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Prescriptions (Chronic Diseases)

3.31 pm

Mr. Paul Marsden (Shrewsbury and Atcham): I beg to move,

That leave be given to bring in a Bill to make provision in relation to prescribing for those suffering from chronic diseases.

The Bill will review the prescription charges levied against the chronically ill, to make the system fairer and more equitable. It will also seek to raise awareness to increase the take-up of the current pre-paid certificates by the chronically ill, and—in the light of a review that recommended free prescriptions—to ensure that there is full take-up.

In 1968, the British Medical Association approved a list of medical conditions whose sufferers should be exempt from prescription charges. Some of the decisions on those conditions were based on medical knowledge current at the time. For instance, children with cystic fibrosis were not expected to live to see adulthood, so children were exempt but not adults. Today, more than 1,000 adults with cystic fibrosis are penalised by the state for living longer. In today's NHS, that is unfair.

Yesterday, I met Janine, a 21-year-old sufferer of cystic fibrosis. She has to work for seven to eight hours each day with her carers to be fit enough to walk up a flight a stairs and do the things that we all take for granted. She is a courageous person who spends her time as an advocate for other CF patients.

Desiree Eriksson Hills had a heart transplant 14 years ago after developing dilated cardiomyopathy at the age of just 17. But, for a transplant recipient, the operation is not the end of the story—quite the contrary. Desiree and others like her have to take drugs for the rest of their lives. It is not right that they have to pay prescription charges. As Desiree says,

"We cannot live without these drugs, so we are paying a tax on our very existence. That's just wrong."

Thirty-eight-year-old Lorraine Ellard is living with long-term asthma, which is so severe that it prevents her from working, shopping and even socialising. In spite of these factors and the disruption to her life, Lorraine has to pay for her asthma medication. She claims incapacity benefit of £369 per month, but faces a massive monthly prescription bill of £124. If Lorraine is short of cash, the drugs have to be forfeited, but without them she is liable to face a flare-up, with asthma symptoms that could lead to her being rushed into hospital, which represents an added and avoidable cost to the NHS. Without the drugs, Lorraine is placed in a perilous position, as asthma is a matter of life and death. Likewise, someone who suffers from multiple sclerosis, Parkinson's disease, certain types of epilepsy, or even myalgic encephalopathy will have to pay for prescriptions for basic medicines. For someone living in the fourth richest nation in the world, in the 21st century, that is patently unfair and unjust.

According to the National Association of Citizens Advice Bureaux, as a result of the glaring anomalies in the current system, about 750,000 prescribed items are never dispensed because people cannot afford them. Pharmacists and GPs say that many patients ask which is the most important item on a prescription, because they can afford only one. It is argued that those with chronic conditions can limit such costs by buying season tickets,

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but an initial outlay of £89 is too great for many on low incomes. Over the years, the cost of such season tickets can run into many hundreds of pounds. NACAB also discovered that 27 per cent. of those who could benefit from season tickets did not even know of their existence.

The National Asthma Campaign has described prescription charges as an

"unfair tax on people with asthma".

The Cystic Fibrosis Research Trust has also condemned such charges. Typically, it is the poorest in our society who have the worst medical conditions, yet the Government demand that they must pay. For example, students with chronic conditions are told that they should pay for their medical drugs out of their student loan. That is discrimination of the worst kind, and it is perpetuated by this Labour Government.

The Government have not researched the number of chronically ill patients who have to pay for prescriptions, and the Bill would require such a review to be conducted. The anticipated cost of prepaid prescriptions is some £43 million, and a further £40 million would be required to cover those who cannot afford such prescriptions and those who have not even heard of them. The total cost would therefore be £83 million, but that should be set against the billions of pounds that the Chancellor has raised through tax increases for the NHS. Such a sum is surely a small price to pay for justice for the chronically ill. Liberal Democrats say that the chronically ill are a priority and deserve support.

In 1992—10 years ago—Labour said in its manifesto that

"chronically sick patients will be a higher priority."

In 1994, Labour said:

"We will seek to provide free medication as part of ongoing treatment or long-term requirements."

It even cited the example of cystic fibrosis sufferers. In 1996, the then Leader of the Opposition—the current Prime Minister—said that Labour would tackle health inequalities because he believed in a

"universal health care system paid for by taxation that gives every citizen the best health care based upon need not ability to pay".

The then shadow Health Secretary said in 1996:

"I want to see greater fairness between patients; the crucial NHS principle of equity has vanished in recent years."

Labour's 1997 manifesto proclaimed:

"We will save the NHS . . . Labour commits itself anew to the historic principle that if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone—not on your ability to pay."

Hear, hear. I cannot understand why, five years after the election of a Labour Government, nothing has changed for the chronically ill.

Even as recently as 1998, in anticipation of the comprehensive spending review, the then health Minister—he is now Secretary of State for Health—promised a review of the

"list of medical conditions exempt from prescription charges".—[Official Report, 5 May 1998; Vol. 311, c. 350W.]

What was the outcome? A point-blank refusal to change this blatant unfairness. Recently, the Wanless report stated that

"the present system of exemption for prescription charges is not logical, nor rooted in the principles of the NHS".

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Labour has reneged on 10 years of promises to the chronically ill, and has allowed this unfairness to continue for five years. Liberal Democrats are determined to make Labour face up to such injustice. The money is there in the form of the Chancellor's tax increases. Liberal Democrats believe in an NHS free at the point of delivery and based on need, rather than the ability to pay. We will speak up for the chronically ill because it is clear that both Conservative and Labour Governments have failed them.

Even last week, the Prime Minister said in relation to prescription charges that the Government were

"aware of the things that were said previously and we intend to honour them."—[Official Report, 12 June 2002; Vol. 386, c. 864.]

The words "honour" and "new Labour" do not sit comfortably together, coming from a Prime Minister who has more spin than Spiderman. The Liberal Democrats will maintain this campaign for the chronically ill until we get justice for those patients.

No more promises, no more maybes and no more excuses. People like Janine, Desiree and Lorraine need help now.

Question put and agreed to.

Bill ordered to be brought in by Mr. Paul Marsden, Dr. Richard Taylor, Dr. Ian Gibson, Dr. Evan Harris, Mr. David Amess, Sandra Gidley, Mr. Simon Thomas, Mr. Paul Burstow, Rev. Martin Smyth, Dr. Jenny Tonge and John Barrett.

Prescriptions (Chronic Diseases)

Mr. Paul Marsden accordingly presented a Bill to make provision in relation to prescribing for those suffering from chronic diseases: And the same was read the First time; and ordered to be read a Second time on Friday 19 July, and to be printed [Bill 151].

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Opposition Day

[3rd Allotted Day]

World Poverty

Mr. Speaker: Before the debate commences, I inform the House that I have selected the amendment in the name of the Prime Minister.

3.41 pm

Mrs. Caroline Spelman (Meriden): I beg to move,

That this House shared the concerns of the Trade Justice Movement about the plight of the poorest people in the world, and congratulates them on bringing these matters to the attention of the public; notes with great concern the increasing levels of hunger and poverty in many developing nations; further notes that international development targets are not being met in Africa; recognises the depth of public concern on this issue; believes that increasing levels of international trade offer the greatest hope for the alleviation of hunger and poverty in history; further believes that the removal of trade barriers will promote economic growth, trade and investment in poor nations; supports the liberalisation of trade; is concerned that the Common Agricultural Policy is failing both British farmers and consumers, and harming farmers in poor countries; is also concerned at the rising levels of farm subsidies in America; and calls on the Government to use the forthcoming G8 Summit in Canada, the EU Heads of Government Meeting, and future World Trade Organisation meetings to further the liberalisation of international trade to promote the alleviation of poverty and combat hunger and starvation amongst the poorest people on earth.

Before I begin my speech, I should like to welcome the hon. Member for Northampton, North (Ms Keeble) to her new post as Under-Secretary of State for International Development. I very much look forward to debating international development issues with her. I enjoyed my debates with her predecessor, and I am sure that the Under-Secretary's knowledge of South Africa will be a great asset to her.

Given that 10,000 people from every corner of the United Kingdom have come to lobby Parliament today, I am delighted that Her Majesty's official Opposition have chosen to debate an issue that clearly matters to British people. We congratulate the Trade Justice Movement on bringing the matter to the attention of the public. We may not agree with everything for which the movement calls, but we share its concern for the plight of the poorest people in the world. The movement recognises that trade can play an important part in reducing poverty and improving our quality of life. It can generate jobs and wealth.

Conservatives believe that trade could be the greatest force for poverty reduction in history. There is no question but that the opening up of markets and increased trade from developing countries would dwarf any contribution that could be made from overseas aid. That is not idealism, but common sense.

Tariff barriers cost poor countries $100 billion a year—twice as much as they receive in aid. We firmly believe that trade restrictions are the main barrier to development. There is a danger that seeking to impose controls on overseas investment in developing countries may make it less attractive for companies to invest, which would deprive people in the developing world of the jobs and trading opportunities that they desperately need.

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Much progress has been made in reducing poverty over the past 50 years, but it has been patchy. A whole continent—Africa—is being left behind. It is the only region in the world that is completely off target when it comes to meeting the millennium development goals on health, education and poverty.

That is why we have called for the debate today. Despite the onward spread of globalisation, the World Bank has found that many of the poorest countries are in danger of becoming marginal to the world economy. As it pointed out in a recent report, incomes in those countries have been falling, poverty has been rising, and those countries participate in trade less today than they did 20 years ago.

This is our challenge: the Government and the whole international community must do more to allow countries currently excluded from international trade to reap the immense benefits that it offers.

Much pressure has been placed on poor countries to open their markets and liberalise trade, but rich countries—including Britain—are reluctant to practise what they preach. Telling poor countries to end subsidies and open their markets is like sitting in a glasshouse throwing stones, and today we want to address such hypocrisy.

We can alleviate world poverty by freeing up trade, and I want to set out how it can be done. First, it can be done by market access. If Africa were to increase its share of world exports by just 1 per cent., it would generate $70 billion—approximately five times what the continent receives in aid. Conservatives believe that free trade is the engine of poverty reduction. Several case studies show the beneficial effects of increased global trade. The number of rural poor in China declined from 250 million in 1978 to just 34 million in 1999. The level of absolute poverty in Vietnam has been halved in 10 years. India and Uganda have also enjoyed rapid poverty reduction as they have integrated into the world economy. Poverty in Uganda fell by 40 per cent. in the 1990s, and school enrolment doubled. More has been done to address poverty in the past 50 years than in the past 500, but there is much more to do.

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