(South Thanet) (Con)
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.
Ordered,
That , , , , , , , Sir , , , and present the Bill.
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).
