§ 2.36 p.m.
Lord Campbell of CroyMy 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 encourage the more economic use of medicines and the return from the public of unwanted residual portions which may otherwise become a danger for children.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)My Lords, the Government are always actively promoting economical prescribing among doctors. As to the return by the public of the residual portions of unwanted medicines, this we feel should remain a matter for local initiative, and campaigns are generally organised by local branches of the Pharmaceutical Society. The danger of medicines to children has been considerably minimised by the general adoption by pharmacists of child-resistant containers. Parental responsibility is of paramount importance.
Lord Campbell of CroyMy Lords, I thank my noble friend for that reply. While the Government can only encourage and not direct people to act sensibly in this field, has my noble friend seen the report last month in the magazine Best of Health which indicated that no less than £150 million might be saved from unwanted and unused medicines? Also, is she aware of the warning given by the Pharmaceutical Society about the dangers that arise when medicines are left in places accessible to children?
§ Baroness TrumpingtonYes, my Lords, I saw the article and I can give the noble Lord the table of results 126 after Question Time. Doctors do not wilfully prescribe medicine that patients do not want. Doctors prescribe drugs in the expectation that the patients will take them in order to get better. If a patient does not want a drug he should tell his doctor, not just accept the drug and then throw it away.
§ Lord GainfordMy Lords, does the noble Baroness agree that it is not a case of dumping medicines but of patients not properly following the instructions of their medical adviser?
§ Baroness TrumpingtonMy Lords, instructions are now given on containers that patients should follow the entire course of a dose of drugs which is prescribed to them, and doctors are also instructed to tell patients for how long the prescribed drugs should be taken and in what quantities.
§ Lord EnnalsMy Lords, while I warmly agree with both the noble Baroness and the noble Lord about the importance of minimising waste and danger, will the noble Baroness confirm that with the introduction of higher prices for prescriptions many GPs are prescribing larger doses or doses for a longer period, and that this sometimes has the same effect?
§ Baroness TrumpingtonMy Lords, the medical profession is anxious to control the level of repeat prescribing. Many doctors recognise the need for regular reviews of repeat prescriptions and operate their own control systems; but I say again that doctors prescribe the drugs that they think are necessary to make a person well.
Lord WinstanleyMy Lords, will the noble Baroness accept that in fact many lives could be saved if the Government were to do something to discourage the magpie-like quality with which members of the public hoard the remains of old drugs long after the purpose for which they were prescribed has been forgotten? Is she aware that some people store them up for use on some future unspecified occasion, by which time the drug has decomposed and perhaps become dangerous, or certainly has lost any therapeutic powers which it once possessed?
§ Baroness TrumpingtonMy Lords, I entirely agree with what the noble Lord has said, but there are many reasons why people hang on to drugs, and the figures in respect of the "dump" campaign may not relate to a specific period of accumulation. Nor is there any differentiation between whether the medicines that are disposed of come from patients, residential homes, nursing homes or possibly even from pharmacies which are using the opportunity to dispose of out-of-date or obsolete stock.
§ Lord EzraMy Lords, following up the point that was made by my noble friend Lord Winstanley, would it help if the life expectancy of a drug were to be indicated clearly on the container?
§ Baroness TrumpingtonMy Lords, it is indicated in many cases. I myself have had eye drops which were only safe to use for a period of one month.
Lord Campbell of CroyMy Lords, as regards the question of child-proof medicines, can my noble friend provide any information to the House about whether a child-proof top to a medicine bottle which can still be opened by the elderly who have arthritic hands has yet been invented?
§ Baroness TrumpingtonMy Lords, in answer to my noble friend, regulations require solid dose aspirin and paracetamol medicines on sale over the counter to be in child-resistant containers. Since these controls came into operation, there has been a significant reduction in the number of hospital admissions of young children who are suffering from accidental poisoning by medicines. With regard to the elderly or people who have arthritis in their hands, I agree that this may be a problem and doctors are advised to ask pharmacists to avoid dispensing drugs for elderly patients in child-resistant containers. Perhaps I may return to the point that it is up to parents to keep medicines out of the vicinity of their children.
§ Lord EnnalsMy Lords, the noble Baroness may be aware that I introduced the system of child-resistant closures, but I do not know whether that will bring me any credit. But is it not true that pharmacists will always supply on request to elderly or arthritic people containers without child-resistant closures so that they do not have the difficulties referred to?
§ Baroness TrumpingtonYes, my Lords, if they are asked to, but they may not realise that the elderly person has a problem.
The Earl of HalsburyMy Lords, is there not a considerable hazard in taking at face value the description of a member of the public of a particular drug and recirculating it for re-use?
§ Baroness TrumpingtonYes, my Lords.