asked the Secretary of State for Social Services what is his policy on prescribing of drugs by doctors.

Under the National Health Service Acts, family doctors are free to prescribe any drug they consider necessary for the proper treatment of their patients. Doctors may be called upon to justify their prescribing decisions to their professional colleagues if the cost is apparently in excess of what was reasonably necessary. I also refer the hon. Member to the joint statement which the British Medical Association and I issued on 19th April, as follows:

Joint Announcement by the British Medical Association and the Secretaries of State for the Health Departments in England, Northern Ireland and Wales.

The British Medical Association and the Health Departments share a growing anxiety about rising patient expectation and consumption of National Health Service facilities including pharmaceutical products and the implications these tendencies have for public health and Health Service resources. They recognise that the underlying causes of these phenomena are complex and attributable to diverse factors. Nevertheless they ask every doctor to consider how best to contribute towards arresting the trend; and they draw the following points to doctors' attention. It must be noted that this statement covers only one item in the rising cost of the NHS.

1. Both the Health Departments and the British Medical Association recognise that it is for the doctor alone to decide what medicine to prescribe, or whether to prescribe a drug at all.

2. It will be in the patients' interests, both as users of the National Health Service and as taxpayers, if their attention is drawn to the Health Education Council's publicity intended to dissuade them from:

(a) asking for patent medicines they can buy from a pharmacy;

(b) expecting unnecessarily large quantities of medicines to be prescribed at any one time; and

(c) demanding medicines which the doctor has explained they do not need.

3. There are dangers to patients and their families, particularly young children, inherent in the accumulation of unused drugs in the home, in view (among other things) of the physical deterioration to which many drugs are subject, and it is advisable to consider accordingly the quantities prescribed at any one time. It would be helpful for doctors to indicate (whether by use of the "box" on the prescription form or otherwise) the number of days' treatment envisaged.

4. The public are not generally aware that all drugs have side-effects and the reaction of individual patients is often variable. The British National Formulary and the Compendium of Data Sheets are useful and convenient reference works on drug actions and side-effects and the preparations listed meet the needs of most patients. The Health Departments are co-operating with the medical and pharmaceutical professions to develop an improved version of the Formulary which will be revised at more frequent intervals than at present.

5. Where alternative forms of treatment for a particular patient are likely to be equally effective the relative cost should be taken into account.

David Ennals,Secretary of State for Social Services.Dr. James Cameron, C.B.E., T.D., Chairman of Council of the British Medical Association.also on behalf of the Secretaries of State for the Health Departments in Northern Ireland and Wales.

asked the Secretary of State for Social Services if he will make a statement about the level of drug prescription by doctors within the National Health Service.

I refer the hon. Member to the reply that I gave to my hon. Friend the Member for Eccles (Mr. Carter-Jones) on 20th April and to the statement mentioned in that reply.—[Vol. 948, c. 334–5.]

asked the Secretary of State for Social Services whether he has circularised general practitioners advising them not to prescribe expensive drugs on the National Health scheme even where they may be the most appropriate in the individual cases.

No. Family doctors in the National Health are free to prescribe according to their judgment as to what is necessary. I refer my hon. Friend to the reply I gave to my hon. Friend the Member for Eccles (Mr. Carter-Jones) on 20th April.—[Vol. 948, c. 334–5.]