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Limited List Prescribing

Volume 77: debated on Wednesday 24 April 1985

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asked the Secretary of State for Social Services whether he will reconsider the decision to exclude Asilone from the limited list of drugs available on National Health Service prescription; and whether he will give reasons for his decision on this matter.

The Chief Medical Officer's group of medical and pharmaceutical experts, set up to advise on the contents of the selected list, considered that there was no clinical need for antacid containing dimethicone, such as Asilone, and that they should be included in the schedule of products not available under the National Health Service. We accepted this group's advice in full.

asked the Secretary of State for Social Services whether he will list the drugs which are available under the limited list and suitable for prescription for children to act as decongestants for mild sinusitis or eustachian catarrh; and whether he will review this position.

I am advised that doctors might prescribe Sudafed Elixir, Ephedrine Nasal Drops BPC 0.5 per cent. or Xylometazoline Hydrochloride Nasal Drops BP 0.05 per cent., all of which are available under the National Health Service, for children with such conditions.

asked the Secretary of State for Social Services whether, in order to prevent the dispensing of Lobak for prescriptions written as chlormezanone/paracetamol, he intends to add chlormezanone to list B of the prescribing regulations.

asked the Secretary of State for Social Services whether general practitioners may prescribe any medication on the list of prohibited preparations provided the medication is set out in terms of its generic contents which do not appear on the list of prohibited preparations.

asked the Secretary of State for Social Services if he intends to seek consultations with representatives of the British Medical Association and the Association of the British Pharmaceutical Industry to discuss the procedure adopted by some general practitioners of prescribing brand named drugs on the banned list under their generic names; and if he will make a statement.

[pursuant to his reply, 22 April 1985, c. 355]: A very small number of doctors are trying to evade the NHS selected list. I am afraid that they are being encouraged by certain pharmaceutical companies to use various devices in attempts to get scheduled drugs dispensed at NHS expense. One company has even gone so far as to make available rubber stamps listing the generic ingredients of a scheduled proprietary painkiller. I am glad to say that the use of such prescriptions by formula is, however, insufficient to achieve the intended result.Regulations allow a pharmacist to substitute a scheduled drug only for one ordered by a non-proprietary name, which means a name listed in the British Pharmacopoeia or other reference work or formulary of similar standing. A list of ingredients is not a nonproprietary name, and no substitution may be made.We will not penalise pharmacists who have dispensed invalid prescriptions in good faith and in accordance with accepted professional standards. We will, of course, take action against any doctor or pharmacist who continues to

(a), (b) and (c) Hospital inpatient, day cases and outpatient attendances Bradford district health authority (Bradford health district prior to 1. 4. 1982)
Change
19781983NumberPercentage
Inpatient cases49,55055,775+6,225+12·6
Day cases6,8329,219+2,387+34·9
Total outpatient attendances272,271309,613+37,342+13·7

(d) Spending on Health Services

It is not possible to determine the amount of change in real terms because of the change in the composition of health authorities that occurred in 1982. The actual figures for revenue net of income for Bradford were:

1978–79

1983–84

Change Percentage

£

£

27,635,93951,778,600+87

participate in these attempts to evade the regulations for the benefit of pharmaceutical companies at public expense.