HC Deb 28 April 1998 vol 311 cc135-6
8. Miss Anne McIntosh (Vale of York)

If he will make a statement on the financial provision for GP prescription budgets. [38678]

The Minister of State, Department of Health

Nearly £4.4 billion has been allocated to health authorities in England to cover the cost of drugs and medicines prescribed by general practitioners this year.

Miss McIntosh

Does the Minister agree with some practitioners that setting cash limits on prescription budgets will detract from their freedom to act in the best interests of their patients and in accordance with their best clinical judgment? Does he agree that it could lead to a loss of morale, especially in the GP profession; might harm recruitment; and might prevent the best relations between doctor and patient from being established? Does he accept that it should be for the GPs to prescribe what is best for their patients?

Mr. Milburn

The answers to the hon. Lady's questions are no, no, and yes. Yes, of course it is for the family doctor to decide what is in the best interests of the individual patient, but I did not hear any howls of protest from Conservative Members when the previous Government cash-limited drug spending for 50 per cent. of GPs by introducing the GP fundholding scheme. There were no protests then, so why the protests now?

Mr. Barry Jones (Alyn and Deeside)

Has my hon. Friend guaranteed the clinical judgment of general practitioners?

Mr. Milburn

Yes. As my hon. Friend is aware, we have put family doctors and community nurses in the driving seat. We have removed the artificial barriers between prescribing budgets and referral budgets which, in the past, have got in the way of allowing the family doctor to make the right decision for the patient. We have done no more and no less than increase GP freedom.

Mr. John Maples (Stratford-on-Avon)

It was good to hear the Secretary of State say that survey after survey showed how happy people were with the NHS. He was clearly referring to the British social attitudes survey. There has not been one since the election, so presumably he was referring to people's happiness with the health service when it was being run by us.

I should like to bring the Minister back to the question of GPs' budgets. Under fundholding there was a trade-off for fundholders between prescribing and referrals to secondary care. GPs were limited in a much wider budget and in a great many cases they overran it and the money was made available to them by their health authorities. Under the new primary care groups, that will not be the case, will it? Suddenly, the vast majority of GPs believe that there will be a separate cash-limited prescribing budget within the group's overall budget. That is one of the reasons why so many of them are showing, in survey after survey, their misgivings about the new proposals.

Mr. Milburn

On his first point, I remind the hon. Gentleman of what he said in Birmingham recently about the previous Government's record on the national health service. He said that they had failed and that the British people had given their judgment on that. Let us be clear about the facts.

Secondly, the hon. Gentleman referred to GPs' prescribing budgets. I say to him, to the House and to GPs throughout the country that no GP will run out of cash, that patients will be guaranteed the drugs and the treatment that they need, and that, if a primary care group overspends, the overspend will be catered for within the health authority's general allocation.

Miss Melanie Johnson (Welwyn Hatfield)

Can my hon. Friend confirm the excellent comments made by my right hon. Friend the Secretary of State for Health at an Association of the British Pharmaceutical Industry event last Thursday evening? He made a well-received speech, in which he rightly said that we would ensure that money spent on pharmaceuticals and on drugs was used most effectively. His concern was not about budgets, but about effective treatment for patients.

Mr. Milburn

My hon. Friend is absolutely right. The new system that we shall introduce will allow the individual family doctor to decide what is best for the individual patient, without there being any artificial barriers in the way. That may mean that there will be an increase in drugs spending in some GP practices; elsewhere, it may mean an increase in referral patterns to hospital. The key fact is that, in future, decisions will be taken in the best interest of the patient.