HC Deb 21 March 1968 vol 761 cc143-5W
Mr. Victor Yates

asked the Minister of Health what arrangements he now proposes for relieving the chronic sick of the cost of prescription charges under his long-term scheme using embossed cards.

Mr. K. Robinson

In framing such proposals I have had regard to the understandable reluctance of the medical profession to accept responsibility for exercising discretion in the identification of those to be regarded as chronically sick for this purpose. I have therefore tried to define objectively, with the help of representatives of the profession, categories in which are to be found patients certain to need continuous medication for long periods and which admit of no discretion as to identification of individuals. These are as follows:

with regard to those recommendations which have not yet been implemented.

The Prime Minister

I regret that the information for which the right hon. Gentleman asks could only be obtained at a disproportionate cost but I append a list of Royal Commissions set up since 1944 as a guide to the right hon. Gentleman in pursuing his research.

  1. (a) Permanent fistula, including caecostomy, colostomy or ileostomy, requiring a continuous surgical dressing or an appliance.
  2. (b) Diabetes mellitus and other endocrine disorders for which specific substitution therapy is essential, viz.:
    • Myxoedema.
    • Hypoparathyroidism.
    • Hypopituitrism.
    • Addison's disease and other forms of Hypoadrenalism.
    • Myasthenia gravis.
  3. (c) Epilepsy requiring continuous anti-convulsive therapy.
  4. (d) A patient whose continuing physical disability prevents him from moving outside his residence unaided.

This necessarily limited categorisation left the problem of others, outside the categories, who require numerous prescriptions. My proposal for covering them is that they should be able to obtain an exemption card, to last for a fixed period, on payment of a fee representing the cost of no more than say two or three prescriptions a month. Such people will thus be relieved of the excess burden which their special need for medication would otherwise impose.

There would be refund arrangements to cover cases where the cost of such a card would involve financial hardship.

I have commended these proposals to the profession as meeting both the need to prevent hardship among the chronic sick and the understandable desire of doctors, without whose help the chronic sick cannot be defined for exemption from charges, to avoid disputes with their patients which might damage the doctor/ patient relationship.