HC Deb 16 July 1985 vol 83 cc165-6
14. Mr. Meadowcroft

asked the Secretary of State for Social Services if he has yet received the reply of the British Medical Association to his proposals for an appeals procedure on the limited list.

Mr. Kenneth Clarke

Yes, Sir. The general medical services committee of the British Medical Association has now formally declined our proposals for a local appeal mechanism for the selected list of drugs.

Mr. Meadowcroft

Would support from general practitioners wishing to implement such an appeal system be sufficient for the Minister to implement it for them unilaterally?

Mr. Kenneth Clarke

It would be very difficult to implement a scheme without the co-operation of the people who originally asked for it. We have gone through the process of having this mechanism asked for by the BMA. We then negotiated with BMA representatives to their satisfaction. Eventually, our proposal was rejected by the conference of local medical committees. As I said earlier to my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight), what has happened is that, in practice, the need for such a mechanism has turned out to be insufficient.

Dr. Mawhinney

Does my right hon. and learned Friend agree that that is an unacceptable decision by the medical profession? Bearing in mind that he regarded such an appeal mechanism as important for patients when he established the system, will he pursue the proposal, preferably with the help of the medical profession? If that is not possible, will he seek some other way to set up such a mechanism?

Mr. Clarke

The decision was taken on the advice of the conference of local medical committees, a body fairly representative of general practitioners. The history of the matter is that the mechanism was called for before we introduced the selected list system, when there were exaggerated fears about the likely effect on patients. In practice, the need for such a mechanism has diminished and we are getting along well without it, but if the BMA or the medical profession changes its mind we shall, of course, consider the matter again.

Dr. M. S. Miller

Why does the right hon. and learned Gentleman not go straight to the general practitioners themselves? He does not need to have the support of every GP, but if a sufficient number will follow the scheme they will be able to carry out their main purpose of pursuing the best interests of their patients. Why does he not go straight to the GPs and let them work the scheme?

Mr. Clarke

With respect to the hon. Gentleman, who has been a general practitioner, I do not think that a sufficient number of GPs are challenging the decision of their own local medical committees. The present system is working reasonably well, and now that we have set up a new review committee to keep the list up to date it is unlikely that there will be any major difficulties in practice.