§ 3.57 p.m.
§ LORD NEWTONMy Lords, it may be for the convenience of the House if I inform your Lordships of the statement being made this afternoon by my honourable friend the Minister of Health in another place.
The statement is as follows:
"The Secretary of State for Scotland and I recently asked the Standing Joint Committee on the Classification of 885 Proprietary Preparations, of which Lord Cohen of Birkenhead is Chairman, to consider if they could help doctors in prescribing by giving more guidance on proprietary preparations.
"The Committee has now reported and the House will wish to know its principal conclusion. The Committee advise that, while there should continue to be no absolute restriction on the prescribing of any drug which the doctor considers necessary for the treatment of his patient, he need not normally go outside the drugs and preparations described from time to time in the British Pharmacopœia, the British Pharmaceutical Codex and the British National Formulary, together with the drugs that the Committee classify as N (new drugs of proved value not yet standard), and P (drugs for which there is prima facie evidence of therapeutic value but where the Committee want further evidence before firm classification). The Report goes on to advise that a doctor who prescribes other preparations may be liable to be called on to justify his action if the cost of his prescribing is being formally investigated.
"The Report will be published and, in consultation with the medical profession, will be brought to the attention of all doctors.
"My right honourable friend and I are aware that the pharmaceutical industry may be apprehensive of the effect of this advice on its future progress and development; but we are sure that any such apprehension would be ill-founded. Many standard preparations are, and will no doubt continue to be, available only in proprietary form, or cost little more or no more in proprietary than in unbranded form. This, together with categories N and P, and the individual doctor's professional discretion, will continue to provide full scope for the products of the industry's research and development to find their reward."
§ BARONESS SUMMERSKILLMy Lords, I should like to welcome this recommendation of the Committee presided over by the noble Lord, Lord Cohen of Birkenhead. I think that it will go some way towards reducing the cost of these expensive and unnecessary 886 drugs which are consumed in the country to-day. May I gently remind the noble Lord that the spokesman for the Opposition on health in another place recommended that, this should be done, so far as drugs included in the British Pharmacopœia, the British Pharmaceutical Codex and the British National Formulary and those classified as "N" drugs are concerned. But I realise the difficulties that his Committee have been under during the past years. I would only ask him about those classified under "P". Does he think that we are leaving the door a little ajar for the more unscrupulous drug houses to bring pressure to bear on the more gullible doctors? I always feel that the test of any drug is the clinical test.
The other question that I would ask—and I listened to the noble Lord carefully—is with regard to doctors being asked to justify their prescribing. Only those doctors whose costs are under examination will be asked to justify their prescribing. I expect the noble Lord knows that comparatively few costs are examined, and therefore it may be that only a comparatively few doctors will be asked to justify their prescribing. The other point that I want to make is this. I would remind your Lordships that there may be a great outcry from the more Right wing of the medical profession, because they will allege that to-day their freedom has been taken from them. I think those of us who understand these problems are quite happy that proper treatment will be given to every patient, because your Lordships should remember that the first health insurance scheme in the world was introduced in Germany by Bismarck at the end of the last century; and in Germany for many years they have followed, and follow to-day; the advice which has just been given. They are also prepared to examine the prescribing of any doctor who they believe has over-prescribed or has prescribed an unnecessarily expensive product.
§ LORD AMULREEMy Lords, I should like—
§ VISCOUNT HAILSHAMMy Lords, it is rather difficult for my noble friend to bear in mind a great number of comments, and I was wondering if the noble Lord would permit him to answer the noble Lady.
§ LORD AMULREECertainly.
§ LORD NEWTONMy Lords, I am obliged for the general welcome which the noble Lady has given to the statement. The first question she asked was about the risk being taken in including drugs in category "P" among those which the Committee recommend should be prescribable. So far as I know, the noble Lady need not have any fears about this being an unnecessary risk; and I would emphasise that this is a recommendation of a very distinguished Committee. With regard to her second question, I should like to make it plain that the recommendations in this Report in no way alter the present position: that if a doctor appears to be prescribing excessively he may be asked to show that any drug, in whatever category it is, was necessary for the patient.
§ LORD AMULREEMy Lords, I should like to welcome the statement which has been made and which will, I am sure, give a certain amount of satisfaction to members of the profession who have wondered whether there would be some restriction on prescribing. I am pleased to see that if a doctor thinks that certain drugs are necessary for his patient there will be no restriction on prescribing them. Secondly I understand that the Report is to be published and circulated and will be available to members of the profession. I am sure that most of them will try to do what they can to keep down the cost of prescribing expensive drugs.
§ LORD NEWTONMy Lords, I am obliged to the noble Lord.