National Health Service (Charges and Pharmaceutical and Local Pharmaceutical Services) (Coronavirus) (Amendment) Regulations 2021

Baroness Wheatcroft Excerpts

Monday 26th April 2021 Lords Chamber

[Baroness Wheatcroft (CB) [V]]

My Lords, as others have said, community pharmacies make a huge contribution to life in the UK. I support this narrow statutory instrument but I deplore the position in which so many pharmacies have been left.

Let us look at what community pharmacies do and what they could do. They already take a huge weight off GPs and the accident and emergency services, effectively providing a triage service in many cases but often dealing with the problem all the way through. They provide emergency out-of-hours services, particularly for those who are terminally ill and need special medication, perhaps at night when other services are shut. They provide screening services, which are essential if we are to keep our population on the right side of healthy. They deal with minor ailments. They provide obesity management, which we all know is absolutely crucial for the future. They also provide phlebotomy, taking quite a lot of the effort of blood tests out of hospitals, which are so overstretched at the moment. They can provide stop smoking clinics; again, these are essential for modern life, where we need to kill tobacco before it kills people.

As we have seen in the past 18 months, pharmacies can also provide vaccination services. This is going to be increasingly important because it appears that vaccination is going to be not a matter of getting through this particular Covid epidemic but an annual event. We will need all the vaccinators we can find. How much more could our community pharmacies do?

If ever we are to see the combination of health and social care that has long been seen as the holy grail for a healthy, comfortable and happy society, community pharmacies must be a crucial part of it. They can straddle the ground where local government and the NHS meet. They can broker understanding and they can broker solutions, to make it sensible, convenient and comfortable for people to live in the community, rather than being sidelined in homes. But what is happening to those pharmacies? The EY report published last September, commissioned by the National Pharmacy Association, found that the current network in England is

“unsustainable under the current financial framework”.

EY projected that by 2024, 72% of pharmacies will be in deficit, with an overall shortfall to the sector of £43,000 on average to each pharmacy and concluded that no industry is sustainable with so many operators in default. Already 28% to 30% are in default and, according to the survey, 52% are planning to sell their businesses. If the businesses are in deficit, there will not be people queueing up to buy them, yet a hit of 52% to our network of community pharmacies would be completely disastrous. The National Pharmacy Association, which commissioned the survey, called on the Government to take a “public interest focused safeguards” approach against the pharmacy network collapsing. Can the Minister commit to re-examining the funding model with that public interest safeguard central to the thinking?

Pharmacists undergo long training and bring vast medical expertise to their dispensing role, but they dispense far more than just medicines. They are there to provide advice and they offer humanity. For many elderly people, the visit to the pharmacy is one of the major points of contact with human beings during their week. They provide centres for communities. In many cases, they are core to the continued survival of a viable high street.

We have seen so many shops closing due to Covid and not reopening. The trend was already under way with internet shopping, but it has been exacerbated by the virus. In many cases, however, the community pharmacy continues to draw people into an area and therefore provide footfall to sustain the other shops and cafés which bring life to an area. They do not have the type of footfall that appeals to the major chains. In many cases, the major chains have a business model that depends on large sales of make-up, toiletries, photographic equipment—you name it. That is what keeps them trading, while the pharmacy just draws a few extra customers into the business. However, the pharmacies that are hubs to so many communities have only minor add-on sales. They are at the heart of the communities because they provide an essential service to the people who live locally. If those streets are to survive, they need the pharmacies to survive.

Therefore, while I support this statutory instrument, I also support the call from the noble Lord, Lord Hunt, for the Government to re-examine the funding and to make a short-term £350 million improvement to the way these pharmacies survive; otherwise they will simply die in front of us, and we cannot afford to see that happen. Already, the Government have indicated that they would prefer to use a firm such as Greensill to provide these pharmacies with the speedy payments that they need, rather than speeding up the payment itself. So many pharmacies had to opt to use that service because they needed the cash flow immediately and could not wait for the Government to pay their bills. Those who have tried to sign up since the middle of March have been unable to. Therefore, my final question not the Minister is: can he undertake to ensure that the Government pay pharmacies promptly for the service that they provide, so that they do not have to resort to external factors to get their money on time?