§ Mr. Kirkwoodasked the Secretary of State for Social Services if he will list in the Official Report the dates of introduction of all the drugs on his proposed limited list of preparations to be available in the National Health Service.
§ Mr. Kenneth ClarkeOf the medicines included in the provisional list of antacids, laxatives, inhalations, antitussives, analgesics for mild to moderate pain, vitamins, tonics and bitters, and benzodiazepine sedatives and tranquillisers which it is proposed should remain available for prescription on the National Health Service which I gave in my reply to my hon. Friend the Member for Congleton (Mrs. Winterton) on 10 December at columns381–82, all but one were on the market before the start of licensing under the Medicines Act 1968 on 1 September 1971. The exact dates of their introduction are not available from our records.
The first product licences under the Medicines Act, for medicines containing the drug substance temazepam were granted in 1977. The list is of course, provisional and has been published as a basis for consultation. We will not finally decide which drugs will no longer be prescribable at public expense through the National Health Service until after this consultation with the medical and pharmaceutical professions, and the drugs industry, is complete.
§ Mrs. Ann Wintertonasked the Secretary of State for Social Services what measures he intends to introduce in order to compensate those categories of patients who will no longer be entitled to National Health Service prescriptions, exempt of charges, for those categories of medicines included in the limited list proposals announced recently.
§ Mr. Kenneth ClarkeAll patients will be entitled to National Health Service prescriptions in all categories of drugs. Doctors will be able to prescribe at National Health Service expense from a limited but adequate range of drugs in those categories of drugs covered by our limited list proposals. If a patient elects to have a private prescription instead that is a matter of choice but not of medical necessity and the question of compensation does not arise.
§ Mrs. Ann Wintertonasked the Secretary of State for Social Services what percentage of the £100 million which he hopes to save on the National Health Service drugs bill by his limited list proposals will come from a reduction in the number of free prescriptions as issued under current arrangements.
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§ Mr. Kenneth ClarkeOur initial estimates of savings do not assume any reduction in the number of free prescriptions because there will be no need for any National Health Service patient to seek a private prescription. The limited list will meet all clinical needs.
§ Mr. Gryllsasked the Secretary of State for Social services what mechanism he proposes to establish to evaluate the suitability of medicines for prescription under the National Health Service.
§ Mr. Knoxasked the Secretary of State for Social services what professional advice he proposes to use in finalising his limited list of medicines to be available on the National Health Service.
§ Mr. FowlerMy main concern is to ensure that, in the categories of minor medicines to which it applies, the limited list of drugs should be sufficient to meet all clinical needs. We are already receiving a large amount of specific evidence on this as part of the consultation process. In assessing this evidence my Chief Medical Officer will consult a number of eminent individuals from the appropriate branches of the medical and pharmaceutical professions, including Professor Alasdair Breckenridge, professor of clinical pharmacology, Liverpool; Professor David Morell, professor of general practice, London; Dr. John Tomlinson, general practitioner, Hampshire; Dr. Duncan Colin Jones, consultant physician, Portsmouth; Professor Malcolm Hodkinson, professor of geriatric medicine, London; Mr. David Coleman, retail pharmacist, Norwich.
The Chief Medical Officer may also wish to involve other specialists on particular points at a later stage.
§ Mr. Gryllsasked the Secretary of State for Social Services what alternative methods of saving money on the National Health Service drugs bill he considered before introducing his proposals for a limited list.
§ Mr. Kenneth ClarkeAmong the alternatives considered were further efforts to encourage generic prescribing and various methods of introducing generic substitution.
§ Mr. Dobsonasked the Secretary of State for Social Services if he will list the drugs currently available under National Health Service prescription which are not included in the provisional list circulated with the Chief Medical Officer's letter of 14 December to all doctors, indicating those for which a generic alternative will also not be available under prescription under the National Health Service, whether or not a prescription is currently required, and the proportion of current prescriptions for those drugs which are prescribed for people on free prescriptions.
§ Mr. Kenneth ClarkeSome 18,000 drugs available under the National Health Service were not included in our provisional list but most of them are in therapeutic categories which are not affected in any way by our limited list proposals. It would be pointless and a misuse of resources to list them all. If the hon. Member is interested, I would refer him to the current edition of the British National Formulary which lists all frequently prescribed drugs and indicates for each whether they are prescription only medicines.
Adequate and effective alternatives will be available for all medicines no longer available under the National Health Service from 1 April 1985.
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§ Mr. Gryllsasked the Secretary of State for Social Services what criteria will be used to determine which medicines will be approved for prescription under the National Health Service after 1 April 1985.
§ Mr. Kenneth ClarkeOur intention is to provide an adequate range of effective drugs in the therapeutic categories covered by the limited list proposals so that all clinical needs can be met at the lowest reasonable cost.