§ 8. Mr. Viggers
To ask the Secretary of State for Health what estimate she has of the impact of her proposal to introduce a further limited list of pharmaceuticals available for prescription under the national health service on investment in research and development by the pharmaceutical industry.
§ Mrs. Virginia Bottomley
The British pharmaceutical industry is a major international success story, accounting for nearly 10 per cent. of global pharmaceutical research and development, and contributing a positive trade balance of over £1 billion. I welcome the fact that the industry recognises the need to reduce the NHS drugs bill, 755 which is expected to rise by over 14 per cent. this year. I also welcome its co-operation in the work that we are taking forward.
Decisions on research and development investment depend on many factors. It is not possible to identify specifically the impact of the proposed extension of the selected list.
§ Mr. Viggers
Does my right hon. Friend agree that our pharmaceutical industry can be rightly proud of its record in research and development? Has the Department carried out a survey of comparative costs, and the cost saving in the NHS that has resulted from its treating patients with drugs rather than taking up hospital beds? Is my right hon. Friend prepared to meet representatives of Cyanamid, which is the largest civilian employer in my constituency? Its current development plans are being held up because it is concerned about future profitability.
§ Mrs. Bottomley
I certainly commend the United Kingdom pharmaceutical industry. It is, as I have said, an important industry: two of the world's largest pharmaceutical companies are United Kingdom-based.
My hon. Friend has made an important point. We want to encourage the pharmaceutical industry to assess the cost effectiveness of new products and the contribution that they make to improving health care generally. We are making good progress on health technology assessment and we hope soon to commission a code of practice for economic assessment in clinical trials.
§ Ms. Primarolo
Is the Secretary of State aware that the contraceptive pill is included in the 10 categories being considered for inclusion in the extended limited list? Is she aware that 3 million women take the oral contraceptive pill, which is 95 per cent. effective? The reduction in availability of the pill will force women to change to other forms of contraception and will lead to an increase in the number of unwanted pregnancies and abortions. Will the right hon. Lady make a statement to the House, agreeing to withdraw contraceptive pills from the 10 categories?
§ Mrs. Bottomley
Contraceptive pills are free for all women, regardless of means. We are seeking to ensure that all therapeutic categories are safeguarded, but the health service should not fund products that are too costly and have no unique therapeutic value.
The hon. Lady's question is typical of the Labour party's attitude. Labour always shuns or ducks difficult issues. In 1985, when we last introduced a selective list, Labour adopted the same scaremongering approach. It has cried wolf too often. We shall ensure that therapeutic categories are covered, but, in a year when pay increases are being held at 1.5 per cent., we are determined to consider all the options in seeking cost-effective health care.
§ Sir John Hannam
Is my right hon. Friend aware of the drug wastage that results from the present system of repeat prescription, whereby a three-month supply of drugs is dispensed in one go? Will she consider the triple-prescription scheme proposed by the pharmacists, under which drugs would be dispensed only on a month-by-month basis?
§ Mrs. Bottomley
I am determined to examine any way in which we can eliminate waste. We spend £100 million a day on the NHS and eliminating waste is the secret of 756 providing ever higher standards of cost-effective care. I appreciate the pharmacists' suggestion: they are an enormously important member of the health-care team and I greatly respect their particular knowledge and skill. I shall explore the suggestion later.