Motion for leave to bring in a Bill (Standing Order No. 23)
I beg to move,
That leave be given to bring in a Bill to require community pharmacies and other providers of NHS-funded prescriptions to show, on the patient label, the prevailing Drug Tariff value of the items dispensed; and for connected purposes.
I would like to declare that my wife is a community pharmacist and, as would be expected, she has offered me some assistance in considering this Bill. I would like to thank Mr Gurpal Singh Chaggar of Newington pharmacy in Ramsgate in my constituency for his help and support with some of the more technical aspects of how the published NHS drug tariff—amended monthly and, for some items, more frequently—interfaces with software used in all pharmacies. I also thank the House of Commons Library, as ever, for its professional assistance, which it can always be relied upon for.
This Bill has the benefit of elegance, simplicity and, quite rarely for this place, a cost and administration burden as close to zero as any measure could possibly have. Let me lay out the framework for the Bill with some facts. In 2021-22 there were 1.14 billion items dispensed through NHS England, serving a population of 56 million—I will leave Members to do the maths for how many prescriptions per person that amounts to. The cost of the items dispensed, which cover pharmaceutical products and more physical appliances and dressings, was £8.7 billion. Just 11% of all prescriptions bear the current £9.35 prescription fee. If we look at that the other way, 89% of all prescriptions are “free”, but of course, nothing is free. There are a multitude of exemptions—for example, the over-60s, those in receipt of benefits, the under-18s, those in education and those with certain medical conditions. We are all familiar with those.
The prescription fees received in 2018-19—the last year for which the Library could provide me evidence—when the prescription charge was £8.80, were £576 million. By extrapolation, given that people now pay £9.35 for a prescription, I estimate that that figure would be a little north of £600 million today. That means that the prescription system is recovering £600 million out of an overall cost of £8.7 billion.
The bulk of prescription charges comes from those paying for off-patent drugs, for which the cost price may sometimes, marginally, be less than the prescription charge. Such off-patent drugs—often the slightly cheaper generic products—make up about a quarter of all prescriptions in England and include blood pressure drugs, cholesterol-lowering drugs, antibiotics, anti-depressants, skin creams, drugs for rheumatism, oral contraceptives and analgesics.
The main purpose of the Bill is twofold. Primarily, it will allow everyone in receipt of NHS-provided prescriptions to be part of the efficiency measures that the nation needs now, and I think it is fair to ask us all to do our bit. For instance, no one keeps a window open on a winter’s day and then heats the room, or throws food away by design, so why should it be normal, reasonable and ongoing for perfectly good medication to be unused and thrown away?
The Government are working to prevent over-prescribing and assess whether regular medication is still needed or appropriate. Pharmacies receive an NHS payment for the medicines use reviews that they do and, increasingly, medicines optimisation plans are in place in doctors’ surgeries and practices to similarly prevent over-prescribing —but again, that comes at a staffing cost to the system. I will not expand on some of the obvious internal systems failures that could easily be addressed, but those in the industry are fully aware of them and I recommend that Ministers speak to them.
The Bill would allow patients to play a key part in the common-sense optimisation of our resources. My proposal is simple: to use the data field for the drug tariff value of the items prescribed, which already exists in the systems used in doctors surgeries and pharmacies, to be clearly printed on the patient label. That would provide an awareness of the value of often expensive items.
In preparing the Bill, I was not at all surprised by how many right hon. and hon. Members approached me to relate their own family stories, which follow a similar pattern. On the death of an elderly loved one in particular, cupboards and drawers are found to be full of unused drugs that were often issued under long-standing, repeat prescriptions and then have to be returned to pharmacies for complete and utter destruction and disposal. Those drugs are thrown away—valueless—but they all bear an initial cost to the NHS budget.
I attribute to older people—I am getting there—a great deal of common sense and an awareness of value for money. They could be part of the system of medicines optimisation by recognising the value of what they are receiving for free and by intervening themselves, if necessary, when they see high-value drugs, which they know will never be used, simply landing each month. I focus-grouped my plans with an older cohort in my constituency and they said that they agree entirely with my observations and that they would respond to such a sensible nudge.
The secondary purpose of the Bill is transparency, which is important in everything that we do. We accept that freedom of information is a right and benefit in the modern UK, so it follows that we should all be aware of the things that the state provides through taxpayer funding. Let me be absolutely clear for the avoidance of doubt: this is not an attempt to charge; it is a means to achieve transparency so that we all appreciate what we get for free, because we know that “for free” does not exist. Whether it is the provision of NHS services or the collection of our household rubbish, there is a cost behind all those transactions that we pay one way or another. The Bill aims to shine a light on that at no cost and no administrative burden. I hope that hon. Members will see the benefit of it and support it as it progresses through the House.
Question put and agreed to.
That Craig Mackinlay, Julian Knight, Alicia Kearns, Dr Kieran Mullan, Ben Bradley, Greg Smith, Royston Smith, Sir Robert Goodwill, Matt Hancock, Mr Mark Francois, Harriett Baldwin and Virginia Crosbie present the Bill.
Craig Mackinlay accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 3 February 2023, and to be printed (Bill 173).
On a point of order, Madam Deputy Speaker. Earlier today, His Majesty the King appointed the second unelected Prime Minister for these islands in seven weeks. Given that the Government have no democratic legitimacy over Scotland, I wish to invoke Standing Order No. 163.
Order. I draw the House’s attention to the fact that I have allowed extra time for this Division, because I am informed that the Division bell is not working properly at 53 Parliament Street. I have made sure that everybody there has had a chance to know that there is a Division, and I have allowed extra time for them to come and vote, which I hope has been sufficient.