HC Deb 05 March 1991 vol 187 cc122-4
6. Mr. Illsley

To ask the Secretary of State for Health whether he has received any representations regarding the prescribing of high-cost drugs; and whether he will make a statement.

Mr. Waldegrave

Yes, Sir. We have received some representations. All doctors are free to prescribe high-cost drugs. The extent to which hospital doctors do so is governed by how they choose to spend their share of the increasing resources being made available to the NHS, in the light of local health care priorities.

Mr. Illsley

I am grateful to the Secretary of State for that reply. Is he aware that even now there are problems with the prescribing of certain drugs to children, especially child growth hormones? Is he further aware that a conference was held on Monday to try to determine the future prospects for prescribing such drugs? Children in my area are still being denied drugs which are necessary to them because of cuts in funding in the run-up to 1 April. Will he urgently consider organising a new basis for the prescription of such drugs?

Mr. Waldegrave

I am aware of the continuing pressures and I believe that there will always be such pressure in the national health service, whatever the level of funding. If by special measures the hon. Member means that all decisions should be centralised, as some of my hon. Friends have urged on me, I think that that would be wrong. It would mean that a group of doctors in the Department of Health would take away local clinical decisions and that would be wrong. This has to be a matter in which those in hospitals use their clinical judgment to make the best decision for the patient against the other competing claims which will always be made of them.

Dame Jill Knight

Is my right hon. Friend aware that pharmacists believe that there is still much over-prescribing of drugs by GPs and that positively millions of pounds worth of unused drugs lie on the shelves of British bathroom cupboards? Will he continue to fight waste in all departments of the NHS, especially this one?

Mr. Waldegrave

My hon. Friend is entirely right. Against the predictions made, the indicative drug prescribing scheme is already saving unnecessary prescribing. The newspapers this week carried a story which I must draw to the attention of hon. Members, as it is not always the latest and most expensive drugs which turn out to be the best for patients. The story concerned a rival series of heart drugs, but, as the companies involved are suing each other, I had better be careful about what I say. I agree with my hon. Friend that we must be careful to root out waste. My bathroom cupboard certainly has too many unused drugs in it.

Dr. Kim Howells

Does the Secretary of State agree that some of the most expensive drugs are those of the steroid family, which are used as preventive medicine in the treatment of asthma? He will know that 2,000 young people die of asthma each year and it has been estimated that 80 per cent. of those deaths could have been avoided, had the illness been properly diagnosed and the disease treated with the right steroid drugs. Will he ensure that proper diagnosis is made and that treatment is given not on the basis of cost but on the basis of the need to save lives, especially young lives?

Mr. Waldegrave

Of course, that is the criterion on which decisions are made. I agree that it is disturbing that asthma is one of the diseases that are currently on the increase, for reasons that are not fully understood. I also agree that early diagnosis is important: if that will help —along with the primary health care measures that we are introducing—steps can be taken that are much cheaper and much more effective than later treatment.

Mr. Michael Morris

Is my right hon. Friend aware that the success of PACT— prescription analysis and costs— has provided the major savings in GP prescribing, rather than the indicative drug budget scheme? In view of those savings, is not it time to consider prescribing specialist hospital products to meet the commitment made by my right hon. Friend's predecessor that patients will have every drug that they need and that it will not be left to consultants to make clinical judgments based on the resources available to their regional or district health authorities?

Mr. Waldegrave

I agree with my hon. Friend that PACT has played a large part in the current developments, although in due course he will find the indicative drug budget scheme helpful, too. I caution him that there will always be difficult clinical decisions for doctors and clinicians to make. Drugs are not of themselves in a different category from other expensive forms of treatment — for example, those that involve high capital-cost equipment.

Mr. Wareing

Have any of the representations made to the Secretary of State concerned benzodiazepines? They still seem to present a considerable problem, despite the number of circulars that have been sent out. Is not it high time that legislation was introduced to control the prescribing and re-prescribing of dangerous drugs which are addictive and are causing more havoc than cure in the health service?

Mr. Waldegrave

As the hon. Gentleman knows, we strongly sympathise with his anxiety. I am not sure that legislation is the best way forward; it would be difficult to frame. This is the sort of problem which the indicative drug prescribing scheme is aimed to deal with and we continue to press for it to be properly addressed.