Health Bill

Debate between Baroness Pidgeon and Baroness Janke

Committee stage
Monday 9th November 2026 Lords Chamber

[Baroness Janke (LD)]

My Lords, I thank the noble Baroness, Lady Coffey, for noticing my apparent absence and am happy to reassure her that I am here and in the flesh.

Amendments 63, 64 and 108 to 110 in my name underpin the importance of community pharmacies to local healthcare provision and the importance of maintaining continuity of the services that they provide —as well as reassurance for the pharmacy workers and residents. Pharmacies are the pillars of local healthcare and have become even more essential as waiting times for GP appointments have grown. However, the picture of local pharmacies is changing, as the noble Baroness, Lady Coffey, has said, for different reasons. More than 1,300 pharmacies have closed over the last decade and more are operating at a loss, leaving many communities risking a lack of access to a crucial front-line service.

Pharmacies, of course, are independent contractors, not public agencies, so the means of ensuring their continuation and continuity of care are perhaps going to be different. But, on this side, we feel that to maintain continuity of service in the light of the failure of local pharmacies, whether through financial or other difficulties, is essential. Amendments 63 and 108 would give stronger powers of intervention to ICBs when pharmacies are failing to provide their contractual services, whether through business failure or other reasons. They need to maintain their services, which are vital to their communities, and to address issues of availability of treatments and medicines.

Amendment 110 would require that staff be paid and protected during any intervention or remedial action that may take place in the operation of a pharmacy’s services. Staff do not need to lose confidence and leave what they see as an insecure situation, resulting in closure of the pharmacy through lack of staff. Amendment 109 would place an obligation on the Government and ICBs to support, in the event of failing, closed or disrupted pharmacies, new and independent pharmacies taking over to establish new relationships with pharmaceutical manufacturers and suppliers so that the continuity of the local service can be effectively maintained. Amendment 64 would require pharmacy funding to reflect the

“costs of providing services in rural and sparsely populated areas”.

These are often areas of low income, where the health of the local population is poor and pharmacy services are much needed, but where private pharmacy businesses have difficulty in being able to thrive.

These amendments are particularly relevant, as so many pharmacies are increasingly unable to sustain themselves as private businesses and changes to the operation of pharmaceutical services overtake them. These amendments, if accepted by the Government, would show a commitment to local pharmacies as essential providers of local healthcare and ensure that front-line services, which are very much in demand, are retained where and when they are particularly needed.

[Baroness Pidgeon (LD)]

My Lords, getting primary care right is absolutely crucial for our health service to work for patients and to ensure that neighbourhood health really delivers. Amendment 61 in my name would ensure that access to NHS sight tests remains nationally protected and is not subject to local variation once integrated care boards take on the commissioning of primary ophthalmic services. The national sight testing service remains the foundation of eyecare across the country and is one of the most effective public health services in the NHS. Primary eyecare in England provides more than 23.6 million appointments every year, covering sight tests, enhanced eyecare services and contact lens care.

Protecting vision means supporting people’s independence and safety, including from falls and accidents, and enables people to live well and work well. It is important, as raised by my noble friend Lord Scriven, for the needs of people with a learning disability. The national contract model is the most cost-efficient way of commissioning the service for the NHS. This is because the funding offered by the NHS, as we have already heard, does not come close to covering the cost of an eye test, and it is feared that any fragmentation of the commissioning route will only add more bureaucratic costs. This is a probing amendment, and I would be grateful if the Minister could confirm whether the national NHS sight testing service provided through this cost-effective national contract model will remain in place under the Bill. I also fully support Amendment 61A from the noble Baroness, Lady Gerada, on access to community-based, urgent and minor eyecare.

Amendment 218 in this group would give patients a new right in the NHS constitution to receive a GP appointment. Patients should be able to access primary care when they need it, and too many people across the country are forced to wait weeks for a GP appointment, only to see their condition deteriorate, which does ultimately place greater pressure on emergency departments and hospital services.

That is why these Benches are proposing a new right in the NHS constitution for patients to receive a GP appointment within seven days or within 24 hours if their need is urgent. This is not merely a target but a commitment to restore confidence in GP services and to ensure that timely access to primary care is recognised as a fundamental patient right.

General practice remains the front door to the NHS. Ensuring prompt access to a GP can lead to earlier diagnosis, more effective treatment and better management of long-term conditions, as we heard from the noble Baroness, Lady Gerada. Ultimately, it can reduce demand on overstretched hospitals. The amendment on continuity of care from the noble Baroness, Lady Neville-Rolfe, and supported by the noble Baroness, Lady Gerada, is really important to consider as part of the Bill.

My noble friend Lady Janke’s amendments on ensuring that community pharmacies are supported is important. Her challenge on the cost of medicines and how pharmacists are reimbursed is an important issue that was raised when the Public Services Committee looked at medicines security. I was quite astonished that pharmacies often provide medication at a loss; it is no wonder so many are going under. This group is really important, so I hope the Minister can assure the Committee.