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House of Lords

Tuesday, 29th July 1997.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Sheffield.

Lord Saville of Newdigate

The Right Honourable Sir Mark Oliver Saville, Knight, a Lord Justice of Appeal, having been appointed a Lord of Appeal in Ordinary and thereby created a Baron for life, by the style and title of Baron Saville of Newdigate, of Newdigate in the County of Surrey--Was, in his robes, introduced between the Lord Mustill and the Lord Steyn.

Viscount Melville--Took the Oath.

Lord Cameron of Lochbroom--Took the Oath.

Prescription Fraud

2.46 p.m.

Lord Calverley asked Her Majesty's Government:

    Whether they have any plans to implement the recommendations of the National Health Service efficiency scrutiny into prescription fraud and, if so, when.

The Minister of State, Department of Health (Baroness Jay of Paddington): My Lords, as I am sure the noble Lord is aware, the report of the efficiency scrutiny on prescription fraud was published on 19th June. The Government have announced immediate decisions to implement some of the important recommendations, including, for example, security measures in the printing of prescription forms which will come into force next April. We are committed to a comprehensive programme to reduce fraud. At the moment work is going on to establish priorities for implementing some of the other recommendations in the report and we expect to make decisions about those later in the summer.

Lord Calverley: My Lords, I thank the Minister for a very reassuring answer. Unfortunately, some of the thunder has been stolen from my Question, as has just been explained. However, is the Minister aware of an expose on the BBC "Panorama" programme some weeks ago which highlighted a very serious problem? A small minority of GPs were misusing an archaic paper-sift system by ghosting patients and over-prescribing. In some cases, they were even prescribing to deceased patients. Does she agree that the introduction of a computerised costing system within the NHS would reap great benefit for a cash-strapped service?

Baroness Jay of Paddington: My Lords, I am grateful to the noble Lord. I saw the "Panorama" programme to

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which he refers. It displayed an extraordinarily complex web of fraud within the prescription service, not simply among GPs but sometimes involving patients who nominated themselves for exemption without being entitled to it. I understand exactly what he says about improving the IT systems and indeed the computer systems within that service. It is something which the Government are examining. IT systems are expensive, but, then, so is fraud.

Lord Dean of Beswick: My Lords, can the noble Baroness give any figures or a guesstimate of what the powers-that-be consider to be the total amount of money fiddled? Can she confirm that a considerable sum is involved, especially if added to the money being fiddled on housing, as noted in the latest report of the National Audit Office and the Audit Commission? Does she agree that it is no wonder that some vital services in the country, such as the health service, are badly short of funding when money is stolen at such a rate?

Baroness Jay of Paddington: My Lords, undoubtedly it is a serious problem. The estimate of theft and forgery with prescription forms, which was the subject of the original Question, is that approximately £15 million annually is lost. On patient charge evasion, the sum is in the region of £70 million to £100 million. Clearly, it is money worth saving.

The Earl of Carlisle: My Lords, can the noble Baroness inform the House how many patients have been prosecuted over the past 12 months and how many medical practitioners have appeared before the General Medical Council?

Baroness Jay of Paddington: My Lords, I am afraid that I cannot give an answer to the second question about the General Medical Council. I shall write to the noble Lord. I imagine that he refers specifically to the problem of prescription fraud. It is extremely difficult to identify patients who are defrauding the system. People simply present forms and, when asked if they are exempt, claim that they are when they are not. One proposal of the report, which was the subject of the initial Question, accepted by the Government, is that evading charges should become a criminal offence and be subject to the kind of standard fine which is, for example, appropriate for a motoring offence.

Baroness Cumberlege: My Lords, is the Minister aware that there is a view around that a vendetta is being exercised by the Government against old age pensioners, both current and future? Will she put matters right by giving an undertaking that no charges will be introduced for prescriptions for old age pensioners during the life of this Government?

Baroness Jay of Paddington: My Lords, as I am sure the noble Baroness is aware, the comprehensive spending review, which is looking at all subjects of expenditure and cost-raising under the NHS, is being undertaken by the Department of Health. There is a firm

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commitment by this Government to stand by their manifesto commitment that the NHS should be available free at point of need to those who need it.

Baroness Wilcox: My Lords, I am not quite clear about the reply to the question put by the noble Baroness, Lady Cumberlege. Am I to understand that the Minister said that this Government are not ruling out the possibility that they will introduce prescription charges for old age pensioners?

Baroness Jay of Paddington: My Lords, that question is rather wide of the Question on the Order Paper. I gave the general response to the question of the noble Baroness, Lady Cumberlege.

Road Accident Costs: Budget Proposal

2.51 p.m.

Baroness Miller of Hendon asked Her Majesty's Government:

    If insurance companies are required to pay the "full cost of treating road traffic accidents" as announced in the Budget Statement and pass that cost on to policyholders by way of increased premiums, what effect that will have on the cost of living index and the overhead cost to public transport, the transport of goods and to trade and industry generally.

Baroness Jay of Paddington: My Lords, under Section 157 of the Road Traffic Act 1988 insurance companies are already obliged to pay the costs of treating road traffic accidents for those who make insurance claims. In the Budget Statement my right honourable friend the Chancellor of the Exchequer announced the intention to ensure that hospitals actually collect those payments that are due to them. The proposal is to make the process of recovering those sums easier. There will probably be some administrative costs attached to that, but improving efficiency will not have the widespread implications suggested by the noble Baroness.

Baroness Miller of Hendon: My Lords, as the Minister says, there was always a right to recoup some of the costs. But how do the Government reconcile the new proposal--the extra collection mentioned by the Minister--with the principle that the National Health Service should be free at the point of delivery, particularly in view of her answer to the previous Question? Also, do the Government have any plans to extend the new tax to other claims against insured third parties for matters such as breaches of safety at work, defective goods or premises, or indeed for train accidents?

Baroness Jay of Paddington: My Lords, I am grateful to the noble Baroness. To take her second point first, it is true that the Law Commission made some recommendations on the wider use of this type of recovery of payment. For example, its proposal said that

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anyone responsible for accidents through negligence should bear the costs. My right honourable friend the Secretary of State told the Law Commission that he is looking at those proposals. As to the specific of the road traffic accidents, it is the insurance companies who pay the costs, not individual patients.

Treaty of Amsterdam: Religious Freedoms

2.53 p.m.

Baroness Young asked Her Majesty's Government:

    How they propose to deal with the effect that new Article 6a in the draft Treaty of Amsterdam may have on religious freedoms.

Lord Whitty: My Lords, the Government strongly supported the inclusion of new Article 6a on non-discrimination in the Treaty of Amsterdam. The article is clearly couched as a legal base which allows for future action, and not as a free-standing unrestricted principle. It should not have any immediate or direct effect. Moreover, all measures under Article 6a must be appropriate and are themselves subject to unanimity. We do not therefore believe that the new article will have any detrimental effect on religious freedoms in this country.

Baroness Young: My Lords, I thank the noble Lord for that reply. However, will he accept that the new article is a wide-ranging extension of anti-discrimination legislation covering, as it does, religion, sex and sexual orientation? It contains inherent contradictions and could cause serious problems in the United Kingdom, particularly for church schools and, I suspect, for the established Church.

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