LETTER : Bromley's policy on prescribing

From Ms Claire Perry and

Dr Jackie Spiby

Sir: We were pleased to see the debate about the prescribing of expensive drugs (reports, 3 May). We should like, however, to make a number of points clear.

Bromley Health has not told GPs that they cannot prescribe certain drugs because they are too expensive. If a doctor writes a prescription for a drug he or she takes full clinical and legal responsibility. What we have done is to make it clear to our GPs that if they are unhappy about prescribing certain very specialist drugs because they do not feel that they have the specialised knowledge to manage the care of those patients, then we will back them up by talking to the hospitals and asking the hospitals to prescribe the drugs and to manage the care of the patients. They have, after all, the specialist expertise necessary to provide the very best care for patients.

If GPs are happy to take on the responsibility for such patients, they are free to prescribe any drug which is on the Department of Health's list. They are not expected to ask Bromley Health's permission. There is certainly no question of Bromley Health denying patients the care and drugs which they need.

The work has been developed using national guidance, and in conjunction with our local GPs, pharmacists and doctors. Although we have taken an additional step of identifying specific drugs, it is not a unilateral or unprecedented action but a continuation of national policy.

Yours sincerely,

CLAIRE PERRY

Chief Executive

JACKIE SPIBY

Director of Public Health

Bromley Health Authority

Hayes, Kent

3 May