Jackie Baillie (Dumbarton) (Lab): I welcome the opportunity to debate prescription charges and consider the NHS's spending priorities. Given the short time that is available to me, I will focus on prescription charges. I hope that there will be further opportunities in the months to come for us to debate priorities for the NHS at greater length.

It is no secret that, in the previous session, Labour members did not favour the complete abolition of prescription charges; rather, we preferred an incremental approach that would have meant extending free prescriptions to those with long-term chronic conditions and those on a range of top-up benefits as a result of low incomes. Some have questioned—it has happened again today—why MSPs should be given free prescriptions, given that we can afford to pay for them. Currently, 92 per cent of all prescriptions in Scotland are issued free, but there is an issue: a proportion of the remaining 8 per cent of people have chronic conditions and may require substantial levels of medication, which some might struggle to afford—I agree with the cabinet secretary on that.

We could spend a lot of time rehearsing old arguments today, but I do not want to do that. The cabinet secretary and the Scottish Government have reached a judgment about the value and affordability of prescription charges. I confess that that flies in the face of John Swinney's speech on the budget yesterday, but they have reached a judgment, and we will not stand in the way of the policy. Some £32 million has been provided in the budget for the policy for the coming financial year, £45 million has been provided for the next financial year, and the total recurring cost has been set at £57 million from April 2011. As I said, we will not stand in the way of the policy, but that does not mean that we will suspend our critical capacity to consider how it is developed.

I want to focus on three issues. The first is how sustainable the policy is. We know that it is likely that demand for medicines will grow, and I understand that the cabinet secretary has factored that in, but I cannot tell at what level. What percentage growth has been allowed for? What will the costs be as we move forward to 2012, 2013 and 2014 and the financial belt begins to tighten? We need to know how sustainable the policy is so that we can base our views on that.

Secondly, can the cabinet secretary guarantee that the policy will not compromise patient care? I am sure that members understand the concern that already exists that the so-called efficiency savings that health boards are making are having an impact on front-line services. If the cost of funding free prescriptions continually rises, that will have an impact on money for other priorities. I am sure that no member would want that, and am therefore interested in the cabinet secretary's view on the matter.

David McLetchie (Edinburgh Pentlands) (Con): Will the member explain why her party never considered abolishing prescription charges in the more than 10 years for which her party was responsible for the health service in Scotland and health expenditure was rising, but it is suddenly not standing in the way of that when health expenditure is likely to flat line?

Jackie Baillie: The member will recognise that health spending in Scotland is at an historic, all-time high and that it is above the per capita level in the rest of the United Kingdom. The Tories and Labour have maintained that over our history. As I explained earlier, we were moving to extend the coverage of free prescriptions.

The third issue that I want to consider is the impact of free prescriptions on the minor ailments service. That issue has been raised several times with ministers, but I regret that no clear response has been given.

Nicola Sturgeon: Will the member give way?

Jackie Baillie: I will develop my point, after which I will be happy to let in the cabinet secretary.

The minor ailments service applies to people who do not pay for prescriptions. People can go to their local pharmacist for advice or to get medicine for a minor illness without needing to make an appointment with their GP. That service is tremendous: it is convenient and it frees up GP appointments. Of course, we will all have free prescriptions soon. Does that mean that we will be able to get free medicines for minor ailments directly from pharmacists? I will give members an idea of some of the minor ailments that I am talking about: they include backache, earache, hay fever, headache, indigestion, mouth ulcers, pain—that is a general term—and sore throat. The list goes on and on. On 5 December 2007, the cabinet secretary told members that the Government was considering the implications of abolishing prescription charges and that announcements would be made. I am not clear that those announcements have been made, but perhaps I missed them; I would welcome clarification on that. I do not think that any member wants the unintended consequence to be that, rather than using pharmacists, people revert to cluttering up GP surgeries, because the prescriptions that GPs issue will be free.

I am happy to give way to the cabinet secretary if she can clarify that point.

Nicola Sturgeon: I apologise if Jackie Baillie has not seen the clarification of that. I may be wrong, but I am sure that it has been given to her colleagues in the past. There is no evidence, from our experience so far, that the number of GP appointments is increasing in that way because of prescription charges. We have made it clear that the eligibility criteria for the minor ailments system, which are currently based on the eligibility criteria for free prescriptions, will remain the same after prescription charges have been abolished. We gave that clarification some time ago, and I am happy to provide it to Jackie Baillie in writing.

Jackie Baillie: I just looked at Mary Scanlon and Richard Simpson, who have held the health brief for much longer than I have, and they do not recall that clarification being given either.

Is it the case, as the cabinet secretary has just said, that everybody who is in the minor ailments scheme will be eligible for free prescriptions for all the services that are offered?

Nicola Sturgeon indicated agreement.

Jackie Baillie: I take that as a yes from a sedentary position.

I am conscious of the time, so I turn finally to the consequences of the Tory motion. Members will know that we have encouraged the Scottish Government to bring prescriptions for cancer patients in Scotland into line with those in England and Wales. We are not asking for that to be done instead of addressing prescription charges for other chronic conditions, and it is wrong of the cabinet secretary to suggest that. Ours is not an either/or amendment. Charges for cancer patients were scrapped by the UK Government last April, yet cancer patients in Scotland are still waiting for that. It was absolutely right to abolish charges for cancer patients, and it has transformed the lives of around 150,000 people who have benefited by saving up to £100 a year. Voting for the Tory motion would put that in jeopardy, never mind the benefits to the other categories of people who would qualify in the roll-out of free prescriptions. We, on this side of the chamber, will not do that. The challenge for the Government is to include cancer patients now and to ensure that concerns about the sustainability of the extension of free prescriptions are addressed.

I move amendment S3M-5572.1, to leave out from "withdraw" to end and insert:

"immediately implement free prescriptions for cancer patients as has been the case in England since April 2009."

Official Report Thursday 21 January 2010 - Prescription Charges