HC Deb 25 July 1989 vol 157 cc842-3
6. Mrs. Maureen Hicks

To ask the Secretary of State for Health how many complaints he has received from patients and general practitioners in the last four years as a result of the introduction of the limited drugs list.

Mr. Mellor

Since the selected list scheme was introduced in April 1985 the Department has received some 6,000 letters about the scheme, but not many recently. Recent correspondence has tended to recognise that the selected list scheme has produced worthwhile financial savings while fully protecting the interests of patients. None of the dire predictions made at the time of the introduction of the scheme by the British Medical Association and others has proved to be true.

Mrs. Hicks

My hon. Friend will recall only too clearly that the outcry and fears expressed by general practitioners four years ago before the introduction of the selected list was not dissimilar to the present outcry from general practitioners about prescribing costs. For the sake of those vulnerable patients who are completely confused, will my hon. and learned Friend take the opportunity to bang on the head once and for all the untruth going about that any patient might be denied medicine? Will he reassure the elderly and those on long-term medication that they have nothing to fear under the Government?

Mr. Mellor

I am very happy to give my hon. Friend the reassurance that she seeks. Every patient will receive the medication that they require—that is a categorical promise. Despite the controversy over the limited list, it establishes that worthwhile savings of about £75 million per year can be made, which can be deployed elsewhere in the Health Service to the greater benefit of patients. The controversy shows also that, unfortunately, some groups within the Health Service are so resistant to changes that they will seek to blackguard them with the most wild charges—none of which, in respect either of the selected list or of other reforms, has proved to be true. The same will doubtless be true of the dire predictions made about the White Paper.

Mr. Rooker

One of the drugs that is the subject of most concern and, I suspect, of most representations, is Mucodyne—which was restored to the list, but only in the children's version. Many elderly people suffering from bronchial complaints, including a number of my constituents, have found no substitute for Mucodyne that meets their needs, and must fork out about £13 or £14 every time that they purchase a bottle. They have no choice because there is no proven, practical alternative. Mucodyne has also been the subject of many parliamentary questions, and I ask the Minister to bear my comments in mind if the list is ever reviewed.

Mr. Mellor

The hon. Gentleman knows that the drugs included on or omitted from the selected list were the subject of professional evaluation by an advisory committee, so those decisions were taken not by the Government but on specialist advice. The hon. Gentleman will know also that we offered the British Medical Association an appeal mechanism but it did not take us up on it. That would have been a way of dealing with any residual points.

Dame Jill Knight

Is not the simple truth that if my right hon. and learned Friend and his colleagues had listened to the BMA's campaign against the limited list, £75 million per year less would have been available to spend on patients?

Mr. Mellor

Yes, and that £75 million equals the cost of building a new Great Ormond street hospital every year for the past four years. That is what the debate is all about. Of the £2 billion currently spent in the NHS on prescribed drugs, tens of millions of pounds is misspent because of the refusal by some general practitioners to prescribe generic alternatives, slack repeat prescribing, and other reasons. Just as it is necessary for patients to have the drugs that they need, it is important that patients are not prescribed drugs that they do not need.