GPs (Drugs Choice) (Hansard, 14 May 1996)

§ 2. Dr. Goodson-Wickes
To ask the Secretary of State for Health what consultation he has had on recommendations to GPs on choices of rugs. [27982]

§ The Minister for Health (Mr. Gerald Malone)
We fund several sources of information for general practitioners on drug treatments, consulting a wide range of professional and other bodies as appropriate. GPs are, of course, free to choose which drugs to prescribe for their patients, in the light of the information available to them.

§ Dr. Goodson-Wickes
My hon. Friend will remember the understandable disquiet expressed by GPs about the limited list, which was subsequently, and rightly, replaced by, and expanded to, a selected list. The pilot study being done on a computer-aided scheme known as Prodigy is also causing concern. Will he give an absolute assurance that this is a flexible system that will ensure that economic considerations do not override the most important consideration: the patient's clinical needs?

§ Mr. Malone
I am happy to confirm that. That is exactly the purpose of the project: to enable general practitioners to prescribe more effectively for their patients. The system is based on 600 guidelines, which are based on already published information from, for example, the British National Formulary, so I can give him that undertaking. We will, of course, see how the project proceeds. As he knows, it will be thoroughly evaluated.

§ Mr. Simon Hughes
If the Government believe in taking action on the basis only of the best scientific advice, why, last October, did they issue vague advice to every GP about certain third-generation oral contraceptives—with the result that about 200,000 women stopped taking the pill and about 3,000 women had abortions—when it is clear that there was no new scientific evidence that there was a danger, when the European regulatory body ruled last month that there was no new scientific advice and when there has been no other support for that Government action? Will the Minister apologise for an appalling piece of advice and confirm that no action will be taken against any of the drugs in terms of regulating differently?

§ Mr. Malone
I disagree with the hon. Gentleman profoundly. The best possible scientific advice was made available to the medical community at the first available opportunity, which it has the right to expect from a Government and a Government organisation. The hon. Gentleman need not shake his head because he has had detailed replies to what I think must be between 200 and 300 written parliamentary questions that he has tabled on this matter. Every morning, as I do the 30 or 40 more that he has tabled from some inspired source, he is seldom absent from my mind.

§ Dame Jill Knight
Have not the Government's fundholding schemes given GPs great freedom to treat their patients in the way in which they wish? Is my hon. Friend aware of many GPs' extensive concern that the Labour party proposes to get rid of the scheme?

§ Mr. Malone
Especially in relation to the ability to prescribe and to retain any savings that are made in prescription budgets, my hon. Friend is right. At present, 53 per cent. of the population in England are covered by GP fundholders. It would be appalling if that system were abolished, as the Labour party is promising.

§ Ms Harman
Will the Minister admit that approved prescribing practice was one of the many unsubstantiated claims that he has made for GP fundholding? Will he take this opportunity, before the Audit Commission report next week, to admit that he has made wildly exaggerated claims about fundholding? Does he understand that all general practitioners, fundholders and non-fundholders, want to work on the basis of partnership, not division and co-operation, and not cut-throat competition? That means replacing fundholding with Labour's system of GP commissioning.

§ Mr. Malone
When it comes to shooting from the hip about documents that have not been published, we do not need any lessons from the hon. Member for Peckham (Ms Harman) do we, Madam Speaker? I thought that her public accusations yesterday about fundholding and a primary care-led NHS were a disgrace. They were totally unsubstantiated. Unlike the hon. Lady, I do not intend to break a confidence about a report that we have received. That is extraordinary, coming from a party that has changed its policy on fundholding so many times, from outright abolition under the hon. Lady's predecessor to a half-way house from her initially. Now, in The Times today, I see that the Labour party is not even going to bring its policy to abolish fundholding to the House, but will do it by some covert means as yet undescribed because, if it were ever to form a Government, it would not have the courage to bring to the House a measure to abolish something that has the support of 51 per cent. of general practitioners in England.

§ Mr. Congdon
I welcome the fact that generic prescribing has doubled over the past 10 years. Does my hon. Friend agree that it represents good value for the taxpayer and good care for the patient? Following the question asked by my hon. Friend the Member for Wimbledon (Dr. Goodson-Wickes), can my hon. Friend confirm that, whether GPs use Prodigy or any other computer-based software, steps will be taken to ensure that they are given the widest possible choice of drugs from which to select?

§ Mr. Malone
My hon. Friend is right. The Prodigy system is not designed to limit GPs' ability to prescribe. I fully support the move to generic prescribing. It is excellent and should be encouraged. I can tell my hon. Friend that the Prodigy scheme, which gives clinical guidelines to doctors, is also capable of being amended by them in the light of what they think will be best for their patients.