Generic Medical Prescribing (Hansard, 15 February 1984)

§ Lord Hunter of Newington
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)
My Lords, we have been reviewing the information and advice already provided to doctors on prescribing. We are currently considering ways in which this information could be improved in order to persuade the medical profession of the value of generic prescribing.

§ Lord Hunter of Newington
My Lords, in thanking the Minister for that Answer, may I further ask him whether a report published by the Royal College of General Practitioners, entitled Prescribing—A Suitable Case for Treatment, which strongly advocates the use of generic terminology, will be taken into consideration by the Government? Secondly, do the Government have views about the colouring of tablets prescribed under the National Health Service?

§ Lord Glenarthur
My Lords, the report to which the noble Lord has referred made a number of recommendations on factors which influence general practitioner prescribing. We are considering these in the context of our planned campaign. It suggests, however, that there are savings to be made through generic prescribing. This is a view which we share. So far as the presentational characteristics are concerned—the colouring, the shape and the size of drugs—the Greenfield Report noted that some patients might have reservations about differences in size, shape and colour, but there is no evidence that such differences are a major problem. I am sure that the manufacturers of generic drugs will respond to demand, should it become a major problem.

§ Lord Kilmarnock
My Lords, will the Government consider assisting doctors in this matter by bringing in the recommendations contained in section 24 of Dr. Greenfield's report?

§ Lord Glenarthur
My Lords, the Government have said that they will encourage generic prescribing but that there are problems associated with generic substitution.

§ Lord Ennals
My Lords, is the Minister aware that a recent random survey of prescribing by general practitioners which was carried out by St. Mary's Hospital in North London showed that, after receiving information on the cost of their own prescribing, the general practitioners voluntarily reduced their prescription costs by £200 a month? If this were replicated among all general practitioners, is the noble Lord aware that it would represent a saving of £60 million a year? Can he say what action the Department of Health and Social Security is taking to ensure that all doctors are given this information about their own prescribing costs in order that they may do likewise?

§ Lord Glenarthur
My Lords, it is certainly true that not only the effect of generic prescribing but also the quantity of drugs which are prescribed account for a very great deal of the cost. I have seen evidence about information, stored on computers, which can be recalled to show when a patient was last prescribed a drug and, when he comes for a repeat prescription, whether or not it is right that he should have it. That is looked at on its merits by the doctor at the time; but certainly the department will take note of what the noble Lord has said.

§ Lord Segal
My Lords, could not the manufacturers of proprietary medicines be encouraged to show in larger letters the generic name rather than the proprietary name, instead of vice versa?

§ Lord Glenarthur
My Lords, that is a point which will certainly be borne in mind by the manufacturers.

§ Lord Kilmarnock
My Lords, I understand the difference between generic prescribing and generic substitution, but would the noble Lord not agree, reverting to his previous answer, that section 24, which advocates generic substitution, will be of very great assistance to doctors?

§ Lord Glenarthur
My Lords, the Government have decided not to adopt generic substitution. The Greenfield Report recommended that pharmacists should, wherever possible, substitute near equivalents. This is already widely practised in hospitals, but in general practice it was felt by many retail pharmacists and doctors that it was impracticable for a number of reasons, not least of which were the problems of quality control and divided responsibility for the treatment of patients.

§ Lord Hunter of Newington
My Lords, could the Minister tell us how long this practice has existed in hospitals?

§ Lord Glenarthur
Not without notice, my Lords.