§ 2.52 p.m.
§ The Countess of MarMy Lords, I beg leave to ask the Question standing in my name on the Order Paper.
§ The Question was as follows:
§ To ask Her Majesty's Government whether they will reconsider their decision to restrict the right of rural doctors to prescribe certain drugs under the National Health Service, particularly in view of the effect such limitations would have upon dispensing doctors and their patients in rural areas.
The Earl of CaithnessMy Lords, the Government's proposals on prescribing, which will apply to all doctors, will ensure that an adequate range of effective drugs, sufficient to meet all clinical needs, will still be prescribable under the National Health Service.
§ The Countess of MarMy Lords, I thank the noble Earl for that not very informative Answer. Can he say what is the response of the Secretary of State to concern shown by dispensing doctors following the DHSS letter of 8th November 1984? What response will the department make to the attack on these doctors by the Pharmaceutical Society at a public meeting on 7th February 1985?
The Earl of CaithnessMy Lords, with regard to the second point, I think that it is for the doctors to defend themselves against any attack from the pharmaceutical industry. We have considered carefully the responses to our consultation paper with regard to the limited list from all doctors, including the rural ones.
The Lord Bishop of CarlisleMy Lords, is the Minister aware of the major inconveniences and sometimes the impossibility for patients, who are of necessity on drugs that are not on the list, to obtain their supplies in some remote rural areas such as exist in Cumbria? Does the Minister not agree that some special arrangements ought to be made for dispensing GPs in those particular areas? Further, will the Minister say whether any consideration has been given to ways of helping dispensing GPs, who at the moment have on their shelves drugs that are not on the list, to dispose of their drugs after the date of the regulations?
The Earl of CaithnessMy Lords, with regard to drugs that are not on the list, this is not relevant to the Question on the Order Paper. With regard to allowing doctors to dispense and charge for drugs that are not on the list, this would mean a change in the terms of contract and this is being considered at the moment.
§ Lord Nugent of GuildfordMy Lords, is the noble Earl aware that many people, including myself, think it is a wise policy to limit the drugs list to generic types and to exclude expensive brand names? This will save a great deal of money in the health service which can be used for other purposes. Will he give an assurance that when his approved list is finally published he really will have covered every kind of drug that might be needed by patients?
The Earl of CaithnessMy Lords, I am grateful to my noble friend for his questions. We had a very good debate on this subject very recently and I think we covered most of the points then. So far as I and my right honourable friend the Secretary of State are aware, we have confirmed that all clinical needs will be met by drugs on the limited list.
§ Lord EnnalsMy Lords, does the noble Earl accept that in the very useful debate to which he has just made reference not a single speaker from any of the Benches supported the proposals put forward by the Government? Referring to the question of consultation, has there been any consultation with people who live in the rural areas? Does he not accept that, quite apart from the elderly, the disabled, the sick and the poor, the people who live in rural areas will suffer very considerably in so far as they may have to travel to chemists at a very considerable distance in order to get drugs if those drugs are not on the list that is under the National Health Service? Will he give some consideration to relieving the already heavy pressures upon people who live in rural areas?
The Earl of CaithnessMy Lords, with regard to the debate, there were noble Lords who supported us. They however asked a number of questions, which is inevitable. We have discussed this matter with doctors, and others in rural areas and of course their views have been considered. The revised list, the limited list, will, as I have repeated more than once, cover all clinical needs. If there is difficulty getting to a chemist now, the limited list will make no difference at all.
Lord Campbell of CroyMy Lords, is my noble friend aware that many doctors appear to recognise that there is scope for rationalisation in this field but they also feel that the first list that the Government published was seriously deficient in certain respects?
The Earl of CaithnessMy Lords, we too realise that it was deficient. It was for consultation. That is what we have done. The revised list will cover all the clinical needs.
Lord WinstanleyMy Lords, having been the only noble Lord, apart from the Minister, on the Government side of the House who sat through the debate to which reference has been made, the noble Earl will recollect that every single speaker asked the Government if the Ministers would think again on this subject. Could the noble Earl tell us now whether Ministers are in fact thinking again?
The Earl of CaithnessMy Lords, all the Ministers are thinking, but we are convinced that this is the right path to pursue, having had the consultations.
§ Lord KilmarnockMy Lords, as the original Question concerned rural areas, have the Government given any consideration to the problem of elderly people having to make possibly long bus journeys to the nearest town in order to get prescriptions which they cannot get from their dispensing doctors?
§ Lord Maude of Stratford-upon-AvonMy Lords, is the Minister aware that, since the Government have now reconsidered the original list and have arrived at a list which they are confident will meet all clinical needs, there is no reason why people in rural areas should be any worse off than people in urban areas or anywhere else?
§ Lord KilmarnockMy Lords, as a result of the noble Earl's "Yes" to me, will he expand on that in a letter?