Letter: No simple prescription for drug bill

Sir: Your correspondents David Sharpe and Selwyn Learner (Letters, 14 March) say much about the Audit Commission's report on prescribing and Mr Sharpe, in particular, argues the pharmacist's corner. What they both, and Nicholas Timmins in his original article (8 March), sidestep is the overriding issue when looking at the complex area of prescribing. That is the principle that responsibility for clinical judgement on a patient's condition and any subsequent treatment is the GP's and should remain so.

Mr Sharpe highlights the issue of generic prescribing, and my committee will consider this shortly, but I am afraid 'he would say that, wouldn't he?' has to be my response to his other pleas for a greater role for pharmacists to the detriment of GPs and the principle outlined above.

The reality in addressing any such calls for changes in current practice on prescribing is that the overwhelming workload of GPs militates directly against such ideals. When you're on duty 24 hours a day at times and more and more patients are coming through your door with higher expectations fuelled by initiatives such as the Patient's Charter, then it is difficult, some would argue impossible, to re-examine prescribing practices in the fundamental way indicated in the Audit Commission's report.

We will discuss these proposals with the Department of Health but it is important that the issue of prescribing is not seen in isolation - there is no simple prescription for this particular problem.

Yours faithfully,

IAN BOGLE

Chairman

General Medical

Services Committee

British Medical Association

London, WC1

14 March