The second interim report of the Joint Committee on Prescribing.

  • Great Britain. Joint Committee on Prescribing.
Date:
1950
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Licence: Public Domain Mark

Credit: The second interim report of the Joint Committee on Prescribing. Source: Wellcome Collection.

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    practitioner of any drug which in his opinion was necessary for the treatment ef his patients. This meant that if we were to recommend that certain drugs should not be prescribed by a practitioner, he would still be at liberty to prescribe them; or if a list of ““ approved ”’ drugs were drawn up the practitioner could still prescribe drugs not on this list. In either case, however, he might have to justify his action before his colleagues on the Local Medical Committee. This freedom of prescription was a fundamental assumption throughout our discussions. METHOD OF APPROACH: LETTER TO DOCTORS 5. The Departments provided us with a list of several hundred proprietary preparations which were amongst those being prescribed on Form E.C.10. The majority of these preparations consisted of drugs singly or in combination which did not differ materially from the drugs and preparations included in the British Pharmacopeeia, the British Pharmaceutical Codex or the National Formulary. Such proprietary preparations are usually more expensive— often very much more expensive—than standard drugs or preparations of reputed analogous therapeutic effect. There is no medical advantage in prescribing an expensive proprietary brand of a standard drug or preparation, but equally no objection to such prescriptions can be taken on purely medical grounds. 6. We were not unanimous in our views on the desirability of drawing up at this stage lists of proprietary preparations and other drugs which a doctor could or could not prescribe without risk of his having to justify his action. A minority thought that a list of any sort would be resented by general practitioners and that the existence of any form of restriction would create a bad effect on the public in fostering a belief that some drugs, however essential they might be for the treatment of a patient, could not be obtained in the National Health Service. The majority, however, thought that the issue of a list would be welcomed by practitioners, for they then would know what they could prescribe in reasonable quantity without risk of having to justify their action, and they would be in a stronger position to resist the requests of unreasonable patients. 7. We were, however, agreed that the co-operation of doctors should be sought before any attempt was made to impose positive restrictions. We therefore recommended to the Health Services Councils in a first interim report dated December, 1949, that a letter should be sent to all practitioners stating that the Committee was reluctant to recommend any restrictions on the drugs which could be prescribed in the Health Service but was disturbed at the high cost of the pharmaceutical services, particularly where caused by the prescription of expensive brands of proprietary drugs, and asking for the co-operation of the profession to prevent excessive prescribing. We also recommended that because a patient was often supplied with a proprietary brand of drug at hospital and then was recommended to continue with the same brand, the letter should be sent to hospital staffs as well as to general practitioners. A letter was accordingly drafted by the Departments and its terms in general approved by us. COMPILATION OF A LIST OF DRUGS 8. Although we decided that no attempt should be made to impose positive restrictions until the effect of the letter to doctors had been determined— even though this might mean a delay of some months—we also decided (by a