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Prescribing Costs

Volume 485: debated on Tuesday 16 December 2008

Annual growth in primary care prescribing costs in the year to March 2008 was 1 per cent. That is set against a 5 per cent. increase in the number of prescription items dispensed. Unfortunately, it is not possible to attribute a specific cash sum to more efficient prescribing, because variables, such as the cost of the drugs themselves, will affect the savings that are made by primary care trusts. I think that the hon. Gentleman can see that there has been some progression in efficient prescribing over the past year or so.

The Minister may recall that in its 2007 report, the Public Accounts Committee recommended, and the Government accepted, that more than £200 million a year could be saved for the NHS by prescribing generic drugs, rather than branded ones, without any adverse effect on patients. Has that target of £200 million been achieved? Which PCTs have made the most progress and which have made the least progress? If he does not have the information to hand, he may write to me.

The PAC report was very helpful, and I am grateful to the hon. Gentleman’s Committee for the work that it has done. The health service pays an £8 billion drug bill at the moment, so I am pleased to be able to tell him that PCTs are making considerable progress. Generic prescribing has increased from 51 per cent. in 1994 to 83 per cent. in 2008—that is the highest rate in Europe. He will know that PCTs are independent bodies and that they make their own decisions about these matters, but we have issued guidance to PCTs. Although it is ultimately for them to decide, the practice-based commissioning that we have seen and other guidance that we have issued is definitely driving the NHS forward in the right direction, towards the more efficient prescribing of drugs.

Five thousand of my constituents have written to the Minister, via me, asking that their general practitioners be allowed to continue dispensing. Will he take heed of this Bassetlaw common sense?

My hon. Friend has been at the forefront of the campaign on the issue of dispensing by doctors. We are analysing the responses to the consultation on pharmaceutical provision in England, and we will be making an announcement on these wider issues as soon as possible in the new year. I am aware of the strength of the responses we received on the various options for amending the criteria for dispensing by doctors. We have taken into account the views of those attending the listening events, the meetings and so on, and as a result I am pleased to announce to him that there will be no change to the current arrangements on GPs dispensing medicines to their patients.

Building on the remarks made by my hon. Friend the Member for Gainsborough (Mr. Leigh), does the Minister accept that if his June steering group report recommendation that there should be statutory regulation were implemented for complementary medicine, herbal medicine and acupuncture, that would create further downward pressure? That is because doctors would be prepared to refer to these practitioners, who charge a lot less, and, thus, the cost to the health service would be less.

I thank the hon. Gentleman for his question; I shall certainly consider the contribution that he is making and write to him on the particular point that he raises.

Has my hon. Friend considered the wastage of drugs through inefficient prescribing, especially in relation to free prescriptions? Many people accept the drug offered on the prescription, but do not use it. Even though the drug is unused and still in its original packaging, it cannot then be used and has to be destroyed. That loses the NHS a huge amount of money.

I understand my hon. Friend’s concerns and those of other hon. Members who have written to me about wastage. We are all concerned about wastage caused by unused medicines. The difficulty is that the recycling of medicines in the way that he and others have suggested is regarded as unethical and unsafe according to the code of ethics produced by the Royal Pharmaceutical Society. Indeed, some hon. Members have suggested that we could donate unused drugs to other countries, but the World Health Organisation guidelines state that no drugs should be donated that have been issued to patients and then returned to pharmacies. I understand the concerns about wastage, but we must take clinical matters into account when making decisions.

The Government have shown themselves willing to qualify the autonomy of primary care trusts when they feel it necessary to do so. Why then are they ignoring the huge disparity between the best and worst performing primary care trusts in the drug-prescribing habits of their practitioners and the related costs?

I referred to that matter when I answered the question asked by the hon. Member for Gainsborough (Mr. Leigh). We are drawing the attention of primary care trusts to the value of more efficient prescribing commissioning, and—as I said—generic prescribing has increased from 51 to 83 per cent. We are making excellent progress and I hope that PCTs, autonomous bodies as they are, will none the less take notice of the guidelines that the Government have issued, which will ensure that we have more efficient drug prescribing in future.