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Ministry Of Health

Volume 721: debated on Monday 22 November 1965

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Prescriptions

26.

asked the Minister of Health what has been the increase to date in the number and cost of prescriptions issued since the abolition of prescription charges.

In the period from 1st February to 31st August, 1965, the latest for which information is available, chemists in England and Wales dispensed 23 million more prescriptions than in the corresponding months of 1964, an increase of about 19 per cent. The cost was £13 million, or 22 per cent. higher.

Would not the right hon. Gentleman agree that this very considerable increase represents an unnecessary wastage of the nation's resources and, furthermore, a considerable additional burden on our general practitioners, who are called upon to write out these prescriptions? Does not be agree that this is one of the factors which are causing dissatisfaction with the National Health Service?

No, Sir. I do not accept either statement in the hon. Member's supplementary question. Although the increase in the number of prescriptions since the abolition of charges is a good deal higher than was expected, the average cost per prescription is lower than was expected. This seems mainly due to the prescribing of small quantities. Past experience has shown an upward trend in the drug bill, and no doubt this would have continued whether or not charges had been abolished.

Does not my right hon. Friend agree that hon. Members opposite are implying that these prescriptions were issued unnecessarily? Is not this a reflection upon the integrity of the medical profession?

That is a perfectly reasonable interpretation on the part of my hon. Friend.

Can the Minister then explain the basis of the confident estimate that he gave, when these charges were abolished, that there would be no sizeable increase?

It may be that the degree of deterrence, and perhaps the hardship which the existence of charges brought about, was underestimated, but, as I have told the House, it is very difficult to analyse the complex of causes that leads to changes in the size of the drug bill. There is no doubt that these figures are not solely the result of the abolition of the charges.

Can the Minister tell up what the figures would have been had the rate of increase in recent years been maintained?

General Practitioners

27.

asked the Minister of Health what has been the increase or decrease in the number of general practitioners on the medical lists in the years 1963, 1964 and to date in 1965.

In the year ended 1st October, 1963, the number of principals providing full general medical services in England and Wales increased by 23; in the years ended 1st October, 1964 and 1965, it decreased by 103 and 219 respectively.

Does the Minister agree that this is a very alarming trend? Does not he also agree that, quite apart from the dissatisfaction with remuneration and conditions of service in the National Health Service, one of the reasons why the number of general practitioners is falling is that their waiting rooms are being filled more and more by people who are waiting for prescriptions, and whose only complaint is that they refuse to pay for their own aspirins or cotton wool?

No, Sir. I have no evidence that this is a significant factor. We should get this matter in proportion. Expressed as a percentage of the number of principals, the decrease in the year ended 1st October this year was 1·08 per cent. In a period when the image of general practice has suffered from the publicity given to the discontent felt by doctors, it is not surprising that the numbers have fallen.

Can my right hon. Friend say whether a high proportion of those leaving general practice are the more elderly general practitioners, possibly with small lists?

No, Sir. It is a fact that a rather disturbingly high proportion has consisted of general practitioners of under 45 years of age. I hope that when the new contract goes to the review body for pricing and is accepted—as I hope it will be—by general practitioners, this trend will be reversed.

Can the Minister say what specific steps are now being taken to increase the supply of general practitioners? This was an objective which figured extremely prominently in the Labour Party manifesto.

As I have told the right hon. Gentleman before, this matter is under urgent consideration by my right hon. Friend the Secretary of State for Education and Science, who will be making a statement to the House about it as soon as possible. The right hon. Gentleman will be glad to know that there has been a further increase in the intake of students into the medical schools in this academic year.

28.

asked the Minister of Health if he will give an estimate of the number of general practitioners in private practice exclusively at the latest available date and in 1955.

Can the right hon. Gentleman tell the House whether in his view, as a Minister, private practice is either expanding or contracting—and say whether he would like to see an expansion in private medicine?

I should not like to make a guess at this. It could be a guess only, because information on the number of private practitioners is not required for the purposes of the National Health Service.

Sainsbury Committee (Interim Report)

30.

asked the Minister of Health if he expects to receive an interim report from the Sainsbury Committee which is inquiring into the relationship of the pharmaceutical industry and the National Health Service.

So far as I am aware, the Committee is not at present proposing to submit an interim report.

As winter has undoubtedly started early this year, and my right hon. Friend the Chancellor of the Exchequer predicts that spring will start late, will the Minister seek to find from the Sainsbury Committee whether or not it is possible to do something about the provision of drugs for bronchitis in the winter period?

I doubt whether this would be a matter for the Sainsbury Committee. I have not suggested to the Committee that it should produce an interim report on any aspect of its deliberations, though it would no doubt do so if it thought desirable.

Dentists

31.

asked the Minister of Health if he has yet had representations from the British Dental Association on the revision of the conditions of service for dentists in the National Health Service; and if he will make a statement.

No, Sir. I have received a copy of the Association's report on their survey and expect to have early discussions with them about it.

When my right hon. Friend discusses this, will he look at the possibility of having closer integration between dentists giving general medical service, those in hospitals and those in schools? Will he, particularly, consult his right hon. Friend the Secretary of State for Education and Science on the possibility of more preventive work by dentists in schools in association with general practice?

I will certainly bear the latter point in mind. There is no limit to the scope of my discussions with the British Dental Association.

Diabetics (Syringes)

33.

asked the Minister of Health whether he will make disposable needles for syringes available for diabetics treated under the National Health Service.

Where disposable needles are essential for a diabetic on clinical grounds, they can be supplied through the hospital and specialist services.

May I ask my hon. Friend why, if they can be supplied, as they are in the hospital which I have in mind, for clinical purposes—a child is trained on them, as it were—the child cannot receive the sharper disposable needle when he goes outside the hospital, and treats himself, rather than the blunt undisposable needle?

This is a medical matter and there is no reason why the child should not receive disposable needles. It depends on whether the hospital concerned considers that it is necessary for him to do so. I see little difference between the child going to the hospital for his needles and his going to the chemist.