Working for Patients: NHS reform and drug budgets

Abstract

fter 12 months of secret planning,the Conservative’s plans for reform -ing the NHS were outlined in Working forPatients, published in January 11989.The white paper voiced government con -cerns over public spending on drugs:‘Expenditure on medicines has grown onaverage by 4 per cent a year above therate of inflation over the past five years’,and the cost of the drugs is ‘more thanthe cost of the doctors who wrote the pre -scriptions’. Not only were worries expressedabout the growth in the drugs bill, but thepolicy document also announced the gov-ernment’s desire to reduce unexplainedvariations in prescribing costs, which hadbeen found to exist between different GPsand regions in the UK. At the time, theaverage cost of the prescriptions dis -pensed in the 90 English Family HealthServices Authorities (FHSA) variedbetween £33.30 and £59.65 per patient,around a mean of £47.66, with sizeablevariations also existing between practiceswithin the various areas.