§ 4.7 p.m.
§ THE PARLIAMENTARY UNDERSECRETARY OF STATE FOR COMMONWEALTH RELATIONS AND FOR THE COLONIES (LORD TAYLOR)My Lords, a Statement has just been made in another place by my right honourable friend the Minister of Health on the subject of the abolition of prescription 554 charges. I will read it to your Lordships, in his own words:
"I wish to make a Statement about the Government's intentions regarding National Health Service charges. First, prescription charges. These comprise the ordinary 2s. charge for prescriptions and charges for elastic hosiery, which are payable both by the patients of general practitioners and by hospital out-patients, together with the charges payable by hospital out-patients for certain appliances. With effect from February 1 next, we propose to abolish all these charges, which since 1952 have created a financial barrier between the patient and the treatment he needs. My right honourable friend the Secretary of State for Scotland and I are starting at once the necessary consultations with the professions on amendment of their terms of service, with a view to making regulations for this purpose when the House reassembles after the Christmas Recess. Until February 1 the existing charges will continue to be payable.
"There will remain the charges for dental treatment and appliances and those for spectacles. It is our aim to abolish these charges also, in due course, by means of legislation which will revoke the statutory powers authorising the levy both of these charges and of prescription charges. It will not be possible to introduce such legislation during the current Session."
§ THE MARQUESS OF LOTHIANMy Lords, I think that the House will be grateful to the noble Lord, Lord Taylor, for repeating the Statement made by his right honourable friend in another place. May I say at once that we recognise that prescription charges have imposed upon certain people some difficulties, though not, I feel, insuperable difficulties. I am thinking of such persons as those on National Assistance or disabled pensioners, and the chronically sick and aged who are in need of what I believe is called maintenance drug therapy.
Although the proposals outlined in the Statement will solve these problems, they appear, to us at any rate, to be a somewhat crude and somewhat indiscriminate way of dealing with a fairly limited problem. May I also point out to the noble Lord, although I am quite certain he does not need me to tell him, the vital need to continue the policy of the late 555 Government of spending every available penny on the urgent requirement to improve hospitals, to extend hospital accommodation and the medical services generally, which equally affects every man, woman and child in the country. Will he give an assurance to the House that the somewhat eye-catching measures which he has announced to-day will not be at the expense of these other, and equally important, improvements in our medical services? May I also ask him whether he can give the House any indication of the total cost to the Exchequer of abolishing all the prescription charges, both in this Session and, as I understand from the Statement, in the future?
§ LORD TAYLORMy Lords, to answer the noble Marquess's last question first, I would say that the estimated cost of abolishing the prescription charges and charges for certain appliances for hospital outpatients, which will be carried out, we hope, on February 1, will be £25 million per annum. The second list of charges to be abolished to which I referred were charges for dental treatment and appliances and those for spectacles, which it would not be possible to deal with during the coming Session. Those we estimate to cost something under £20 million per annum. So the answer is, £25 million for the first, and £20 million for the second, the second not to apply immediately.
The noble Marquess asked for an assurance that there would be no curtailment in the efforts to improve hospitals. I gave that assurance only a few days ago, in answer to another Question, and I will willingly repeat it now. I could not agree with him that this is an eyecatching measure; nor could I agree with him that it is a fairly limited problem, although I concede that it is a difficult problem if one is thinking of it purely from the technical point of view. I feel that we are approaching it in probably the best way as a matter of general principle and general humanity.
I could not agree with him, for example, that it is easy to isolate those people in need of maintenance therapy and abolish charges for those people only. So many people now require continuing therapy over a number of years and are greatly benefited by this—I have 556 in mind many psychiatric patients—that to single these out for exception would make it most difficult. Therefore, speaking purely medically, I am sure that Her Majesty's Government have on balance done, and will be doing, the right thing.
§ BARONESS HORSBRUGHMy Lords, may I ask the noble Lord whether, in the £25 million that he has mentioned, he has now included the elastic stockings of which he spoke? Because previously we were given the amount of £25 million as the cost of abolishing prescription charges only. Have the stockings now been included, or are they an extra?
§ LORD TAYLORMy Lords, I am pleased to be able to answer the noble Lady. The stockings are included in the £25 million, as also are surgical boots and shoes, abdominal supports and wigs when they are issued through the hospitals, as indeed they can only be issued, from the point of view of the National Health Service.
§ LORD COLYTONMy Lords, is the noble Lord aware that since these proposals were first put forward by Her Majesty's Government it has become more clear that it is the view of most of the doctors, and I believe also of the British Medical Association, that while they favour the abolition of prescription charges in principle, this will lead to a vast increase in the calls on the ordinary general medical practitioner, and they expect that more and more of a desperately busy doctor's time will be taken up with trivial cases, to the detriment of patients who are seriously ill? Is the noble Lord aware that, in the main, and for those reasons, doctors strongly oppose the introduction of these proposals at the present time?
§ LORD TAYLORMy Lords, I am aware of some of the things which the noble Lord, Lord Colyton says, but not of others. It is true that the British Medical Association, having steadily maintained their opposition to prescription charges over all the years until this year, reversed their decision by, I think a two-thirds majority at their Annual Conference. But I would point out, respectfully, that that Annual Conference is not necessarily representative of the majority of medical opinion. We have no way of knowing for certain what the 557 majority of the doctors think. It is, however, fair to say that many doctors are anxious about whether this may lead to extra work for them, and in so far as people have been prevented from seeking their doctor's aid because of fear or an inability to pay the necessary fee, it may lead to a slight increase. I do not myself think the increase will be of any substantial size at all, and I hope that by other measures, which are now being discussed between the doctors and the Ministry in the Working Party, the conditions of general practice may be improved, so that the real needs of the patient may be met, despite any inevitable small increase in calls for the general practitioner.
§ LORD AUCKLANDMy Lords, does not the noble Lord think that this is a typical example of the Government getting their priorities quite wrong? Surely it is more important for spectacles to be dealt with first and prescription charges later? There is a good deal more hardship being caused to people who wear spectacles and who need a replacement than to the vast majority of wage earners who can well afford the prescription charges.
§ LORD TAYLORNo, my Lords, I could not agree at all with the noble Lord. In my experience, most of the hardship occurs amongst old people who need repeated and multiple prescriptions. If an old person requires three drugs at once, is on an old age pension and has to pay six shillings when he goes to the doctor, this places a substantial burden on his small income, and I am glad that we are dealing with prescription charges first. Moreover, these drugs for old people have to be received and taken often and repeatedly, and are essential, whereas spectacles can wait a little.
§ BARONESS HORSBRUGHMy Lords, is it not the case with the old person that he or she needs spectacles the whole time as well as drugs?
§ LORD TAYLORYes, indeed. But having got some spectacles, one can get along for a little while without the same degree of urgency that there is in the case of drugs.