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Trivial pursuit

With so many big issues to tackle, should MPs be playing with prescribing costs

I don't do quizzes. I avoid pub-quizzes, charity-night quizzes, programmes on TV that have anything remotely to do with answering questions. I don't do crossword puzzles.

I have no patience with the people who don't know the answers to things that I think are obvious and I can't bear the smug self-satisfaction of competitors who know the answers I don't.
That said, here's a little quiz for you.

What have building and maintaining river and coastal flood defences in England; tackling rural poverty in developing countries; building for future sustainable construction and refurbishment on the government estate; prescribing costs in primary care and the evasion of vehicle excise duty have to do with each other?

Can you figure out what prescribing costs in primary care have to do with flood defences? Trust me there is a link.

I'll give you a clue. The following people are involved: Richard Bacon; Annette Brooke; Angela Browning; David Curry; Ian Davidson; Philip Dunne; Edward Leigh; Austin Mitchell; John Pugh; Gerldine (yes, it is spelt correctly) Smith; Don Touhig; Alan Williams and Phil Wilson.

I'll give you another clue. This group of people all do the same job.

Do you give up, or are you sitting smugly, thinking: This is soooo obvious?

Here's the answer. The people are all members of the House of Commons Public Accounts Committee; they are Members of Parliament. The list of disparate topics are the subjects that these eminent brains have recently examined. Letís face it, they must have eminent brains; in fact their brains must be the size of Milton Keynes to un-fathom excise duty, flooding, world-wide poverty and prescribing doctors. The ability to pronounce on maintaining the governmentís estate, stopping rivers from flooding and what pills we are taking must  mean they know everything about the world and who made it.
I am in awe - not.

I don't think we can trust this rag-bag lot one little inch. On the upside, they probably wouldn't want to be trusted an inch; they are more likely to want to be trusted a centimeter.

This is with the possible exception of Annette Brooke, Liberal Democrat Member of Parliament for Mid Dorset and Poole North. Brooke asked the Secretary of State for Trade and Industry what representations he had received to repeal or amend the 1871 Peddlers Act. She is obviously on top of things.

That said, can we trust these big brains to do a job for us? How do you actually measure what Members of Parliament do, how well they do it and if we want them to continue doing it?

We can only measure them against what we know to be true and weigh their judgement against ours. Do they say the things we know - from our own life experiences - to be right?

Here's what the collected big brains had to say about the NHS drugs bill. The drugs bill is something you know about. It is your business to know about it. You are, in all probability, experts on the subject. It is your living and it is what you do, all day, every day.

The brains said: Millions of pounds could be saved if people took generic drugs. More must be done to curb NHS spending on prescription drugs in England, which has more than doubled in a decade to £8.2bn a year.

There is more. The big brains want to restrict drug firm influence by forcing GPs to declare significant gifts and hospitality.

How does this match with what we know about the NHS and the drugs industry?

Patricia Hewitt's Herceptin fiasco is a further example of why politicians should get nowhere near the first aid box, let alone the NHS money box

On May 18, 2007 the National Audit Office published a report. It said: NHS has made significant progress in improving generic prescribing rates in recent years, with generic prescribing increasing from 51 per cent in April 1994 to 83 per cent in September 2006. This is one of he highest generic prescribing rates in Europe.

What do we know about GPs and hospitality? We know that on Wednesday, November 16, 2005, the ABPI published its new Code of Practice that says: It is now specifically stated that items must not be offered for the personal benefit of health professionals or administrative staff. It remains the case that items must be inexpensive - the limit is £6, excluding VAT - and relevant to the recipient's profession.

No doubt, with me in mind, it also bans the use of promotional competitions and quizzes. Thank god!

The Code goes on to say that as far as meetings and seminars are concerned: Subsistence must be strictly limited to the main purpose of the event and be secondary to the purpose of the meeting. Companies must only offer economy air travel to delegates sponsored to attend meetings. Lavish venues must not be used and companies should avoid using venues renowned for entertainment facilities.

What else do we know? The blanket prescribing of statins has pushed up the drugs bill, as has many parts of the quality and outcomes framework for GPs, who struggle with patient groups with diabetes, fat back-sides and high blood-pressure.

And it will get worse. More screening means more prescribing. More technology often means less invasive techniques and more pills. Is there a better example than a stomach ulcer? Once cured by a blood-dripping, life-threatening operation and six weeks off work, it is now a course of pills.

Cancer drugs are busting the budget and Patricia Hewitt's Herceptin fiasco is a further example of why politicians should get nowhere near a first aid box, let alone the NHS money box.

If this is the best the big brains can do, I'm worried. I'm worried that rivers will flood and the coastline will erode. I'm worried about people starving in Africa. I'm worried that the 'government's estate' will crumble and no one is going to buy a tax disc for their car.

I'm not worried about prescribing in primary care.

I am worried that an eminent group of parliamentarians can waste our taxes on such drivel. Goodness knows what it costs - no doubt they'll have a committee to find out.


The Author
Roy Lilley

19th February 2008

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