Official Report 172KB pdf
National Health Service<br />(Charges for Drugs and Appliances) (Scotland) (No 2) Regulations 2007<br />(SSI 2007/389)
Item 3 continues consideration from last week of Scottish statutory instrument 2007/389, which is subject to the negative procedure. We decided last week to ask officials to give evidence on charges for wigs under the NHS. I refer members to the copy of correspondence from Shona Robison, the Minister for Public Health. I welcome Chris Naldrett, Shelagh Scott and Billy Reid, from the Scottish Government. I invite Mr Naldrett to say a few brief words before we move on to questions. I hope that I have pronounced your name properly, Mr Naldrett.
You have indeed. I am assuming that members have read the letter from the minister dated 24 September, so I will keep this brief and reiterate the key points. The statutory instrument makes a couple of technical amendments, which we can go into if the committee wishes. The key change is to regulation 7, which in practice lists all exemptions from prescription charges. To it is added a new exemption category in the shape of medicines that will be prescribed and dispensed for sufferers of tuberculosis. That is being done on public health grounds and in parallel with health administrations in the rest of the United Kingdom. Patients who have TB, or people with suspected TB, require a cocktail of antibiotics to treat their condition. If they are not exempt from charges, there is, given the number of prescriptions that they have to be given, a possibility that they will not be able to take all their medication because of the prescription charge. The provision will remove a financial barrier to patients continuing and finishing their treatment for TB.
Thank you. The minister's letter was helpful.
I have no wish to delay the TB aspect of the SI from going through, but I would like to know whether alopecia is regarded as being a chronic condition. There are many hundreds of alopecia sufferers, including young women and children. I had a big meeting in Parliament on the issue.
There is currently no strict definition of "chronic condition", although the Scottish Government is considering its manifesto commitment in that regard. What we can say, which is in the minister's letter, is that the group that is reviewing the matter of supply of wigs has made its recommendations to the minister. Chronic conditions fall outside the medical exemption from prescriptions.
You say that the supply of wigs investigation group has now reported to the minister. When can we expect an outcome?
I am not sure. Billy Reid was policy lead on that matter. The report was compiled and presented to the previous Administration at the end of its term of office, but it is just within the past week or so that it has been resubmitted to the current minister. Billy Reid might have a better idea of timetables than I do.
I do not think I do. The report was presented to the minister on 20 September, so we are waiting for a response.
I suggest that we write to the minister, who might give us some idea of when we are likely to have the report.
That would be helpful. I would not want the SI to be delayed today. In writing to the minister, I encourage the committee to agree to support the form of words that I have brought with me.
I wonder whether I can first put some questions to the committee and see then whether we can reach a form of words that you might be content with.
In light of the working group's review, the comments that we have heard today on the details in the minister's letter about the provision of wigs in the NHS and the fact that we have agreed to write to the minister to find out when she will report to us on the matter, does the committee agree to wait for the review's outcome and then to comment accordingly in our report on the regulations to the Subordinate Legislation Committee?
When we write to the minister, can we ask specifically for a copy of the working group's report?
I think that it will be in the public domain, but we can certainly ask for a copy.
On a technical point, are people who suffer from total alopecia as a result of cancer treatment eligible for free wigs or do they still have to pay prescription charges?
That depends on where the prescription is made. If the prescription is made for dispensing at the hospital, it will be free of charge; however, if a patient is in the community and is not exempt under other exemption criteria, he or she will be liable to the charge.
So the provision is provider-focused, rather than patient-focused.
Yes.
I suggest that, in writing to the minister, we ask that the review be patient-focused, not provider-focused.
We do not think that the review has dealt with that matter, so we can certainly raise it with the minister.
The executive note to the regulations states:
The provision is specific to people who are being treated on the premise that they have TB.
So people who might have TB will have to pay for their drugs.
Yes, until it becomes a condition that looks as if it is TB.
We are backtracking somewhat. So far we have agreed to await the review's outcome, to write to the minister and to ask whether the review has been patient-focused rather than provider-focused. Have I missed anything?
We were going to ask for a copy of the report.
Indeed. I missed that.
I am not backtracking. I agree that any treatment that is to be prescribed—
All I am saying is that we have already agreed part of our response to the Subordinate Legislation Committee. However, Dr McKee raises an interesting issue from experience that he might wish to pursue with the minister or through a parliamentary question.
It seems only reasonable for such a public health issue to be covered in public health regulations.
Are members content with the other points that we have been discussing?
I thank the witnesses for their evidence and thank members, particularly Helen Eadie, for raising certain issues.