical needs, but if it is demonstrated that there is a real problem in particular circumstances, we shall consider how best to deal with it. I am grateful to my hon. Friend for his suggestion.

Mr. Abse

The 900 people employed at the Parke-Davis factory in my constituency could be severely affected if the list is restricted. Has the Secretary of State for Wales, as I requested, made representations to his colleague the Secretary of State for Social Services pointing out the serious employment consequences if the proposed drugs list goes through?

Mr. Roberts

My right hon. Friend has of course been closely involved with my right hon. Friend the Secretary of State for Social Services because of the responsibility that my right hon. Friend the Secretary of State for Wales has for health in Wales. He has made known his views about likely effects on the pharmaceutical industry in Wales. I cannot comment further on our proposal until conclusions have been reached.

Sir Raymond Gower

Is it possible for my hon. Friend to give assurances that where there is a long history of a patient being allergic or intolerant to certain generic drugs, but able to take some particular proprietary drug, the doctor will have some scope for selecting such a drug?

Mr. Roberts

My hon. Friend is basically on the same point as my hon. Friend the Member for Delyn (Mr. Raffan), and I stress yet again that it is our intention that the list should meet all clinical needs, but we are aware of problems, and they will be considered before the final list is drawn up.

Dr. Roger Thomas

Why does the Minister not accept the method suggested by the Greenfield report, which will lead to savings in the drugs bill that will not discriminate against the less well-off members of our society?

Mr. Roberts

We have no intention of discriminating against the less well-off members of our society, and I draw the hon. Gentleman's attention to the comments by my right hon. and learned Friend the Minister for Health in an Adjournment debate last Thursday. He said: The Government have no intention of debarring any of the poor or elderly from the treatment, free if necessary, under the NHS that they require. We have every intention that under the NHS it should be possible for doctors and patients to have access to a complete list of preparations, which is sufficient to cope with all the clinical and medical needs of the service."—[Official Report, 7 February 1985; Vol. 72, c. 1231.]

Mr. Best

Is my hon. Friend aware that there is a capacity for real saving in the prescribing of drugs by ensuring that doctors, whether through oversight or otherwise, do not over-prescribe? Many recipients of drugs commonly find that they are given far more than they need for a course of treatment. Will my hon. Friend look into that aspect?

Mr. Roberts

The point has been made by hon. Members on each side of the House, in particular in the debate on 8 November. There has been a doubling of the cost of drugs used in Wales. In 1978–79 the cost was £41.2 million; in 1983–84 it had risen to £80.7 million. That is an increase of 96 per cent.

Mr. Roy Hughes

Does the Minister appreciate that Aneurin Bevan introduced a National Health Service based on the principle that the best health service should be available to all, and that money should not be the consideration or the passport to better and quicker treatment?

Does he further appreciate that the proposal to limit the range of drugs will, if implemented, bring a two-tier system of medical care into every surgery, and that such a system has been banished since 1948?

Mr. Roberts

It is clear that the hon. Gentleman has not listened to my remarks. It is our intention that the drugs list will cope with all clinical needs of people within the Health Service.