§ 2.35 p.m.
§ [The Question was as follows:
§ To ask Her Majesty's Government whether they would now consider allowing drugs prescribed by doctors to be named by pharmacists on the packet or bottle of medicine, unless otherwise stated on the prescription.]
§ THE PARLIAMENTARY UNDERSECRETARY OF STATE FOR COMMONWEALTH RELATIONS AND FOR THE COLONIES (LORD TAYLOR)My Lords, I ought first to correct the implication in the noble Lord's Question that in some way the permission of my right honourable friend the Minister of Health is required before pharmacists may put the name of the drug on a dispensed medicine. Neither the law nor the pharmacists' National Health Service Terms of Service prohibit it. The ruling convention at the present time between the pharmaceutical and medical professions is that the pharmacist should not name the medicine unless specifically directed to do so by the prescriber.
There are arguments for and against a change in the present practice, but it is clearly essential that any change should command general support in the two professions. Some years ago, following a request from the then Minister of Health, the Joint Formulary Committee, on which the British Medical Association and the Pharmaceutical Society are represented, examined the problem, and in 1960 issued a statement which upheld the present practice. The British Pharmacopœia Commission have 342 recently informed my right honourable friend that in their view there are strong and compelling reasons why the labelling of dispensed medicines should be made normal practice. I understand that they have also brought this view to the attention of a number of other interested bodies, particularly the Joint Formulary Committee.
LORD ST. JUSTMy Lords, while thanking the noble Lord for his reply, may I ask whether he would not agree with the information that I have been able to obtain, that on the whole doctors are not against this idea so much as the pharmacists themselves?
§ LORD TAYLORMy Lords, I think that what the noble Lord suggests is substantially correct, but it is only fair to the pharmacists to say that the automatic labelling of all prescripions would involve them in a great deal of extra work, particularly where prescriptions were written out in full. There are pros and cons. It is encouraging that the British Pharmacopœia Commission have taken this strong view, and I hope that the Joint Formulary Committee will in fact consider their view sympathetically.
§ BARONESS SUMMERSKILLMy Lords, in view of what the noble Lord says, I hope that he will follow this up and will press for this small reform. Is he aware that the hospitals are already doing it, that the nurses and midwives are all asking for it, and that the only people who object to it are some conservative practitioners, elderly practitioners, and the retail pharmacists? Is my noble friend not aware that, although he has told the House that the reason why the retail pharmacists do not want to do this is that it will cause them a little more work, surely the most telling reason is that it would reduce their dispensing fees?
§ LORD TAYLORMy Lords, I do not quite follow the last portion of my noble friend's argument. But on her formerpoints, it is perfectly true that in many hospitals the pharmaceutical staff adopt this practice as a general rule; and the Royal College of Nursing has certainly spoken in favour of labelling dispensed medicines with the name, and probably the majority of the medical profession would favour this. It is, however, only fair to say that many retail pharmacists 343 are heavily burdened with work, and it would involve them in substantially extra work.
§ LORD NEWTONMy Lords, I do not know whether the noble Lord can say what his noble friend means by "conservative pharmacists".
§ BARONESS SUMMERSKILLDoctors.
§ LORD NEWTONI was going to ask thenoble Lord this. Is it not really as simple as this: any doctor who wishes whatever he dispenses to be fully described on the label, can secure that that is done simply by what he writes on his prescription?
§ LORD TAYLORMy Lords, yes, that is true; but it may mean that he has to repeat every prescription twice on the prescription form, because he writes a direction to the chemist stating how the drug should be labelled and the dose to be given, as well as the actual prescription.
§ LORD FRASER OF LONSDALEMy Lord, is the noble Lord aware that every medicine that is sold openly in a chemist's shop or elsewhere must be labelled with the prescription on the bottle, or indeed, where possible, on each unit; that this has been the law for 23 years, and now it is only the doctors who purvey secret remedies? And is he aware that this is positively dangerous, because one may have in one's cupboard, as I have to-day, half a dozen bottles, and one has forgotten what they contain and what they were for?
§ LORD TAYLORMy Lords, that is indeed one of the compelling reasons why it would be desirable that all prescribed medicines should be labelled.
§ LORD AMULREEMy Lords, would it not be possible, I wonder, in view of the dangers which may come from the mixture of incompatible drugs which are not properly labelled now, for the Minister or someone at the Ministry, to encourage consultations once more between the medical profession and the pharmacists, to see whether they cannot come to some sensible way of settling this matter?
§ LORD TAYLORMy Lords, I sincerely hope that as a result of the recommendation by the British Pharmacopœia Commission to the Joint Formulary Committee, 344 on which both the pharmacists and the British Medical Association are represented, this matter will be considered again most seriously and swiftly.
§ BARONESS SUMMERSKILLMy Lords, may I clear up one point by way of a supplementary question? The noble Lord seemed rather surprised that I pointed out what was surely a most telling argument for the pharmacists, whether it is spoken or not, that they will lose dispensing fees. My noble friend wondered what I meant by that. If the people in the country used up all the half-filled boxes of tablets which were in their medicine cupboards, because they were not fearful of taking something which was labelled, then inevitably retail pharmacists must lose financially.
§ LORD TAYLORMy Lords, with all due respect to my noble friend, the self-medication of patients with the residue of labelled products is not always desirable.