§ Mr. MichaelTo ask the Secretary of State for Wales whether, in the case of a hospital trust or other self-governing trust offering an out-patient service on a continuing basis, all prescribing costs deriving from such a service will be met entirely from within the resources of such a trust.
§ Mr. GristI refer the hon. Gentleman to the answer I gave earlier today which makes it clear that the costs of drug prescribing should fall to be met by whoever has clinical responsibility for the patient concerned. NHS trusts will be in no different position in this respect from other NHS units.
§ Mr. MichaelTo ask the Secretary of State for Wales if he will instruct family practitioner authorities to exclude from their consideration, when determining the monetary budget or prescribing amount for a particular practice or general practitioner, any sum likely to arise from the transfer of prescribing costs from hospital consultants to general practitioners in those circumstances where patients attend hospital out-patient clinics on a continuing basis and to make separate provision for such amounts.
§ Mr. GristSuch instruction is not needed. Policy in this matter is clear. Where clinical responsibility for a patient, including the responsibility to prescribe, rests with a hospital doctor, the cost of prescribing is attributable to hospital service expenditure. Where such responsibilities are accepted by the patient's GP, the cost of prescribing is attributable to family practitioner services expenditure. The decision as to clinical responsibility in any individual case rests with the clinicians involved.
The indicative amounts that family health service authorities will ascribe to GP practices will take account of cases where a GP has clinical responsibility for a patient whose treatment requires the prescribing of particularly high-cost medication.