§ Mrs. Ann WintertonTo ask the Secretary of State for Health what estimate he has of the total current annual cost to the National Health Service of special payments made to general practitioners for contraceptive advice and prescription.
§ Mr. MellorThe provisional 1988–89 cost, in England, of payments to general medical practitioners for contraceptive services is £32.4 million.
§ Mrs. Ann WintertonTo ask the Secretary of State for Health what estimate he has of the total current annual cost to the National Health Service on contraceptive drugs and devices issued to patients.
§ Mr. MellorWe cannot identify the cost of contraceptive drugs and devices issued at health authorities' family planning clinics or those provided by hospitals or by dispensing doctors.
The net ingredient cost of contraceptive drugs and appliances prescribed by GPs and dispensed by retail pharmacists and appliance contractors was estimated at £21 million in England in 1987, the latest full year for which figures are available. This figure is based on a sample of approximately one in 200 prescriptions.
§ Mrs. Ann WintertonTo ask the Secretary of State for Health (1) if he will make a statement outlining the reasons for special payments to general practitioners for contraceptive advice and prescription;
(2) if he will make it his policy to cease to make special payments to general practitioners for contraceptive advice and prescription.
§ Mr. MellorFees are paid to general practitioners who provide contraceptive services, in recognition of the time and effort of those doctors who choose to provide these services to patients. This is consistent with our policy that GPs' remuneration should be sensitive to the numbers of patients in their care and the range of services provided. The participation of GPs in the provision of contraceptive services gives patients a choice between practice-based services and health authority clinics. We have no plans to change the current arrangements.
§ Mrs. Ann WintertonTo ask the Secretary of State for Health (1) whether he has any plans to issue new guidance to general practitioners concerning the prescription of contraceptive drugs;
(2) what response his Department has made to the recent reports of increased levels of cancer in long-term users of contraceptive drugs.
§ Mr. MellorThe Committee on Safety of Medicines (CSM) was provided with advance details of the recent study by Chilvers et al on oral contraceptive use and breast cancer risk in young women and was able to formulate and issue advice to doctors and pharmacists in its bulletin "Current Problems No. 26." A copy is in the Library. CSM advice was also sent to a range of other interested bodies including family planning organisations. In88W addition, officials of the Department have met representatives of pharmaceutical companies marketing oral contraceptives and have been in touch regarding this and other studies with their counterparts in the World Health Organisation and regulatory bodies in other countries. The CSM is continuing to monitor ongoing studies and cancer registration rates and will maintain close communication with all those involved. More generally the handbook of contraceptive practice issued by the Department to all general practitioners and family planning doctors includes advice on oral contraception. Work on a new edition by representatives of the Royal College of General Practitioners, Royal College of Obstetricians and Gynaecologists and Standing Medical Advisory Committee is well in hand for distribution later this year.