Prescription Charges (Hansard, 16 October 1995)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
No, my Lords, because we believe that although a standard prescription charge may mean that in some cases patients pay more than the cost of an item, in others they will pay less.

§ Baroness Gardner of Parkes
My Lords, I thank the Minister for her reply. In view of the reply to my Question on pharmaceutical matters during the summer months, when it was confirmed that 80 per cent. of National Health prescriptions are totally free, can she state what is the element of beneficial cross-subsidisation that results from this fixed charge for NHS prescriptions?

§ Baroness Cumberlege
My Lords, about half of the items that are charged at £5.25 cost less and about half cost more. But the estimated average cost of each item is about £8.80.

§ Baroness Jay of Paddington
My Lords, does the Minister agree that the main point is the one that she mentioned in her reply to the noble Baroness's supplementary question—that more than half the number of existing prescriptions are charged at less than the NHS prescription charge? Surely this must lead to completely unnecessary administrative costs. The new Secretary of State for Health is, I understand, conducting a 90-day review of unnecessary costs and administrative burdens in the Health Service—burdens which have presumably grown up under his predecessor. Will the Minister try to find a way to include the issue of prescription costs in that 90-day review?

§ Baroness Cumberlege
My Lords, I should like to make two points. It was the Labour Party which introduced prescription charges. In 1968 the Labour 571 Party re-introduced prescription charges. The charges raise £310 million a year, which is the equivalent of 75,000 hip replacements and 235,000 cataract operations. It is income which the National Health Service sorely needs.

§ Lord Avebury
My Lords, by how much would it be necessary to increase the national insurance contribution to cover the total cost of prescriptions? What administrative saving would be made by doing that?

§ Baroness Cumberlege
My Lords, I do not have those figures with me.

§ The Countess of Mar
My Lords, is the noble Baroness aware that a great many people on the poverty line who are not receiving income support, and thus the passported benefits, are going to pharmacists and saying, "What can I do without on this prescription because I cannot afford to pay for the whole of it?"? Can the Minister say whether any research is being conducted within the Department of Health to find a more equitable way of charging people? For example, some pensioners can afford to pay for prescriptions. Can she say what is being done?

§ Baroness Cumberlege
My Lords, many groups of people are exempted from prescription charges. As my noble friend mentioned, 80 per cent. of the medicines dispensed do not attract a charge. With regard to old age pensioners, the Government have no intention of introducing prescription charges for old age pensioners.

§ Baroness Jay of Paddington
My Lords, I should be grateful if the Minister could respond to my point on whether or not prescription charges will be included in the 90-day review. The matter is particularly relevant because, as I hope the Minister will be aware, the committee on this subject in another place said that it wished to look at this whole issue and I believe that the Government's response was that they would examine the potential for change in the prescription charging area.

§ Baroness Cumberlege
My Lords, the answer to the noble Baroness is, no. A fundamental review of health expenditure took place in 1993. The conclusion of the review was that the present scheme operates effectively, is well targeted and does not cause hardship.

§ Baroness Nicol
My Lords, the noble Baroness has obviously done some research on prescription charges in order to deal with this Question. Can she say when the cost of the prescription began to outstrip the cost of the drugs? Is that a new phenomenon or did it happen some years ago?

§ Baroness Cumberlege
My Lords, every year the prescription charge increases, but so does the cost of some of the drugs. Indeed, some of the drugs, for which people have to pay only the £5.25 prescription charge, are extremely costly. For instance, some drugs for diabetes and for lowering cholesterol cost around £70 a month. The recipient has to pay only £5.25.

§ Baroness Seccombe
My Lords, does the Minister agree that whenever we are talking about prescriptions we should remind ourselves how successful our drug industry is?

§ Baroness Cumberlege
Yes, my Lords, my noble friend is absolutely right. Ten out of the world's top 35 medicines were discovered in the UK and more than one-third of all European biotechnology companies are based in this country.

§ Baroness Fisher of Rednal
My Lords, how many asthma sufferers are without nebulisers, which ease their lives considerably, just because they cannot afford to purchase them? Cannot those items be supplied by the National Health Service? Many children, particularly in the Birmingham area, are suffering very severely.

§ Baroness Cumberlege
My Lords, children are exempt from prescription charges.

§ Lord Rea
My Lords, what is the position with regard to National Health Service general practitioners giving private prescriptions to patients registered with them when the cost of the drug concerned is below the prescription charge?

§ Baroness Cumberlege
My Lords, it is open to GPs to offer private prescriptions to those who need their medicines.

§ Baroness Gardner of Parkes
My Lords, perhaps I may ask a follow up question to that asked by the noble Countess, Lady Mar. I understand that if someone feels unable to afford any form of National Health treatment, whether it be dental or ophthalmic treatment or a prescription, special forms can be completed for exemption from the cost. Does that apply to pharmaceutical products in the same way as it applies to medical and dental treatment?

§ Baroness Cumberlege
My Lords, we are anxious to ensure that people who need medication and who are on low incomes are exempt. Indeed, they are. As the noble Baroness said, 81 per cent. of all items are free of charge. That compares with 60 per cent. in 1979.

§ The Countess of Mar
My Lords, can the noble Baroness put something right? Unless people are on income support and in receipt of passported free prescriptions they cannot have their prescription charges waived. People have to be in receipt of income support, or be over the age of 60 in the case of women and 65 in the case of men, or be children or suffer from special illnesses. There are people who cannot afford to pay for prescriptions.

§ Baroness Cumberlege
My Lords, I believe that I made it very plain to your Lordships' House that there is an enormous number of exemptions. I believe that those on income support, family credit, the disability allowance and low incomes, etcetera, are exempt. We do not find cases of people being unable to get medication because they cannot afford it.