HL Deb 20 November 1997 vol 583 cc648-9

3.16 p.m.

Lord McColl of Dulwich

asked Her Majesty's Government:

Whether they are satisfied with the present level of prescription charges.

The Minister of State, Department of Health (Baroness Jay of Paddington)

My Lords, my right honourable friend the Chief Secretary to the Treasury announced in June that prescription charges were to be one element of the Department of Health's comprehensive spending review. We aim to complete the review by next spring. I reaffirm to the noble Lord and the House that that spending review is taking place in the context of our manifesto commitment on the health service that the NHS will be there to help if you are ill or injured and access to it will be based on need and need alone, not on ability to pay.

Lord McColl of Dulwich

My Lords, I thank the Minister for that helpful reply. Does she agree that what Prime Minister Attlee had in mind in introducing the concept of prescription charges was that they should act as a deterrent in an effort to reduce excessive and unnecessary use of the NHS? That being so, does the Minister further agree that it has been quite reasonable that the prescription charge, expressed as a fraction of the total expenditure of the NHS, has remained constant over the past 40 years?

Baroness Jay of Paddington

My Lords, I am tempted to ask why, in that case, it did not—particularly under the previous government's 18 years of administration. The NHS drugs budget is currently about £4 billion; that is, 13 per cent. of the total spend of the NHS. But it is rising faster than other areas of expenditure. There are anomalies within the prescription charge with which we have dealt many times in this House. That is the reason why it is appropriate that it should be examined under the comprehensive spending review.

Earl Howe

My Lords, bearing in mind that over 80 per cent. of items on prescription are currently dispensed free, compared to 60 per cent. in 1979, do the Government propose to re-examine the current structure of exemptions?

Baroness Jay of Paddington

My Lords, I do not wish to appear discourteous, but I believe that 80 per cent. of prescription items are—I am sorry, I misunderstood the noble Earl—about 50 per cent. of prescriptions are exempt. As the noble Earl will know, we are concerned about the number of exemptions, which may reveal something of an exploitation of that system. The matter is being examined under the comprehensive spending review.

Lord Monkswell

My Lords, will the Minister confirm that part of the reason for the increase in the percentage of exempted prescriptions is the massive increase in poverty that took place during the past 18 years of the previous administration?

Baroness Jay of Paddington

My Lords, that may well be an element in the numbers of exemptions. However, as I said in answer to the previous question, there are definite anomalies in the ways in which exemptions are currently registered. That is being examined closely.