HL Deb 26 April 1993 vol 545 cc4-7

2.47 p.m.

Lord Molloy asked Her Majesty's Government:

What is the annual revenue to the Department of Health from prescription charges for the latest period for which figures are available; and how much of that revenue is spent on the administration of the prescription scheme.

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

My Lords, it is estimated that £338 million will be raised from prescription charges in the current year. It is not possible to identify the exact cost of collection, but we believe it to be minimal.

Lord Molloy

My Lords, I thank the Minister for that Answer. I acknowledge the difficult situation with regard to prescription charges. Will she say, for example, whether general practitioners are meeting their immunisation targets? Are many people going to the chemist to collect various forms of medicament only to find that they cannot afford them when they know the cost? Should not such things be looked at? The pharmaceutical industry earns a great deal of money overseas for Britain, which is good for the NHS and the Treasury. Nevertheless, should not its price regulation scheme be reconsidered to bring it into line with everyone's efforts to help the NHS?

Baroness Cumberlege

My Lords, the Government are well aware of the contribution which the pharmaceutical industry makes to this country's balance of payments. Vaccination and immunisation rates have never been higher. That says a lot for the Government's scheme of incentive payments for GPs to reach their targets. For those people who cannot afford to pay for medicines, there are some very comprehensive exemption schemes available.

Lord Mellish

My Lords, will the Minister be good enough to confirm or deny the reports which have appeared in the local and national press stating that some pharmacists are going out of business because the Government intend to challenge the present rate of charges?

Baroness Cumberlege

My Lords, a fundamental review is going on at the moment concerning pharmacists' remuneration and the way medicines are dispensed. I think that the present fears will prove to be unfounded.

Lord Bruce of Donington

My Lords, despite the many exemptions and allowances being made in respect of these charges, is the Minister aware that the point has been reached where the charges are extortionate and a public scandal?

Baroness Cumberlege

My Lords, 80 per cent. of all items dispensed by pharmacists are free of charge. We have no evidence showing less use of medicines due to the increase in charges.

Lord Ashley of Stoke

My Lords, is the Minister aware that there are always people just above the poverty line and that they are always being hit? The increase in prescription charges is yet a further blow. Those people are not poor enough to qualify for the Government's inadequate exemption scheme but they are too poor to pay for medicines. Therefore, their suffering will be exacerbated. Will the Government please recognise that prescriptions are not a dispensable commodity and that sick people must have medicines, which should be affordable by everyone?

Baroness Cumberlege

My Lords, I cannot accept what the noble Lord says. People who receive either income support or family credit, men aged over 65 and women aged over 60, children under the age of 16, students in full-time education, pregnant women and women who have had a baby during the previous 12 months, war disablement pensioners and people who suffer from certain medical conditions, are granted remission of charges. That is a very comprehensive exemption list.

Lord Ennals

My Lords, will the Minister give two other relevant figures? Will she give the amount of savings expected from the new 10-item limited list announced in November? Secondly, will she say how much is expected to be saved as a result of the instruction by the Secretary of State to the NHS executive to make savings on treatments which in future will not be available on the National Health Service?

Baroness Cumberlege

My Lords, it is impossible to say how much money will be saved by the new selected list since the advisory committee has not yet decided on the medications which will be included. However, I wish to remind your Lordships that the money which accrues from prescription charges alone is enough to buy 88,000 hip replacements or 57,000 coronary artery bypass grafts. Without that money the National Health Service would be much the poorer.

Lord Stallard

My Lords, will the Minister comment on reports that old age pensioners in receipt of free prescriptions will in the near future be charged for their prescriptions based on new means test procedures?

Baroness Cumberlege

My Lords, the Government at this moment have no plans to introduce such a scheme.

The Countess of Mar

My Lords, does the Minister agree that the vast majority of prescriptions are issued to people over the age of 65 and that it has been estimated that approximately 40 per cent. of hospital admissions of the elderly are due to adverse drug reactions? Does she further agree with the large body of opinion which suggests that there is a great deal of overprescrihing for the elderly? Will she say what procedures the Government are taking to ensure that there is no such wastage?

Baroness Cumberlege: My Lords, the Government have invited family health service authorities to introduce a scheme to give advice to GPs on prescribing. That is already having some effect. I agree with the noble Countess that there is not a pill for every ill. I believe that the general practitioners should look more carefully at their prescribing habits.

Lord Desai

My Lords, will the Minister confirm that the rise in prescription charges is 12 times that of the rate of inflation? Will she also confirm that although £339 million is a lot of money it is one-third of what the internal market set-up has cost the National Health Service? Should not the Government be economising where economies are more necessary rather than through prescription charges?

Baroness Cumberlege

My Lords, it is the duty of every Government to try to hold down costs. Although the increase in prescription charges has been higher than the rate of inflation it has not been higher than the rate of increase of the drugs bill. During our recent debate I welcomed very much the support of the Opposition Front Bench for the selected list.

Lord Molloy

My Lords, is the Minister aware that the ABPI says that there is a danger of cheap drugs driving out efficient and expensive drugs, which could threaten research and lead to a deterioration in patient care? Will those issues be taken into consideration?

Baroness Cumberlege

My Lords, that is very much the purpose of the advisory committee which will be considering the issue.