Clause 60 - Extension of prescribing rights
Health and Social Care Bill
3:00 pm
Mr John Denham (Minister of State, Department of Health; Southampton, Itchen, Labour)
It may be helpful if I explain briefly how the next few clauses relate to one another. Clause 60, together with clause 44 and parts of clause 42, deals with the extension of prescribing rights. The remainder of clause 42 and clause 43 deal with the remote provision of NHS pharmaceutical services--home delivery, mail order and internet services. The genesis of these clauses is the final report of the ``Review of Prescribing, Supply and Administration of Medicines'', which was published in March 1999.
The review, by Dr. June Crown, made a number of recommendations relating to the prescribing and supply of medicines. One of its major recommendations was that legal authority to prescribe in the United Kingdom, including authorising NHS expenditure, should be extended beyond the current prescribers--doctors, dentists and some nurses. It also recommended that legal authority for new professional groups to prescribe should normally be limited to areas within the expertise and competence of each group. Two types of prescriber were recognised: independent prescribers, who would be responsible for the assessment of patients with undiagnosed conditions and for decisions about their clinical management, and supplementary prescribers, previously known as dependent prescribers, who would be responsible for the continuing care of patients who have been clinically assessed by an independent prescriber. The review also recommended that Ministers should receive advice on granting prescribing rights to new professional groups from a UK-wide advisory body, set up under the Medicines Act 1968.
The provisions in clauses 60, 44 and parts of clause 42 help us to implement the review's most important recommendations. Clause 60 amends section 58 of the Medicines Act 1968, and deals with the prescribing of prescription only medicines, whether privately or dispensed as a cost to the NHS. Clauses 42 and 44 make like changes to the National Health Service Act 1977, in respect of ordering drugs and other items on the NHS.
We consulted the NHS and relevant professional organisations before agreeing to implement the main recommendations of the review. A strong majority of the organisations consulted on the review's recommendations were in favour of extending prescribing rights to other health professionals. That is why we are now taking powers that will enable us to implement those recommendations through orders. I
was glad that on Second Reading the proposals were supported by both sides of the Chamber. Action to extend the rights to prescribe medicines will help to break down the divisions between health professions and play an important role in the introduction of more flexible team working throughout the NHS.
I shall give one or two examples of the potential benefits of extended prescribing rights. Physiotherapists may be able to prescribe non-steroidal anti-inflammatory drugs and analgesics rather than having to refer their patients to a GP, and optometrists could prescribe medicines for the treatment of conjunctivitis and other eye infections. However, the proposals will also mean better and speedier access for patients to the medicines they need, as envisaged in the NHS plan.
Clause 60 does not confer any prescribing rights. Instead, it makes it possible for Ministers to extend by order such rights to members of any recognised and regulated health profession. Patient safety will, of course, be paramount during implementation, particularly when considering whether to grant prescribing rights for specific medicines to a professional group. An advisory body under the Medicines Act will take account of concerns when considering the granting of prescribing rights to any specific group of health professionals. That advisory body will make recommendations to Ministers. More detailed proposals for granting prescribing rights for specific medicines to a particular group of health professionals will be subject to both informal and formal consultation with relevant organisations.
The Government amendments are related. Clause 60(3) lists the registered health professionals who may be considered for prescribing rights. Government amendment No. 217 extends that list to ensure that health professions, regulated under separate Scottish and Northern Ireland legislation, have the same potential right to prescribe as health professionals regulated under the specified Acts of Parliament.
Clause 42(3) lists the registered health professionals whose prescriptions may be dispensed under the NHS in England and Wales. Government amendment No. 213 extends that list to ensure that prescriptions of Scottish and Northern Irish regulated professionals will be able to be dispensed in England and Wales.
Finally, clause 44(3) lists the registered health professionals whose prescriptions may be dispensed under the NHS in Scotland. Government amendment No. 216 amends that list to make similar provisions in Scotland for health professionals regulated under Northern Ireland legislation.