Community Pharmacies
Jonathan Ashworth Excerpts(9 years, 4 months ago)
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Jonathan Ashworth (Leicester South) (Lab)
I beg to move,
That this House notes that community pharmacies are valued assets that offer face-to-face healthcare advice which relieves pressure on other NHS services; calls on the Government to rethink its changes to community pharmacy funding; and further calls on the Government to ensure that community pharmacies are protected from service reduction and closure and that local provision of community pharmacy services is protected.
This is an issue that affects many of our constituents, and it has aroused considerable opposition from so many of them that 2.2 million people have signed a petition. Community pharmacists, I am sure, have lobbied Members of all parties about these cuts and have explained why they should be opposed. Indeed, Members of all parties have raised their concerns and their opposition to these cuts.
I pay particular tribute to my hon. Friend the Member for Barnsley East (Michael Dugher), who has campaigned tirelessly on this issue, and to my right hon. Friend the Member for Rother Valley (Kevin Barron). Government Members have also raised their opposition in Westminster Hall debates, Adjournment debates and parliamentary questions. Their opposition to the cuts is entirely understandable.
When the Government announced, in December last year, that they were going to pursue the cuts, they talked of cutting the budget for community pharmacy services by £170 million, with further cuts to follow. Opposition to the cuts was clear, and indeed was heightened when the previous Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), who I see in his place and for whom I have tremendous respect, suggested that the cuts could lead to the closure of up to 3,000 community pharmacies.
Andy Slaughter (Hammersmith) (Lab)
We have had a lot of correspondence from local pharmacists and their customers worried about essential parts of the local community such as businesses, but is it not also the case that, with massive cuts in acute services and with primary care under pressure, those pharmacies provide an essential and cost-effective part of the local health service, which we simply cannot do without?
Jonathan Ashworth
My hon. Friend has anticipated my argument—I could probably sit down now that he has put it so eloquently, but I shall plough on while I have the indulgence of the House.
I was saying that the right hon. Member for North East Bedfordshire had said that the cuts might lead to some 3,000 community pharmacies closing. Then, of course, the right hon. Gentleman left his post in the Department of Health, which we are all very sad about. Now we have a new Minister, and we are delighted to welcome the hon. Member for Warrington South (David Mowat) to his place—not least because in one of his first interventions when he was allowed out, he visited the Royal Pharmaceutical Society’s annual conference in September and said he was delaying the cuts. He said:
“I think it is right that we spend the time, particularly me as an incoming minister, to make sure that we are making the correct decision”.
He continued by saying that
“what we do is going to be right for you, is going to be right for the NHS and right for the public more generally.”
Well, if the Minister had left it there—with that U-turn—he would have won the praise of Labour Members.
Unfortunately, we then had a U-turn on the U-turn from the Minister. When the Minister came before the House last month we found out that, far from having listened, taken account of various consultations and decided to do what was best for the NHS, he intended to impose a 12% cut on current levels to pharmacy budgets for the remainder of this financial year—giving pharmacists just six weeks’ notice—and a 7% cut the year after that.
Jonathan Ashworth
Because she represents my mother’s home town, I will give way first to my hon. Friend the Member for Stretford and Urmston.
Kate Green
It is a privilege to represent my hon. Friend’s mother, and he, of course, knows my constituency well. The constituency has high levels of deprivation, and our primary care services face incredible pressure owing to unsuitable practice premises and the difficulty of recruiting GPs. Does my hon. Friend agree that with only seven weeks’ notice, it is impossible for GPs, other primary care providers and pharmacists to accommodate and make provision for these cuts in a way that will allow them to continue to support deprived communities in my constituency and, indeed, the constituencies of all Members?
Jonathan Ashworth
My hon. Friend is absolutely right. That is why the cuts have aroused so much opposition from not just Labour but Conservative Members.
Catherine McKinnell
My hon. Friend is making an excellent speech. Over the past few years, a significant amount of work has been put into the Think Pharmacy First campaign, whose aim is to take pressure off GPs, ambulances and A & E services, but is “Think Pharmacy First for cuts and closures” really what the Government have in mind?
Jonathan Ashworth
My hon. Friend has made a powerful point, which completely blows apart many of the arguments that the Government have advanced in recent years.
Jeremy Quin (Horsham) (Con)
Given the clustering of pharmacies, does the hon. Gentleman believe that no better way of funding the service can be envisaged?
Jonathan Ashworth
The cuts are not aimed at clusters. They are completely arbitrary, and they will result in the closure of many pharmacies in some of the most deprived parts of the country.
Several hon. Members rose—
Jonathan Ashworth
I want to make a bit of progress, because I know that many other Members wish to speak.
The cuts will mean that patients, many of them elderly and unable to travel long distances, will be forced to go elsewhere for essential medical advice and support. What we need from the Minister now are the details of how many pharmacies will close. The previous Minister, the right hon. Member for North East Bedfordshire, told us that up to 3,000 community pharmacies—a quarter of all pharmacies—could close.
Alistair Burt (North East Bedfordshire) (Con)
It may be helpful if I make a brief intervention at this stage. I gave an estimate which was based on what we thought was a possible worst-case scenario. The Department never had any plans to close pharmacies. It was the best estimate that I had at the time, but it was not a definitive figure.
Jonathan Ashworth
The right hon. Gentleman is an extremely experienced former Health Minister, possibly the most extreme—[Laughter.] He is definitely not an extremist, but he is possibly the most experienced Conservative former Health Minister apart from, perhaps, the right hon. and learned Member for Rushcliffe (Mr Clarke). It is very noble of him to try to get the Minister off the hook, but the fact remains that he was the one who said that 3,000 pharmacies would close, and we will continue to remind Ministers of that.
Jonathan Ashworth
I will give way to the former Chief Whip, but then I will make some progress.
Dame Rosie Winterton
Doncaster pharmacists have told me that at least 20 pharmacies in the town will close as a result of the cuts. That is their estimate, on the ground. They have also told me that the Government should sit down with pharmacists and engage in meaningful discussions about pharmacy delivery. For example, setting up a minor ailments service and cutting the drugs budget could possibly save the NHS £5 million in Doncaster and £650 million overall.
Jonathan Ashworth
My right hon. Friend is absolutely correct. She was not only an exceptional Chief Whip but an exceptional pharmacies Minister in the last Labour Government, and she knows how foolhardy it would be to make cuts in the pharmacy sector.
Dr Andrew Murrison (South West Wiltshire) (Con)
Will the hon. Gentleman give way?
Jonathan Ashworth
I should like to make a bit of progress, if I may. As I said earlier, I am extremely conscious that other Members wish to speak.
As we have heard, the former Health Minister said that 3,000 community pharmacies could close. When pressed about the figures last month, the current Minister said
“no community will be left without a pharmacy.”—[Official Report, 17 October 2016; Vol. 615.]
I hope he will confirm that he still stands by that statement. He also claimed:
“Nobody is talking about thousands of pharmacies closing”. —[Official Report, 17 October 2016; Vol. 615, c. 602-3.]
He obviously did not receive the memo from the right hon. Member for North East Bedfordshire. But what did he say when he was pressed by my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) about the number of closures? What soothing, reassuring words did he offer to all our constituents? He said, “I do not know.”
I am sorry that the Minister has not got a clue, but I hope that when he winds up the debate he will be able to tell us how many pharmacies will close as a result of these cuts. If he is not prepared to tell us that, will he tell us how many services will be cut?
Jonathan Ashworth
I will give way to the vice-chair of the all-party parliamentary group on pharmacy, but then I must make progress.
Oliver Colvile
Is the hon. Gentleman aware that the number of pharmacies has increased by 18% over the past 10 years?
Jonathan Ashworth
I know that the hon. Gentleman works tirelessly as a champion for pharmacies, but he knows that these proposals will mean cuts in many services.
Maria Eagle (Garston and Halewood) (Lab)
Many pharmacies in Halewood deliver medication, up to 8.30 pm, to elderly and vulnerable people who cannot get out of the house, and to care homes. What does my hon. Friend think will happen if those pharmacies have to close?
Jonathan Ashworth
I do not need to say what I think; I need to say what the sector thinks, and the sector has made it clear today that it will have to cut services such as the delivery of medicines to some of the most elderly and vulnerable members of society.
Jonathan Ashworth
I will give way to my right hon. Friend the Member for Exeter, but then I really must make some progress.
Mr Bradshaw
Although the Government say that they want to devote a greater proportion of overall health spending to primary care, our Health Committee’s report on primary care, published in the summer, showed that a smaller proportion was being devoted to the primary care sector, which, of course, includes pharmacies. Is that not the ultimate false economy? If we do not invest more in primary care, all the pressure goes into the acute sector.
Jonathan Ashworth
My right hon. Friend is another experienced former Health Minister, and he is right. As we learned this week, the Health Committee has completely blown apart the Government’s figures on the financing of the NHS.
Jonathan Ashworth
If I may, I shall make some progress. I promise to give way to the hon. Gentleman in a few moments, but I know that others wish to speak.
The Government will say that they are mitigating the cuts by introducing a pharmacy access scheme, but the scheme takes no account of the needs of the most deprived communities. The four constituencies that top the health deprivation and disability indices are Liverpool Walton, Blackpool South, Manchester Central and Blackley and Broughton. Not one pharmacy in those constituencies is eligible for the pharmacy access scheme. The least deprived constituencies are Chesham and Amersham and Wokingham. In Chesham and Amersham, 28% of pharmacies are eligible for this mitigating scheme, while in Wokingham 35% are eligible. [Interruption.] The Minister says that it is a disgrace, but those are the figures. Only this Department, which spins figures all the time and which has been discredited for the way in which it uses them, can call a pharmacy cuts package an “access scheme”.
Today, in an article in The Times, the Minister himself focuses on cities such as Leicester and Birmingham. He claims that if you walk
“along roads in Leicester you will see 12 pharmacies within ten minutes of each other”.
As the Member of Parliament for Leicester South, I walk along roads in Leicester every day. I do not know whether the Minister has actually walked along any of those roads; he has never told me that he has. Let me therefore extend an invitation to him to come to Leicester, where he will see numerous community pharmacists in areas with a high proportion of black and ethnic minority communities providing specialist services for families who have relied on them for 20 or 30 years, often dealing with elderly people and speaking to them in Gujarati, Urdu and Punjabi. Many of those people will have to go to GPs’ surgeries and A & E departments if the pharmacies are closed. The Government’s assessment takes no account of the disproportionate effect that the cuts will have on black and ethnic minority communities in cities such as Leicester and Birmingham.
Robert Jenrick
Will the hon. Gentleman at least acknowledge that we all support community pharmacies? The town I live in has 3,500 residents and there are four pharmacies within a quarter of a mile. Will he at least acknowledge that a model that gives a block grant of £25,000 to each of those pharmacies purely for establishing themselves regardless of demand obviously needs review?
Jonathan Ashworth
If the hon. Gentleman wants to tell his constituents he is in favour of closing pharmacies, good luck to him.
Of course it is not just pharmacy closures that we will see. The National Pharmacy Association has reported today that that 81% of community pharmacies will have to restrict services that help elderly people and 86% will have to restrict free services such as delivering medicine to housebound patients. Does that not confirm that the elderly and the most vulnerable will be hit the hardest by the cuts to community pharmacies, and the Government are entirely to blame?
Dr Murrison
Surely the hon. Gentleman accepts that we have to get the most efficiencies we possibly can from the system? His party colleague the right hon. Member for Doncaster Central (Dame Rosie Winterton) made a serious point about engaging with pharmacies to see how we can do it better. Does he agree—I would be interested to know why this is not in his motion—that category M clawbacks, which are levied exclusively on small independent pharmacies, might be extended to vertically integrated wholesalers as a way of making sure the system is more efficient than at present?
Jonathan Ashworth
The hon. Gentleman talks of efficiencies; he will presumably have seen the research that says if people cannot get to a pharmacy one in four will go to a GP. We will see greater demand on GP surgeries and A&E departments. That is not efficient. It is a false economy, which is why the Pharmaceutical Services Negotiating Committee has said the proposals are
“founded on ignorance of the value of pharmacies to local communities, to the NHS, and to social care, and will do great damage to all three. We cannot accept them.”
It is why the chief executive of Pharmacy Voice described the decision as
“incoherent, self-defeating and wholly unacceptable”,
and it is why charities such as Age UK have said the plans are
“out of step with messages encouraging people to make more use of their community pharmacists, to relieve pressure on overstretched A&E departments and GP surgeries.”
Age UK has hit the nail on the head: these cuts to community pharmacies completely contradict everything we have been told by Ministers over recent years and will lead to increased pressures and increased demands on GP surgeries and A&E departments.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
My hon. Friend has made some crucial points about how the funding has been allocated across our country. There are 129 community pharmacies across the whole of Liverpool, yet just two of them will be eligible for this payment. Does my hon. Friend agree that that is absolutely outrageous and will impact on the entire population of Liverpool?
Jonathan Ashworth
My hon. Friend is right, and even after this scheme is in place pharmacists who are eligible for the mitigating funds are still saying that they will have to close despite them.
We believe in the importance of community pharmacies, because
“pharmacies have a big role to play in this, as one in 11 or 12 A and E appointments could be dealt with at a pharmacy”—[Official Report, 25 February 2014; Vol. 576, c. 162.]—
and:
“Pharmacies have an important role to play, because they could save a significant number of A and E and GP visits.”—[Official Report, 23 October 2014; Vol. 586, c. 1049.]
Those are not my words: they are the words of the Health Secretary, said from that Dispatch Box over the last two years.
If the message the Health Secretary has been giving at that Dispatch Box is that community pharmacies are a way of relieving pressure on A&Es and GP surgeries, why is he now coming to the House to support cutting community pharmacies? It is a complete false economy. I will give way if he wants to explain that. He does not, probably because he knows it is a completely false economy.
Neil Coyle (Bermondsey and Old Southwark) (Lab)
Arundhati Patel runs the Jamaica Road pharmacy in my constituency and an alcohol cessation service is one of the services it provides to the local community. He pointed out there were 1,400 hospital stays in Southwark due to alcohol harm. On the point about efficiencies and avoiding visits to hospital that Members have talked about, is this not another example of what my right hon. Friend the Member for Exeter (Mr Bradshaw) called a false economy?
Jonathan Ashworth
My hon. Friend is right, and Government Ministers, including the Health Secretary even on Monday, justify these as part of a package of efficiencies. Indeed when I raised this a few months ago with the previous Minister, the right hon. Member for North East Bedfordshire, he told me in correspondence that these cuts were necessary as part of delivering the £22 billion-worth of efficiency savings. So this is more proof that when they talk of efficiency savings, they are actually talking of cuts to frontline services.
Jonathan Ashworth
I am sorry, but I need to make progress.
The NHS is going through the worst financial crisis in its 68-year history. Even the previous Health Secretary, who is now in the other place, said he did not expect another five years of such tight budgets for the NHS.
The black hole in hospital finances last year was £2.45 billion. Under Labour, we spent the European average on health as a proportion of GDP; we are now spending less than Greece. We are seeing a huge financial squeeze on the NHS and the cuts are part of that squeeze agenda.
We want the Government to think again on the cuts, because they will lead to more pressures on GP surgeries and A&E departments. There is a consensus not just among the Labour party, but among our constituents, the sector, clinicians and indeed Conservative Members against the cuts. It is Ministers who stand outside that consensus. The hon. Member for Stevenage (Stephen McPartland) has said:
“It does not make sense that we are encouraging pharmacies to take on a bigger role in the NHS, while potentially reducing the number of them.”
The right hon. Member for Broxtowe (Anna Soubry) has said:
“I do not think this 4% cut is a wise move.”—[Official Report, 20 October 2016; Vol. 615, c. 974.]
The hon. Member for Colne Valley (Jason McCartney) said
“when our A&Es are under so much pressure, we need community pharmacies”.—[Official Report, 17 October 2016; Vol. 615, c. 598.]
I agree and our message to Conservative Members who want to stand up for their constituents and who have been lobbied by pharmacists is, “Join us in the Division Lobbies and get Ministers to think again on these damaging cuts.” I commend the motion to the House.
David Mowat
The access scheme is the device that will ensure that pharmacies are not closed in a random way. I want to address the point about closures head on. It is my belief that there will be a minimal number of closures. The impact analysis talks about 100 and it models 100. The average pharmacy has a margin of 15%, and the amount of efficiency savings that we are asking pharmacies to make over two years is 7%. In addition, the average pharmacy is trading for £750,000 when it closes or merges, even after we announced these efficiency savings a year ago. That value is being retained.
Jonathan Ashworth
The previous Minister put a figure on this. Will the hon. Gentleman tell us what he means by a “minimal” number of closures? What is the number?
David Mowat
These are private businesses, each with a different business model and a different amount of income from the NHS, from other retail activities and from services. Each is financed in a different way. Indeed, 30% of them are owned by two public companies, and 70% of them are multiples.
David Mowat
I need to make some progress. I will give way in a moment.
At present, the average pharmacy receives NHS income of £220,000 a year, which is based on throughput of £1 million from the NHS. That translates into a value of the order of £750,000 for each pharmacy. When pharmacies merge or are sold, that is what they are traded for and the changes will not make a significant difference.
Returning to an earlier point, 40% of all pharmacies are located within a 10-minute walk of at least two others. Instances exist of a dozen or more pharmacies located within half a mile of each other. As I noted earlier, each one will most likely be receiving £25,000 a year just for being there.
David Mowat
I was brought up on the outskirts of Leicester, so I am delighted to tell the hon. Gentleman that I have indeed been there. Giving all these clusters £25,000 of national health service money is not the best way to spend precious resources.
In addition, the extra services that pharmacies will choose to provide, such as winter flu jabs and public health services, are commissioned separately and will be unaffected by the reset. For example, 600,000 flu jabs have been given in community pharmacies this year—more than all of last winter.
NHS Funding
Jonathan Ashworth Excerpts(9 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Jonathan Ashworth (Leicester South) (Lab)
(Urgent Question): To ask the Secretary of State if he will make a statement on NHS funding.
The Secretary of State for Health (Mr Jeremy Hunt)
Compared with five years ago, the NHS is responsible for 1 million more over-75s. In five years’ time, there will be another 1 million over-75s. Our determination is to look after each and every NHS patient with the highest standards of safety and care, but there is no question but that the pressures of an ageing population make this uniquely challenging.
I welcome the chance to remind the House of this Government’s repeated commitment to supporting our NHS. The NHS budget has increased in real terms every year since 2010. NHS spending has increased as a proportion of total Government spending every year since 2010, and is 10.1% higher per head in real terms than when we came to office. The OECD says that our spending is 10% higher than the OECD average for developed countries. At 9.9% of GDP, it is about the same as that in other western European countries, for which the average is 9.8%.
Given the particularly challenging current circumstances, in 2014 the NHS stepped back and for the first time put together its own plan for the future. It was an excellent plan, based on the principle that because prevention is better than cure, we need to be much better at looking after people closer to or in their homes, instead of waiting until they need expensive hospital treatment. The plan asked for a minimum increase of £8 billion in NHS funding over five years. It asked for this to be front-loaded to allow the NHS to invest in new models of care up front.
Following last year’s spending review, I can confirm to the House that the NHS will in fact receive an increase of £10 billion in real terms over the six years since the “Five Year Forward View” was published. In cash terms, that will see the NHS budget increase from £98.1 billion in 2014-15 to £119.9 billion in 2020-21. That rise is highly significant at a time when public finances are severely constrained by the deficit that this Government regrettably inherited. Because the NHS’s particular priority was to front-load the settlement, £6 billion of the £10 billion increase comes before the end of the first two years of the spending review, including a £3.8 billion real-terms increase this year alone. That £3.8 billion represents a 52% larger increase in just one year than the Labour party was promising over the lifetime of this Parliament.
Jonathan Ashworth
This morning the Chair of the Health Committee and her colleagues on that Committee said that the Government’s NHS spending claims were “inaccurate” and “false”. The Opposition agree with that analysis. Ministers—and the Secretary of State has just done this again—tell us that they are investing £10 billion more in the NHS, but it has now been confirmed that that figure is
“not only incorrect but risks giving a false impression that the NHS is awash with cash.”
Is not the reality that the Government have cut adult social care, the public health budget and the NHS capital budget? Now we learn that the average amount we spend on healthcare for each person in this country will fall in 2018-19. Does that not raise serious questions about the claims that Ministers, and, indeed, Prime Ministers, have been making from that Dispatch Box? In fact, the only way the Government’s figures could be further discredited is if the Secretary of State slapped them on the side of a bus and got the Foreign Secretary to drive it.
Will the Secretary of State admit that the Government have not actually given the NHS the money it needed? Will he give us an accurate account of spending plans for the NHS? Will he tell us when the Chancellor is going to respond to the Health Committee’s letter, and what representations he himself is making to the Chancellor ahead of the autumn statement?
We have also learned today from Health Service Journal that one in three local areas intend to close or downgrade A&E departments within 18 months, one in five expect to close consultant-led maternity services, and more than half plan to close or downgrade community hospitals. Will the Secretary of State confirm whether those reports are accurate? How many A&E departments, maternity units and community hospitals does the Secretary of State expect to close or be downgraded within the next year and a half? Our constituents want those answers.
Before the last election, the Secretary of State told us he was “confident” about delivering the money the NHS needed. Today that confidence has been exposed as utterly misplaced. Tory promises are completely in tatters. Rather than defending the Prime Minister’s spin on the £10 billion figure, why does the Secretary of State not stand up for patients and staff, and deliver the funding that the NHS and our social care sector desperately need?
Mr Hunt
I start by welcoming the hon. Gentleman to his first urgent question in his new role. As I am a relative old timer in my role, I hope he will not mind me reminding him of some of the facts about health spending.
First, the hon. Gentleman said that the Government did not give the NHS what it asked for. Let me remind him that Simon Stevens, a former Labour special adviser—I know for new Labour, but he was none the less a Labour special adviser—said at the time of the spending review settlement last year that
“our case for the NHS has been heard and actively supported”
and that the settlement
“is a clear and highly welcome acceptance of our argument for frontloaded NHS investment. It will…kick start the NHS Five Year Forward View’s fundamental redesign of care.”
I will tell the hon. Gentleman who did not give the NHS what it asked for: the Labour party. At the last election, it refused to support the NHS—[Interruption.] I know this is uncomfortable for the new shadow Health Secretary, but the reality is that the party on whose platform he stood refused to support the NHS’s own plan for the future. As his question was about money, I will add that the Labour party also refused to fund it. The NHS wanted £8 billion; Labour’s promise was for additional funding of £2.5 billion—not £6 billion or £4 billion, but £2.5 billion, or less than one third of what the NHS said it needed. Even if we accept the numbers of the Chair of the Select Committee—and, as I will go on to explain, I do not—Labour was pledging over the course of the Parliament only around half of what this Government have delivered in the first year of the spending review.
The hon. Gentleman used other choice words, one of which was “spin”. I will tell him what creates the most misleading impression: a Labour party claiming to want more funding for the NHS when, in the areas where they run it, the opposite has happened. Indeed, in the first four years of the last Parliament, Labour cut NHS funding in Wales when it went up in England—[Interruption.] Yes, it did. Those are the official figures. That is in a context in which the Barnett formula gives the Government in Wales more than £700 more per head to spend on public services, so there is more money in the pot.
The hon. Gentleman talked about social care. May I remind him of what the shadow Chancellor at the time of the last election—Ed Balls, who is now sadly no longer of this parish—said? During the election campaign, he said of funding for local councils “not a penny more”. We are giving local councils £3.5 billion more during the course of this Parliament.
The hon. Gentleman talked about other cuts that he alleges will happen in A&E departments and other hospital services. I simply say to him that we have to make efficiency savings. I do not believe they will be on the scale he talked about, but how much worse would they have to be if the NHS got a third of the money it currently gets?
If the hon. Gentleman and his party think the NHS is underfunded, they need to accept that the policies that they advocated in the past two elections were wrong —they advocated spending less than the Conservatives. Until they are serious about changing their policy, no one will be serious about listening to their criticisms.
Community Pharmacies
Jonathan Ashworth Excerpts(9 years, 4 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
David Mowat
I agree with my right hon. Friend. Boots makes a big contribution. It owns 1,724 pharmacies and is the biggest of the big four, which between them own 40% of all pharmacies. The Government’s position is that community pharmacists make a big contribution, but I repeat that the number of locations has increased by nearly 20% over the past decade, and each one gets £25,000 per annum just for being open and for being a pharmacy. One consequence is that we have seen a great deal of clustering, and 40% of pharmacies are within half a mile of three others. It is right that the Government look at that and make a judgment.
Jonathan Ashworth (Leicester South) (Lab)
I congratulate my hon. Friend the Member for Barnsley East (Michael Dugher) on securing this urgent question and on his exceptional campaigning on the issue. He is, no doubt, as disappointed as I am by some of the Minister’s replies.
Ministers appear to be intent on pushing ahead with the cuts that have been outlined, under which thousands of community pharmacies could close and patients could lose out on essential medical services. The Pharmaceutical Services Negotiating Committee has described the Government’s proposals as “founded on ignorance” and warned that they will do “great damage”. The National Pharmacy Association says that the proposal is a “dangerous experiment” that
“shows a complete disregard for the well-being of patients.”
Is that not an absolute indictment of the Government’s handling of this matter? The Minister has said that he will make an announcement shortly. Given the concern among Members from across the House, including Conservative Members, can he be more specific and tell us when he will give us a final decision? Will he also be negotiating a solution with the Pharmaceutical Services Negotiating Committee? As the Minister knows, his predecessor talked of the potential for up to 3,000 pharmacies to close. Is that correct, in the Minister’s judgment? If not, can he tell us how many pharmacies he thinks will close, and how many of those will be in deprived areas?
Has the Minister had a chance to study the PwC report that describes the cash savings that community pharmacies bring to the NHS? What will be the financial impact on the NHS of more patients presenting themselves at A&E departments and GP surgeries because pharmacies have closed?
Is not the real reason why Ministers are pressing ahead with these cuts the complete mismanagement of NHS finances? Hospitals ended last year £2.45 billion in the red. We have had continual warnings from experts in the NHS, and over the weekend we learned from the Prime Minister that there is no more money for the NHS. The Secretary of State and the Prime Minister would be wrong to continue to ignore the advice of experts and pretend that everything is going to be okay. Unless the Government get a grip of the funding crisis facing the NHS, I fear that these cuts are just the start and that there is worse to come.
David Mowat
The Government spend more than the OECD average on the NHS. We spend more than the commitments made by the Labour party before the last election. That does not mean that we do not have a duty to spend that money as effectively as we can, however, and that is exactly what we intend to do. The money that may be saved by the measures we are consulting on will not go to the Treasury; it will be recycled back into NHS England. That is what NHS England wants to happen.
The hon. Gentleman mentions the excellent PwC report, which reaffirmed the value of community pharmacists to this country. PwC did not consider whether that same value could be still provided after some savings to the network. That is what we are looking at, and it is reasonable and responsible for the Government to do so. To say that that is not the case is simply incorrect.
The hon. Gentleman mentioned that the previous Minister talked about 3,000 pharmacies closing. We do not believe that the number will be anything like that big. In some areas, there are 10 or 11 pharmacies within half a mile of each other. [Hon. Members: “Where?”] Leicester, Birmingham—we can talk more about this. It is quite possible that at the end of the review, some of those pharmacies will merge. If that happens, it will not mean that provision has been reduced. We do not believe that patient provision will suffer at all from the changes that we are considering.
Oral Answers to Questions
Jonathan Ashworth Excerpts(9 years, 4 months ago)
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Jonathan Ashworth (Leicester South) (Lab)
The Minister says that no rhetoric or scaremongering was used last week. Can he explain to the House what the Prime Minister meant when she said:
“there will be staff here from overseas in the interim period until the further numbers of British doctors are trained and come on board in terms of being able to work in our hospitals”?
What did that mean? What should we expect next—ambulances plastered with “Go home” slogans?
Mr Dunne
That is exactly the kind of ill-judged remark I have been talking about, and I am surprised that the hon. Gentleman has used it in his first appearance in his new post. By the way, I congratulate him on that new post, but I very much hope that he will use more measured language in the future, rather than spreading that kind of inappropriate rumour. The interim period referred to is the period during which doctors will be trained. We will not get new doctors coming in under the increased allocation until 2023, and during that time we will clearly need to use all measures to ensure that we fill the spaces that I acknowledge we have across several of our hospitals.
Jonathan Ashworth
I appreciate the Minister’s warm welcome, and I can tell him that I am very much looking forward to shadowing the Secretary of State, but his comments on ill-judged remarks should be directed at the Prime Minister, not me. We have seen 8,000 fewer nurses, student nurse bursaries are set to be cut, there is a reliance on agency staff and a failure to train enough doctors, and now, after six years in office, the Government are talking about self-sufficiency. Given the concerns that these plans do not go far enough, will the Minister tell us what steps he will take to ensure that no staff from the EU lose their jobs, and will the NHS still be able to recruit from the EU if necessary post Brexit?
Mr Dunne
Health Ministers have been very clear about reassuring all the 53,000 EU citizens working in our NHS that their roles are secure. Regarding clinicians, I remind the hon. Gentleman that, although we have some vacancy rates, which are acknowledged, we now have 7,800 more consultants employed in the NHS than in May 2010, 8,500 more doctors than in May 2010, and over 10,500 more nurses working on our wards. We have gone through a very consistent policy of recruiting more people to work in the NHS under this Government.