Healthcare Services: Acute, Primary and Community

Baroness Leaman Excerpts

Thursday 25th June 2026 Lords Chamber

[Baroness Leaman (LD)]

My Lords, I am grateful to my noble friend Lady Janke for securing this important debate. I will focus my remarks on the crisis in medicine supply, the collapse of our community pharmacy network, and the impact that these failures are having on patients, particularly children with ADHD, many of whom have just finished sitting their exams without access to the medication they need.

Since September 2023, we have witnessed a sustained and debilitating shortage of ADHD medications across the UK. Medicines on which hundreds of thousands of children and adults depend have been intermittently unavailable for nearly three years. At the height of the crisis, patients were reported to be travelling over 50 miles simply to find a pharmacy with stock. The House of Lords Public Services Committee, in its February report, Medicines Security: A National Priority, made the stark assessment that medicine supply shortages represent a potential national security issue. Some 73% of pharmacy workers stated that ongoing supply issues are putting patients at risk.

Consider what it means for a child with ADHD to face their GCSEs or A-levels without their medication. For many young people, that medication is the difference between demonstrating their knowledge, ability and hard work, and sitting in an exam hall unable to engage with the paper before them. Students have reported rationing tablets, taking half doses or going without entirely during the examination period. Parents have spoken of the distress of watching children who have worked diligently throughout the year face their papers in a state of disadvantage not of their making.

This is a vivid illustration of the Motion before us. When primary and community services fail to ensure consistent supply, the fallout is immediate. We do not only jeopardise a child’s health but derail their education and shatter their well-being. In the most severe cases, this pushes vulnerable young people into acute crisis, ultimately driving up demand on the very services already at breaking point.

The causes of these shortages are complex but not mysterious. The OECD identified, as far back as 2022, that medicines shortages were increasing globally, but here in the UK we have compounded these global pressures through our own policy choices. The first is our departure from the EU. A Nuffield Trust report in March confirmed what many had long warned: Brexit has been a key factor in the worst UK medicine shortages in four years. Between 2020 and 2023, drug shortages in this country more than doubled. Leaving the European Medicines Agency, losing our place in the EU bulk-buying scheme and creating additional regulatory complexity has significantly weakened our position.

The second is our overreliance on overseas suppliers. The Lords Select Committee noted that the majority of active pharmaceutical ingredients required by the NHS are controlled by China, India or other single sources. We have allowed our domestic manufacturing capacity to wither. The Government’s commitment of up to £520 million to manufacture more medicines domestically is welcome, but it comes late and it must be accelerated.

Even when medicines are available, patients must be able to access them. As my noble friend Lady Janke highlighted, some 700 pharmacies have closed permanently since 2022, leaving England with its lowest number of pharmacies in nearly 20 years, with the National Pharmacy Association warning that 63% of pharmacies could close within the next year.

The Government have taken some steps: the Community Pharmacy Contractual Framework for 2025-26 provides £3 billion in funding, and the expansion of Pharmacy First is welcome. We need to treat medicine supply chain resilience as the national security issue it is and place it on the national risk register, as the Lords committee recommended.

We need a critical medicines list and an active pharmaceutical ingredients list to identify vulnerable supply chains, inform stockpiling and guide domestic production. We need better communication of shortages to front-line staff, so that GPs, pharmacists and hospital clinicians can take timely action. We need proper investment in community pharmacy, enough not merely to survive but to thrive and expand services as the NHS 10-year plan envisages. As a matter of urgency, we need specific measures to protect children with ADHD during examination periods: emergency supplies, priority allocation and whatever it takes to ensure that young people are not disadvantaged by failures in our supply chain.

The relationship between acute, primary and community healthcare services depends fundamentally on patients being able to access the medicines they need, when they need them and where they need them. At present, we are failing that test: children are sitting exams without medication, pharmacies are closing at an alarming rate and supply chains remain fragile and reactive. The Government have acknowledged the problem, but acknowledgement is not enough. Urgent, sustained and adequately funded action is needed. I look forward to hearing the Minister’s response and I hope we will hear commitments that match the scale of the crisis.