HL Deb 02 March 1992 vol 536 cc568-70

2.47 p.m.

Lord Molloy asked Her Majesty's Government:

Whether they will make further arrangements to help those in financial difficulties to meet the cost of National Health Service prescriptions.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)

My Lords, extensive arrangements for charge exemption on grounds of health or status, the availability of prescription prepayment certificates, together with the separate scheme for the remission of NHS charges on the grounds of low income already ensure that no one need be deterred from obtaining necessary medication for financial reasons. In 1979 one item in three dispensed in the NHS attracted a charge. Today only one item in six does so.

Lord Molloy

My Lords, I thank the Minister for that reply. However, is she not aware that the increase runs at twice the rate of inflation? It is another attack on the principle that all NHS costs should be met by general taxation. Is she aware also that the dental and medical associations are deeply upset at the proposed increase in prescription charges because they are afraid that many people who cannot afford them will be deterred from seeking treatment?

Baroness Hooper

My Lords, the increase from £3.40 to £3.75 is comparable to the percentage increase in the National Health Service drugs bill overall. In that context, it is fair and reasonable. The charge continues to represent less than half the average total cost of a prescription item to the National Health Service. As regards the final point made by the noble Lord, we believe that across the board payments do not provide a fair solution. If someone can afford to pay £3.75 for a medicine which may cost something like £90, then that person should do so. The income received as a result—estimated for 1992–93 at£240 million—could pay for the building and running of five district general hospitals or over 268,000 surgical operations in the acute sector.

Lord Skelmersdale

My Lords, does my noble friend recall that it was a Labour Government which introduced prescription charges and that ever since they have been passed through both Houses of Parliament by negative resolution?

Baroness Hooper

My Lords, I am well aware that prescription charges were introduced in 1949 and that categories relating to them were increased in 1968—both occasions during the tenure of a Labour Government.

Baroness Masham of Ilton

My Lords, is the Minister aware that there is anxiety among parents in Glasgow and Edinburgh whose children are being sold drugs by senior citizens who obtain them free on prescription? They are being used, mixed with other substances, for drug abuse. I refer to tranquillisers and sleeping pills.

Baroness Hooper

My Lords, I am not aware of that. I shall certainly pass on that information to my right honourable friend the Secretary of State for Scotland.

Lord Desai

My Lords, is the Minister happy that prescription charges have increased by 1,775 per cent. since 1979? Is she aware that as a proportion of what it costs the NHS, the Government are recovering nearly 50 per cent. as compared with 22 per cent. in 1979? Is the Minister happy with that arrangement?

Baroness Hooper

My Lords, yes.

Lord Molloy

My Lords, is the noble Baroness aware that both she and her colleagues are right to say that it was a Labour Government which first introduced charges in the National Health Service? The authors were described by the then Minister, Aneurin Bevan, as a bunch of dessicated calculators. He has been proved right ever since. Is the noble Baroness also aware of the views of the BMA and the doctors' associations which say that the extra money brought in would amount to £240 million? Many people who can barely afford the 35p increase will be making a contribution towards that. Therefore, would it not be wise for some consultation to take place with all the dental and medical associations to arrive at a more sane and just appreciation of the situation? In the final count they are more responsible than any government department.

Baroness Hooper

My Lords, the medical profession, together with any right-minded person, is well aware that only those who can afford to contribute towards the costs of their medication are asked to do so. If that is seen in the context that since 1979 the number of items for which exemption is claimed has increased by 100 million, noble Lords can draw their own conclusions.

Lord Peston

My Lords, will the noble Baroness repeat the answer given to my noble friend Lord Desai? He asked whether she approved of the enormous real increase in the cost of NHS prescriptions. I thought that the Minister said yes. If so, if those costs doubled so that the drugs budget was fully met by people who were ill, would the Minister say yes even more strongly?

Baroness Hooper

My Lords, any further increase would be a hypothetical issue. The point to which I replied in the affirmative was whether or not I approved of the fact that people who could afford to pay prescription charges should do so. The fact that the overall amount being spent by the National Health Service on prescription costs is much higher than it was in 1979 means that the amounts involved are of considerably more consequence.

Lord Molloy

My Lords, can the noble Baroness say whether the increases to be paid by those who are sick are intended to contribute to the tax relief the Government have promised to the well off if they win the next election? In other words, is the money being obtained from the poor and the sick intended to make a contribution towards tax reductions for the well off?

Baroness Hooper

My Lords, the noble Lord should be aware that the Government intend to spend over£34 billion on the National Health Service. The prescription charges form part of that figure. I have already quoted the uses towards which the money received from the modest payments of the small percentage of people required to pay those charges will be put. Any right-minded Member of your Lordships' House will agree that money is better spent in that way than on any across the board arrangement.

Lord Marsh

My Lords, will the Minister agree that the issue of escalating health care costs is a major and increasing problem throughout all advanced countries in the Western world? There is now a real need for a complete reassessment of the ability of any party to fund health care and meet increasing demands on the present basis.

Baroness Hooper

My Lords, the noble Lord makes a fair point. Escalating costs, due to new techniques and technology and increased expectations, mean that we must justify spending money in the best possible way.

Lord Glenamara

My Lords, while we are grateful for the exceptions, the charges impose a great burden on lower-paid families when sickness comes. Are we not reverting to the position in the 1930s in relation to prescription, dental and optician charges, where people do not receive the treatment they need because of the cost?

Baroness Hooper

My Lords, the fall-back in the matter is that people on low incomes can claim exemption. In addition, there are a number of aids, including prescription prepayment certificates. As well as the annual season ticket, a four-monthly one is available. No one needs to be in difficulty in that regard.