The Doctor-Patient Partnership (Hansard, 30 October 1997)

§ Lord Colwyn
asked Her Majesty's Government:
Whether they will support the current campaign by the Doctor-Patient Partnership to encourage people to self-medicate for cold and influenza symptoms after having sought the advice of their local pharmacist, thereby helping to relieve the pressure this winter on general practitioners.

§ The Minister of State, Department of Health (Baroness Jay of Paddington)
My Lords, the Government support the overall aims of the campaign as part of a long-standing process of encouraging people to take responsibility for treating their own minor ailments. However, I emphasise that the Doctor-Patient Partnership is meant to promote sensible and appropriate use of GPs and not to discourage the use of GP services when they are needed. In particular relationship to influenza, there are certain groups of people for whom influenza may have serious consequences. Influenza immunisation is another important way of cutting down the level of illness which may be seen in connection with 'flu. I know that both we and the Doctor-Patient Partnership are encouraging GPs and indeed practice nurses to make sure that this year's 'flu vaccine is given to as many people as possible.

§ Lord Colwyn
My Lords, I thank the noble Baroness for that Answer. I am sure that pharmacists throughout the country will be delighted to hear that the Government endorse the fact that they are professionals providing a professional service. In view of her reply, would it be appropriate for the Government to consider providing some direct funding for this initiative? Would it be possible for a three or four-year period to make the campaign more effective and to allow fuller development of the programmes and take even more pressure from general practitioners with a view to allowing them to act as an effective filter to the secondary system and perhaps take some of the strain from hospital admissions?

§ Baroness Jay of Paddington
My Lords, under an initiative from the British Medical Association a number of health authorities are already contributing about £1,000 a year from their patient publicity funds to fund a national co-ordinator for this programme and support a range of shared initiatives. I also point out that the 1131 Government are investing in the United Kingdom over £40 million this year in an out-of-hours development fund which will meet some of the requirements to which the noble Lord refers.

§ Lord Walton of Detchant
My Lords, I warmly commend the establishment of the Doctor-Patient Partnership and the principles outlined in the Question of the noble Lord, Lord Colwyn, subject to the provisos mentioned by the Minister. Nevertheless, does the Minister agree that it is important not to discourage patients from seeking medical advice for serious 'flu-like symptoms such as headache and fever which may be the first manifestations of meningitis, a condition requiring urgent medical treatment and one which even the most skilled and dedicated medical practitioners sometimes find difficult to diagnose?

§ Baroness Jay of Paddington
My Lords, I am grateful to the noble Lord for offering us that very authoritative view. It is indeed the case that the Chief Medical Officer, in recommending to all GPs that they should be using influenza vaccine, names a number of conditions where, regardless of age, people should look for an influenza vaccine rather than self-medication. I can list those to the House if any noble Lords feel that they themselves are at risk but they cover a large number of chronic and other diseases.

§ Lord Winston
My Lords, does my noble friend agree that, rather than spending public money on such a campaign, it might be a good idea to devote resources to preventive medicine, perhaps methods of hygiene such as washing hands and, if your Lordships will forgive me, preventing people picking their noses, especially during the winter months?

§ Baroness Jay of Paddington
My Lords, that is another authoritative question from one of my distinguished medical colleagues in your Lordships' House. Given that my noble friend has given me encouragement, perhaps I may draw attention to a wonderful booklet, circulated widely by general practices and health authorities, called What Should I do? It is not for general reference, I may say. The sub-title is, Do I Need to go to the Doctor? I am not sure whether the two situations that my noble friend described fall into that category. But I take his point.

§ Baroness Miller of Hendon
My Lords, I welcome the Minister's agreement that the independent pharmacist has a role to play. But does she know of the initiative of High Speed Health which we started in Barnet some six years ago? Further, if the Government are interested in promoting the work of the independent pharmacists, how do they think they will be helped by the clause in the Competition Bill which will remove from the independent pharmacist the exemption for retail price maintenance?

§ Baroness Jay of Paddington
My Lords, I am grateful to the noble Baroness for drawing attention to what I am sure was a very successful local initiative. 1132 I am afraid that I am not immediately familiar with it, but I know that all the local initiatives which apply the concepts of high street medication are often very successful. With regard to the Competition Bill, the Department of Health is at the moment neutral on the issue of how the RPM clause in the Competition Bill will affect over-the-counter medicines and community pharmacies. If the Competition Act does result in smaller pharmacies going out of business, the Department of Health already has the essential small pharmacy scheme which subsidises small pharmacies, for example, in rural areas, to allow access for the public in areas which might otherwise be difficult and that model, if necessary, could be developed.

§ The Countess of Mar
My Lords, is it not the case that the vast majority of patients are very considerate of their GPs, as I understand a recent survey showed, but there are a few troublesome families who repeatedly appear in GP surgeries? If money is to be spent on education, would it be better to concentrate on the troublesome ones?

§ Baroness Jay of Paddington
My Lords, I am not sure that I would necessarily be competent about describing any group of patients as "troublesome". But the noble Baroness refers to a point which is very close to my interests; namely, promoting the concept of patients' responsibilities about healthcare as well as their rights to it. I have been intrigued by the numbers of local patients' charters I have seen in the past few weeks. Perhaps I may quote from one in Lancashire: a doctor states in his local charter that patients should learn how to treat their own minor illnesses and keep some basic household medicines in a safe place. The doctor also asks patients not to bring bicycles into the surgery or enter wearing dirty boots.