POLITICS

During my ritual Sunday night ring-around in search of columnar knowledge, I had hoped to track down Peter Bradley. The Westminster public affairs consultant-turned-Labour MP for The Wrekin had made an interesting attack on the dirty habits of the pharmaceutical trade about the same time that NATO was attacking Serbia.

No luck. Mr Bradley's airspace was defended by answerphones, pagers and the like. A pity, because he was reviving the 1994 health select committee complaint (echoed in 1996 by the BMA) about drug firms pushing expensive branded drugs in hospitals as cheap 'loss leaders' so that patients insist that GPs continue to prescribe the same medicine, at far greater cost.

Much more cheerful, he raised the prospect that things are finally being done about it. And about time, too. The British pharmaceutical industry is a global mega-player, but it has dirty habits, including over-charging the NHS, as his Dobship complains. In this instance, claimed Mr Bradley, you can pay 20p per patient a day for a diuretic in hospital and£6.20 per patient in the community, where 80 per cent of drugs are actually prescribed.

The difference between branded and generic drugs costs his own health authority, Shropshire,£400,000 a year. To complicate matters, being a rural-ish area, some of its doctors are entitled to dispense drugs as well as prescribe them for the convenience of patients far from Boots. The average dispensing GP makes an extra£7,500 from the task, which compensates for GPs' lower rural incomes.

But - and here's the rub - non-dispensers among our 23,000 GPs only prescribe 24 per cent branded drugs; the 4,000 GP dispensers - with 3.2 million patients - an average 74 per cent. The difference in Shropshire alone is that while the latter dispense only 28 per cent of drugs, they account for 36 per cent of the county's£1m annual overspend. To complicate matters, as the remuneration formula stands, the higher the drug price, the more the GP earns - 'a built-in incentive' to prescribe dearer stuff, Minister Denham conceded.

What is to be done? The Health Bill is taking new powers over prices, but here we are talking habits. Shropshire, says Mr Bradley, is trying to identify costly hospital brands and replace them with cheaper generics in hospital, boosting the initiative with software packages for computer- minded GPs to track down the best buys. Health ministers have proclaimed that by 2002 they want generic brands to account for 72 per cent (currently 63 per cent) of the£5bn NHS drugs budget.

Furthermore, he and John Denham agreed in the Commons that primary care groups from this week will start generating greater co-operation between primary and secondary care, seeking to eliminate what he delicately called 'the temptation to shift the cost of treatment to another budget'.

Menacing phrases like 'peer-group review' and 'unified budgets' were bandied around along with Department of Health-sponsored computerised decision-support systems like Prodigy, though Mr Denham will move more warily about changing the way rural GPs get their cash. Many GPs are well aware of the problem and doing their best, interjected another Labour new boy, Dartford's Howard Stoate, who happens to be a GP himself.

I couldn't raise him on the Sunday night phone either. But I did catch Dr Jenny Tonge, Lib Dem MP for Richmond Park, who was a community physician until 1 May 1997. As such, she never sees a prescription pad. But she was cross with the government over what she calls public health minister Tessa Jowell's pathetic response to her mini-debate on teenage pregnancy, where Britain leads Europe.

If we look at Denmark, it has cut the teen pregnancy rate from 50 per 1,000 30 years ago (the same as ours) to 8 per 1,000, while we are stuck at 30. Good sex education, available contraception and advertising are the answer, fumes Dr T. But ministers are obsessed with fashionable ideas of social exclusion - ie that poverty, low self-esteem and ill-education are the cause.

It's what Sir Keith Joseph used to call the cycle of deprivation. 'I think they're scared of the Daily Mail,' says Dr Tonge. She will be watching the government's long-promised report on teen sex, linked to the problems of sexually transmitted disease, with an eagle eye.