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At the heart of general practice since 1960

Ministers insist ban will aid care despite opposition from MPs and doctors

Government rules out co-proxamol U-turn

By Daniel Cressey

Ministers have ruled out a

review of the co-proxamol

withdrawal and claimed forcing GPs to take legal respon-sibility for its use will improve

patient care.

The Government's bullish

response came as the drug

regulator sparked fresh controversy by claiming there had already been 'public health benefits' from the drug's phase-out.

Speaking in a Commons debate last week, public health minister Caroline Flint admitted some patients would find it difficult to find suitable alternative pain relief.

But she insisted forcing GPs to prescribe co-proxamol on a named-patient basis would produce a 'stronger focus on the risk-benefit judgment'.

Ms Flint faced calls from MPs in her own party to reverse the decision, with suggestions that it could be used as a controlled drug instead.

Citing two separate Pulse

articles, Anne Begg, Labour

MP for Aberdeen, said: 'It is difficult for me, as a lay person, looking at the papers on which the Medicines and Healthcare Products Regulatory Agency based its decision, to find the justification for a full ban.'

Dr Howard Stoate, Labour MP for Dartford and a practising GP, said: 'In effect, the MHRA is saying to GPs that it does not trust them to make the right decision on behalf of their patients, and that clearly runs counter to the Government's policy of devolving more power and clinical responsibility to frontline health professionals.'

But Ms Flint responded: 'Clear provision in legislation gives the right to prescribers to prescribe unlicensed medicines if it is judged to be in the best interests of the patient. That, I think, is the best way forward.'

The MHRA responded to the debate by reiterating its support for the withdrawal and claiming there had already been an impact on suicides.

But when challenged it cited data from before the withdrawal was announced – provoking strong criticism from GPs.

It also claimed co-proxamol-related suicides were dropping.

But Dr George Kassianos, a GP in Bracknell, Berkshire, said: 'The MHRA mentions the number of suicides with co-proxamol but not suicides with the drugs we are using to replace it.

'We are getting a quarter of the story from the MHRA, not even half the story.'

dcressey@cmpmedica.com

July 2005

Public health minister Caroline Flint to the Commons:

'An article in the May edition

of Pulse was authored by a GP who reduced the number of patients in his care on co-proxamol from 438 to 20. That demonstrates that good GP care and discussing issues with patients can effect a change to an alternative that works.'

January 2007

Anne Begg MP to the Commons:

'An article in October's Pulse had the headline "GPs demand U-turn on co-proxamol ban". I've asked for this debate so we can get a sensible solution for a small group of patients – the 20 the GP in the 2005 Pulse article still prescribed co-proxamol to even after trying to remove it from all his patients.'

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