§ Mr. Michael Morrisasked the Secretary of State for Social Services whether every product in the limited list will meet the quality standards of the specifications in the British Pharmacopoeia.
§ Mr. Kenneth ClarkeAll but four of the medicines included in the provisional limited list published for consultation when my right hon. Friend made his announcement and set out in my reply to my hon. Friend the Member for Congleton (Mrs. Winterton) on 10 December 1984 at columns381–2 are subject of monographs published in the British Pharmacopoeia and must therefore comply with the standards specified in those monographs. Of the remaining four products, three have to meet standards specified in monographs published in the British Pharmaceutical Codex 1973; I understand that these are currently being reviewed by the British Pharmacopoeia Commission with a view to the inclusion of monographs in a future edition the Pharmacopoeia. I also understand that the commission is currently preparing a monograph on the fourth product.
We are considering the advice of the Chief Medical Officer's panel of advisers before deciding which medicines should remain available under the National Health Service from 1 April 1985. The quality of all products on that list will have to comply with the requirements of the Medicines Act and relevant directives of the European Commission.
§ Mrs. Renée Shortasked the Secretary of State for Social Services what discussions about his proposal for a limited list he has had with the Standing Medical Advisory Committee; and what was its advice.
§ Mr. Kenneth ClarkeThe Standing Medical Advisory Committee advises my right hon. Friend and my right hon. Friend the Secretary of State for Wales on the provision of medical services under the National Health Service Acts. Its deliberations are and always have been confidential.
§ Sir Dudley Smithasked the Secretary of State for Social Services how many notifications he has received of cancelled or deferred investment by the pharmaceutical industry as a result of his announced decision on a limited list of prescribed medicines.
§ Mr. Kenneth ClarkeSome companies have claimed to us in discussion that investment plans have been deferred and are likely to be cancelled. We have pointed out that most other advanced countries are also trying to reduce their drugs bills and that this country retains several advantages so far as inward investment is concerned such as its attractiveness as a base for pharmaceutical research and development, sound economy, stable political environment, and links with Europe and the Commonwealth.
§ Mr. Michael Morrisasked the Secretary of State for Social Services what account he will take in drawing up the final limited list of the clinical implications of the differing sedative profiles of tranquillisers.
§ Mr. Kenneth ClarkeThe medical and pharmaceutical experts consulted by the Chief Medical Officer on the contents of the limited list have given full consideration to the clinical effects of different tranquillisers.
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§ Mrs. Renée Shortasked the Secretary of State for Social Services how, pursuant to his answer of 12 February to the hon. Member for Birmingham, Edgbaston (Mrs. Knight) Official Report, column 151, he will ensure that money saved on the cost of drugs prescribed by general practitioners as a result of the proposed limited list will be spent elsewhere in the National Health Service.
§ Mr. Kenneth ClarkeThe estimated savings from the limited list have been taken into account in the levels of spending in the NHS for 1985–86 announced in the Autumn Statement on 12 November 1984 at column 415. The savings will therefore enable us to maintain the increased expenditure on the Service which that Statement set out.
§ Mr. McQuarrieasked the Secretary of State for Social Services what representations he has received from general practitioners in rural areas who prescribe and dispense drugs regarding the proposal to ban prescriptions to National Health Service patients of brand-name products which will be excluded from the Government's limited list scheme; and if he will make a statement.
§ Mr. Kenneth ClarkeWe have received about 3,500 letters from doctors commenting on our proposals to limit the range of drugs available in certain therapeutic categories. Some of these letters have come from general medical practitioners in rural areas but it would not be possible to identify these without disproportionate cost.
§ Dr. Glynasked the Secretary of State for Social Services if he will allow doctors freedom to prescribe on the National Health Service any drug in cases which, in their clinical opinion, could only be effectively treated by a particular drug or formulation, and the doctor so certifies.
§ Mr. Kenneth ClarkeWe intend to make a comprehensive announcement shortly which will cover the point raised by my hon. Friend.
§ Sir Dudley Smithasked the Secretary of State for Social Services what meetings he or his ministerial colleagues and officials held in Copenhagen with representatives of the World Health Organisation before he produced his statement on a limited list for prescription drugs; and what subjects were discussed.
§ Mr. Kenneth ClarkeThe Chief Medical Officer and I visited the World Health Organisation regional office for Europe in Copenhagen on 2–4 September 1984. Amongst other subjects, we discussed measures being taken in various countries in Europe to control drug costs.