Drug Tariff (Hansard, 20 July 1981)

§ Sir George Young

For each of these items inclusion in the drug tariff limited lists has already been considered on numerous occasions and currently the respective situations areSoft Cervical Collars— The recently-published report of the working party on orthopaedic waiting times recommended the extension of "open access" referral to hospital physiotherapy departments (a quick and simple way for GPs to send their patients for treatment without having to wait to see a consultant) and noted that this should obviate the need for GPs to prescribe orthopaedic appliances like cervical collars. I endorse this recommendation but, at the request of the general medical services committee of the British Medical 28W Association, I have asked the Department to look again at the arguments put forward for including cervical collars in the drug tariff. Support Tights and Maternity Support Tights— The drug tariff contains a range of elastic compression hosiery, made to agreed specifications, which is sufficiently wide to meet the clinical needs of most patients. However, a British Standard specification for graduated compression hosiery is in preparation and when it is published the opportunity will be taken to survey the market for hosiery made to that British Standard, including any manufactured from non-rubber materials (that is support garments) to see whether changes to the drug tariff range are indicated. At present there is little evidence to show that the majority of the non-rubber hosiery on sale, such as support tights, have any therapeutic value. Dextrostix— Though these chemical reagent strips are proving an acceptable method for specially trained diabetics to monitor their own blood glucose levels they are considerably more expensive than the urine testing equipment which is prescribable. In the present economic climate it is not possible to justify the significant additional cost to the family practitioner services of adding them to the Drug Tariff but I shall keep the matter under review as one of the improvements to be made when resources permit. Disposable needles and syringes— Disposable, that is, single-use needles and syringes offer little advantage other than convenience for patients who have their own reusable hypodermic equipment and who follow good hygienic practice. I do not consider that we would be justified in diverting from other NHS priorities the additional expenditure of over £10 million a year which would be entailed in making them generally available on prescription.

In considering proposals for additions to the drug tariff lists we are governed increasingly by financial constraints and there is now little opportunity for developing the lists unless compensating savings in expenditure or existing items can be achieved. Clearly none of the items mentioned above would be self-financing if added to the lists. Any one of them therefore would have to be accorded a high priority in order even to compete for a place in a future development programme.

Arrangements do exist of course for consultants to authorise the supply of any of these items through the hospital service if they consider it necessary to the treatment of a particular patient.