Elections and Referendums: Spending Rules

Lord Rennard Excerpts

Wednesday 29th March 2017 Lords Chamber

Asked by

[Lord Rennard]

To ask Her Majesty’s Government what assessment they have made of the case for reviewing legislation concerning spending rules in elections and referendums.

[Lord Young of Cookham (Con)]

My Lords, we are considering carefully the conclusions and recommendations of a number of relevant reports on election and referendum spending, including the Electoral Commission’s reports on elections held in 2015 and 2016, and on the EU referendum. While investigations by the police and the Electoral Commission are ongoing, it would not be appropriate for the Government to come to any conclusions.

[Lord Rennard (LD)]

My Lords, reports by the investigative journalist Michael Crick and by the Daily Mirror and others suggest that it was possible at the last general election for political parties to spend several hundred thousand pounds within individual constituencies in order to change the outcome of the election within those seats and avoid previously enforced legislation which prevented the purchasing of particular seats. The defence against this charge is that the law is ambiguous about what is local and what is national spending. If so, should not the law be changed to prevent abuse of the democratic process in this way?

[Lord Young of Cookham]

I am grateful to the noble Lord for the way he put that question. He will understand that I cannot respond to the particular instances that have now been referred to the police and prosecution authorities. The legislation—the Political Parties, Elections and Referendums Act—sought to make a distinction between national spending on the one hand and constituency spending on the other. As I said a few moments ago, I think it makes sense to wait until the investigations by the Electoral Commission and the police are completed. Then, of course, we should stand back and look at the legislation to see whether we need greater clarity for all political parties in interpreting how that distinction should be made.

Political Parties (Funding and Expenditure) Bill [HL]

Lord Rennard Excerpts

2nd reading (Hansard): House of Lords
Friday 10th March 2017 Lords Chamber

[Lord Rennard (LD)]

My Lords, I too congratulate my noble friend Lord Tyler and all those involved in bringing forward this Bill.

It is 17 years this month since I led for my party on the House’s deliberations on the Political Parties, Elections and Referendums Act 2000, generally known now as PPERA. There were hopes in those debates that its provisions for transparency concerning donations to parties, and a maximum cap on the parties’ national spending, would help to clean up the reputation of party funding. It was believed in those debates that it could help to restore the principles of a level playing field in politics, as first set out in the Corrupt and Illegal Practices Prevention Act 1883, which standardised the amount that could be spent on constituency election expenses. Gladstone’s Government introduced that Bill to try to prevent thousands of pounds counting for more than thousands of votes in individual constituencies. That principle has now been almost completely eroded.

The aims of the legislation passed in 2000 have clearly not been met. Politics is not seen to be cleaner and the effect of more recent legislation has been to completely undermine the principle of the 1883 legislation, which for over a hundred years did much to prevent parties purchasing constituencies as a result of superior spending power. The PPERA legislation suffered from the absence of pre-legislative scrutiny. It was then subject to very little scrutiny in the House of Commons and when we considered it in this place, it was subject to more than 500 government amendments, while other amendments which would have helped to avoid many of the problems were not accepted. We missed the chance then to impose a cap on donations. The effect of introducing national spending limits, permitting supposedly national spending to be targeted at individual constituencies, drove the proverbial coach and horses through the principle of a level playing field in constituency elections.

Some of the resulting problems, as identified recently by the excellent investigative journalist Michael Crick, may shortly be tested in the courts, but the only defence that I can see to many allegations that have been made is that the legislation is ambiguous. That is why we need greater clarity in legislation and a commitment to re-establishing a more level playing field in British politics, as provided for in the Bill. It is now clear that the very high limits on ostensibly national campaigns, which I argued 17 years ago should have been lower, are being abused by spending superior resources in individual targeted constituencies. The idea that any letter sent to a voter by a political party is not in some way designed to promote that party’s electoral success in the constituency where the voter lives defies basic common sense.

The failings of the PPERA legislation were largely addressed by the excellent report of the Committee on Standards in Public Life in 2011. The committee’s report provided the only possible route through which the coalition Government could have fulfilled the agreement on which they were based to take the big money out of politics, but vetoing an increase, however modest, in existing state funding for parties prevented the possibility of agreement on a cap on donations, as was proposed, or reform, at that time, of trade union funding.

In evidence to the Committee on Standards in Public Life in 1994, I drew up my party’s then policy on party finance. It was, first, to cap individual donations initially at £50,000 per year from any individual or organisation. As my noble friend Lord Wrigglesworth has just said, that could have avoided the embarrassment to all parties that has happened subsequently. Secondly, it was to prevent trade unions effectively spending their members’ money without them properly choosing to contribute to a party. Thirdly, it was to enable parties to campaign with a limited increase in the state funding which presently provides for things such as the distribution of election communications in parliamentary elections and research and communications support for parties in Parliament. In our debates in 2000, I also argued for more realistic expenditure levels at constituency level and lower limits on national expenditure by the parties.

The Bill takes those principles forward and sets out carefully considered and balanced proposals which also update the excellent work of the Committee on Standards in Public Life early in the previous Parliament. The reasons why we need to address these issues in legislation became more apparent not just in the 2015 general election but in last year’s referendum campaign. My noble friend Lord Tyler referred to the effective laundering of political donations during the recent EU referendum by way of Northern Ireland’s Democratic Unionist Party spending in parts of Great Britain where it does not campaign. Parliament made special provision for Northern Ireland in 2000, for reasons referred to by the noble Lord, Lord Bew, but we did not foresee this abuse of spending rules in a referendum, and I hope it will soon be time to bring Northern Ireland into line with the rules that apply in Great Britain and the Republic of Ireland.

Finally, I turn to the Government’s response to the Select Committee on Trade Union Political Funds and Political Party Funding. As my noble friend Lord Tyler said, it was right for the committee to remind the Conservative Party of its manifesto commitment to seek agreement on a comprehensive package of party funding reform and to call for the renewal of cross-party talks. The Government’s response, which he quoted, tries to kill off progress in those talks before they have even begun by pretending that an increase in funding to political parties is impossible to achieve without increasing the overall burden on the taxpayer.

I would never suggest that very limited spending on democratic engagement by political parties could be at the expense of funding on things such as schools and hospitals or through any kind of tax increase. I suggest that, instead, we cut the cost of government politicking through government advertising. The Minister recently disclosed in Answer to a Written Question from me that the Government are spending well over £100 million per year on advertising. That includes, for example, almost £700,000 on promoting their policy of a tax break for married couples. Many such campaigns seems to be based more on the promotion of Conservative Party policy than on public interest.

The Government’s response to the Select Committee says that the cost of the Committee on Standards in Public Life’s proposals would be almost £20 million a year at 2010 prices, but much of this could be found by re-allocating existing party spending provided by the Government. The Bill makes provision to reduce spend in other areas, for example, by ending policy development grants and by amalgamating the cost of delivering freepost election address mailings. These communications in the present system are sent by individual candidates at a cost to taxpayers in the 2010 general election of some £28 million. These communications could be more cheaply combined into a single booklet, as I first proposed for mayoral elections back in 2000, something which has been adopted successfully in mayoral elections ever since.

The combination of these savings and a reduction in the government advertising budget could cover the modest investment in cleaner politics that was proposed by the Committee on Standards in Public Life in 2011. Politics will be much better when each citizen contributes very modestly to the costs of democracy. This would be in return for a ban on the selling of influence and access, which takes place at the moment as the parties need to fundraise for the cost of their election campaigns.

Of course, in response to these proposals there will be some anger, distortion and misinformation in elements of the press, which would prefer to protect its own power to present issues to the public in its own way, as opposed to letting parties and candidates communicate directly and without all their views being filtered by the media. It is time to make progress on these issues and the Bill before us shows how this can be done.

Electoral Fraud

Lord Rennard Excerpts

Thursday 26th January 2017 Lords Chamber

Asked by

[Lord Rennard]

To ask Her Majesty’s Government what is their assessment of the level of electoral fraud at elections held in Great Britain.

[Lord Young of Cookham (Con)]

My Lords, the Government believe that electoral fraud is unacceptable at any level. In its latest analysis of fraud, the Electoral Commission noted that the number of cases was significantly higher than in previous years. In his review of electoral fraud, Sir Eric Pickles identified the areas that are at risk of fraudulent activity. The Government’s response sets out a programme of work for tackling electoral fraud and building a clear, secure democracy that works for everyone.

[Lord Rennard (LD)]

The evidence suggests that there may be much more of a problem with postal voting than with people being impersonated at polling stations. Is it therefore not time to look again at people’s applications for postal votes, such as the reasons provided for needing to vote by post rather than going to a polling station, and at the declaration of identity accompanying the postal votes to confirm that the ballot paper has been filled in in proper conditions of privacy?

[Lord Young of Cookham]

Sir Eric Pickles made some recommendations on postal votes, although he did not make the recommendations to which the noble Lord referred. Postal voting is an enormous help to those who want to increase participation in democracy and it would be wrong to exclude it. Sir Eric said that postal votes should be renewed every three years. In other words, they should not automatically run on for ever and after three years people in receipt of a postal vote should have to reapply. The Government are consulting on those recommendations.

Voter Registration

Lord Rennard Excerpts

Wednesday 25th January 2017 Lords Chamber

[Lord Young of Cookham]

With respect, I would reject the accusations that we have done very little. As I said, we allocated £7.5 million last May, ahead of the EU referendum, for a whole range of voter registration activities, and we now have a number of targeted initiatives for those who are underregistered—black and ethnic-minority groups, social tenants, tenants in the private rented sector, young people and students. We are developing those initiatives in order to drive up the numbers registered, which, as I said a moment ago, now stand at a record level.

[Lord Rennard (LD)]

My Lords, what would be the problem with amending the letter sent to young people informing them of their national insurance number so that it also told them how to use that number to register online? What would be the problem with extending across Great Britain the system successfully used in all Northern Ireland schools whereby the electoral registration process is undertaken at schools, or with extending across all universities in the UK the system used at Sheffield University for combining electoral registration with registration at the university, thereby ensuring that 76% of its students are registered to vote, compared with only 13% in other HE institutions of a similar size? Are the Government not simply dragging their feet on voter registration for young people?

[Lord Young of Cookham]

My Lords, there were three questions there. On the first, I am all in favour of what is called the nudge, so that when people get notified of their national insurance number they are also encouraged to vote. As for Sheffield, two weeks ago, on the Higher Education and Research Bill, we had a very good debate on the Sheffield initiative, which was part-funded by the Government. We are in the process of analysing that initiative to learn the lessons from it, and when we have done that we will be in touch with other further and higher education institutions to see whether that is the right model for them, or whether there are other models that might work even better. We are determined to do all we can to ensure that no individual is left behind and no community is unregistered to vote.

NHS: Congenital Heart Disease

Lord Rennard Excerpts

Wednesday 14th December 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I appreciate the concerns that noble Lords have raised and the concerns of the hospital trust. However, we must remember that no final decisions have been made and a public consultation will begin shortly. That is when all points can be raised and addressed.

[Lord Rennard (LD)]

My Lords, will the Minister agree that NHS England should review the unfair and inconsistently applied standards that may force the closure of congenital heart disease services at the Royal Brompton Hospital, putting lives and life-saving heart disease research at risk?

[Baroness Chisholm of Owlpen]

I want to share with noble Lords a little of what these standards are about. I feel quite strongly about this: it is so important, and it is the right way forward to determine where these operations should be done. The standards state:

“Each congenital cardiac surgeon must perform a minimum of 125 … congenital cardiac … surgical procedures … each year, averaged over a three-year period … Each consultant congenital interventionist must be primary operator in a minimum of 50 congenital procedures per year, averaged over a three-year period. There must be a designated lead interventionist who must be primary operator in a minimum of 100 procedures per year, averaged over a three-year period”.

This will ensure optimum outcomes for all patients.

House of Lords Act 1999 (Amendment) Bill [HL]

Lord Rennard Excerpts

Committee: 1st sitting (Hansard): House of Lords
Friday 9th December 2016 Lords Chamber

[Lord Anderson of Swansea (Lab)]

My Lords, the noble Lord, Lord True, said that the hereditary Peers are part of the awkward squad—difficult people. I would have thought that there were enough of that category all around in any event.

He said that there has not been a filibuster but how else should we construe virtually overnight putting down 59 amendments in an attempt to swamp this Bill and prevent it making any progress? Perhaps the noble Lord’s speech was short but the plethora of amendments speaks eloquently in a different direction. I wholly endorse and adopt what has been said before, particularly by the noble Lord, Lord Cormack, about reputation. There is an old legal maxim or principle—perhaps no longer said in that way—that if one seeks to define intent it is the natural consequence of one’s acts. What other intent can there be from the plethora of amendments than to effectively destroy this Bill and the reputation of the House?

I will let your Lordships into a secret. Once upon a time, I was in Whitehall for a brief and somewhat inglorious period. I recall a little department, somewhere stuck in Whitehall, the aim of which was to devise means of blocking Bills with an attempt at faint praise. Ministers were told and speeches were written on this basis: “We believe in the principle of what has been put down but now is not the time”, “Rome was not built in a day”, “We should not deal in little steps”, or “We should look at all these matters comprehensively”. I suspect that the noble Lord, Lord Trefgarne, and his friends delved into this same bran tub and will bring out a series of statements of that sort.

Yes, they are clearly against the principle of the Bill. I simply put this question to him: is he happy for this absurdity to continue indefinitely? It is an absurdity and anyone looking from outside must accept it as such. Is he content that by these spurious by-elections, the hereditaries are here by what is, of course, a game of chance—succession? On the other hand, the rest of us are here by—yes—patronage but at least there is an attempt in that patronage to choose people who in principle have a degree of merit. Many of the hereditaries indeed have merit but they may not; it is a game of chance. In my judgment, to continue with this system makes us a laughing stock. If we are serious about the reputation of the House we should wholly endorse this proposal by my noble friend Lord Grocott.

[Lord Rennard (LD)]

My Lords, I associate these Benches with the opening remarks of the noble Lords, Lord Cormack, Lord Hunt of Kings Heath and Lord Dykes, and many others who want to see progress on this Bill. We should not repeat all the arguments we had at Second Reading. Any noble Lord speaking today should endeavour to be brief—I will certainly be.

In addressing the remarks made so far, first, many of those noble Lords who speak about Lords reform accept the principle of the primacy of the House of Commons. The principle of this Bill was approved in 2010 in the then Labour Government’s Constitutional Reform and Governance Act. That received a majority in the Commons and those who are sincere in their belief in the primacy of the Commons should allow this Bill to go forward for Commons consideration.

Secondly, there was the principle about what was said in 1999 and for how many decades or centuries that should be deemed to be binding. There was a principle, which we often refer to and agree with, that no Prime Minister and no Parliament can bind their successors. So I challenge those who are trying to prevent the Bill being properly considered to say whether or not they accept that principle. There is little point in the legislative process unless you accept that you can change a previous decision of a Prime Minister or a Parliament.

The noble Lord, Lord True, suggested that this is about trying to pack the House of Lords or change its composition. He is perhaps a little sore at the moment about the position of the Liberal Democrats after the by-election in the area for which he is the council leader. But it is not realistic to suggest that the Bill is about changing the composition of the House since the power of patronage remains with the Prime Minister to appoint more Peers. On Monday a very strong will was expressed across the House that we must do something to improve our credibility and reduce our numbers overall, but there is no point taking such action unless we prevent top-ups. The first way of preventing such top-ups is by supporting the Bill.

[Lord True]

The noble Lord referred to my speech. He said that we have to prevent top-ups. A few sentences before, he said that of course the Prime Minister could appoint others to replace those who go. By his own words, the question of size is not relevant. He also said that no Parliament can bind its successors. Perhaps that is why the Liberal Democrats have been so quick to remember their policy that numbers here should reflect votes cast in the previous general election.

[Lord Rennard]

If the noble Lord accepts the principle that representation here should be reflective of votes cast in the past election, I would welcome his support for that principle in the House of Commons also.

[Lord Northbrook (Con)]

My Lords, I apologise to the Committee for being unable to take part at Second Reading. I believe the Bill is unnecessary unless part of a full stage two reform, and breaches the undertaking that has already been referred to.

Contrary to the words of the noble Lord, Lord Anderson of Swansea, I maintain that by-elections produce very capable replacement Peers, such as the noble Lords, Lord Grantchester, Lord De Mauley and Lord Ashton of Hyde, the noble Earl, Lord Cathcart, and the noble Viscount, Lord Younger, all of whom are or have been on the Front Bench of their respective parties. In addition, the number of hereditaries is capped, unlike the number of life Peers. Surely it is this that needs attention, to be included in a total package of reform, which may indeed incorporate a change to the by-election system, but that should not happen until then.

The Campaign for an Effective Second Chamber does a lot of good work but the Bill makes the Chamber much less effective.

House of Lords Bill [HL]

Lord Rennard Excerpts

2nd reading (Hansard): House of Lords
Friday 21st October 2016 Lords Chamber

[Lord Rennard (LD)]

My Lords, on 7 September last year I asked from these Benches whether the then Leader of the House agreed that,

“there should be a moratorium on further appointments to this House until sensible measures are agreed to reduce its size and that seeking consensus through a constitutional convention, involving all parties, is the best way forward for reform of this House in the long run”.—[Official Report, 7/9/16; col. 1211.]

I made it clear that I wanted to see action to limit the size of the House, and many noble Lords have referred today to concerns about its size at present. Sadly, the Government accepted neither the principle of a moratorium on appointments, nor the kind of constitutional convention argued for then by my noble friend Lord Purvis of Tweed and others.

The reason that we now have a House of more than 800 Members is a simple one. The last Prime Minister and the present one have between them created 261 Peers over the last six years. That is a rate of 43 per year. Gordon Brown was relatively modest, only creating an average of 11 Peers per year, but his predecessor, Tony Blair, created them at a rate of 37 per year. So the current rate of creating Peers exceeds significantly the number of Members leaving the House for whatever reason. I do not want to dwell too much on actuarial calculations, nor on the fact that the average age of membership of your Lordships’ House is 69. Suffice it to say that what one might call the natural reduction in the size of the House is somewhat less than 20 per year. Some progress has been made on reducing the size of the House through various measures such as the House of Lords Reform Act introduced by my noble friend Lord Steel of Aikwood. Between them, these measures have allowed 61 Members to resign or retire in the past six years—an average of 10 per year. So the size of the House has increased by more than 100 since 2010, giving rise to present concerns.

I want to address particularly the issue of linking the size of this House to that of the House of Commons. I have said before that I agreed with the Lord Speaker when he said in an interview with The House magazine:

“I don’t think that we can justify a situation where you have over 800 peers at the same time as you’re bringing down the Commons to 600 MPs”.

But I also believe that we should re-examine the case for a reduction in the number of MPs. The passage of the Parliamentary Voting System and Constituencies Bill was a very difficult experience for me and for a number of other noble Lords present—I look particularly at the noble Lord, Lord Strathclyde. It was part of the coalition programme that I had to accept if I accepted the coalition. The constituency boundary review proposals were a major part of it, and I was really unhappy about them. This was partly because I did not see the case for reducing the size of the Commons from 650 to 600 without securing the progress that we needed on other related measures such as reducing the size of the ministerial payroll in order to prevent the Executive gaining greater leverage over the elected House, much greater devolution of power from Westminster, and establishing greater legitimacy for this House to hold government to account, which I believe could come only from electing at least some of its Members. In the absence of these things, the case for reducing the size of the House of Commons was, in my view, not made.

It was claimed that the size of the House of Commons had grown inexorably with previous Boundary Commission reviews. But the fact is that membership of the House of Commons grew only from 640 in 1945 to 650 in 2010, while in that 65-year period the electorate grew by more than 12 million voters. In 1945 each MP represented an average of 52,000 voters, while in 2010 each MP represented an average of just over 70,000 voters. The Boundary Commission proposals that have just been published show that in future MPs will be expected to represent an average of 75,000 voters; in other words, after the next general election, MPs will be expected to represent 44% more voters than their predecessors did in 1945, even though expectations of what they can do for individual constituents have risen inexorably. So when we compare the size of the Houses, parity is not such a bad principle, but we need to agree on the relevant size of each House. If we consider again the size of each House, we also have to consider the representation of the Lords Spiritual in this respect, which the Bill does not.

Of course, the fundamental question is: how might we reduce the size of this House? I believe that this Bill does not provide a good way of doing that. The noble Lord, Lord True, appeared to think that the simplest and best answer to the problem is to reduce the size of the representation on the Lib Dem Benches, based on our level of support at the last general election. I would be very happy if our representation was based on the latest election result: 30% in Witney yesterday. My more serious point is that if you do base representation on previous election results, you should not base it simply on the most recent election. In five of the last six general election results, the Liberal Democrat share of the vote was always 20 plus or minus three. So actually our representation of 105 out of more than 800 is less than proportionate if based on votes over the past 30 years. I rest my case.

Repeating the kind of process by which hereditary Peers voted to determine which of their number remained in the House would not be very seemly, as many noble Lords have said. It seems to me, working out the maths, that it would be possible for everyone who wanted to stay here to do so provided that they voted for themselves and found one Peer who wanted to vote for them also. Finding support from people who have been appointed to the House in various ways but do not wish to remain in the House would not, I think, be a great exercise in democracy.

However, we could take some practical and immediate steps to reduce the size of the House. First, we must end the farcical process of the by-elections to replace hereditary Peers. The noble Lord, Lord Grocott, has put forward a Bill to do exactly that and it should be properly considered without the threat of filibuster. I noted the suggestion that this Bill might require a rather long Committee stage. I believe that we should take these issues rather more seriously. Secondly, and most importantly, we have to curb the power of prime ministerial and party leader patronage. The original “Steel Bill” was drafted so as to put the independent Appointments Commission on a statutory footing. Pending the kind of real reform that my party supports, the Appointments Commission should be able to consider and approve party nominations subject to a strict cap on numbers aimed at bringing the size of both Houses into line over time.

In conclusion, we should be acting to reduce the size of the House, and in the absence of other constitutional reforms, the size of the House of Commons may be a good target to aim for over time. This Bill, while worth considering, does not provide the best answers to the problem, but curbing prime ministerial and party leader privilege to appoint Peers may be an important part of the solution.

Community Pharmacy in 2016-17 and Beyond

Lord Rennard Excerpts

Thursday 20th October 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I thank the noble Lord for his questions. These reforms will make the necessary modernisation to provide the best possible service for the patient. He mentioned the problems with pharmacies closing and asked where that was going to leave us. We are investing £112 million to deliver a further 1,500 pharmacies in general practice by 2020. The NHS England pharmacy integration fund will be focused on the deployment of clinical pharmacies and pharmacy services in the community and primary care settings, including groups of general practices, care homes and urgent care settings, such as NHS 111. This will improve access for patients, relieve the pressure on GPs and A&E departments, ensure optimal use of medicines and derive better value, improving outcomes for patients.

The noble Lord also asked about pharmacies in deprived areas and rural communities. That is why we are setting up the primary access scheme and are today publishing the list of those pharmacies that will be eligible for funding from the pharmacy access scheme. These pharmacies will be protected from the full effect of funding reductions, and the scheme will include a review process to deal with any inaccuracies in calculations or any unforeseen circumstances. I hope that that answers the noble Lord’s questions.

[Lord Rennard (LD)]

The noble Baroness said in answer to my question on Tuesday:

“We are not suggesting that any pharmacies close”,—[Official Report, 18/10/16; col. 2225.]

but then went on to imply that some of them would be closed. Does she agree with the former Health Minister, Anna Soubry? She said in the House of Commons on Monday that,

“there is great concern about the proposals”,

and that if,

“there was ever a time to argue to increase the role of pharmacies, it is now”.—[Official Report, Commons, 17/10/16; cols. 593-94.]

Does the Minister accept that it will often be the smaller, independent pharmacies that will be under threat of closure and that closing them will reduce competition, restrict choice and increase prices? Can she say a little more about the integration fund? I understand that it was originally announced as being worth £300 million over five years, but it now seems to be worth £42 million in the next two years. Has the promised cash disappeared?

Will the Minister confirm that the access fund is largely coming out of the general pot to support pharmacies and that most of the expenditure through it will therefore be at the expense of support for other pharmacies? When local authority funding is being reduced for public health projects as a result of cuts in funding from NHS England, is not this another example of a false economy—making short-term savings that will lead to greater costs and pressure on the health service in future, in particular on GP surgeries?

[Baroness Chisholm of Owlpen]

It is important that we offer a level of certainty and stability to pharmacy businesses and contractors providing NHS pharmaceutical services under the community pharmacy contractual framework, which will receive £2.687 billion funding in 2016-7 and £2.592 billion in 2017-8. The pharmacy integrated fund, as I said earlier, will make a huge difference to the NHS integrated fund, which will focus on the deployment of clinical pharmacy services in the community and primary care settings.

Health: Diabetes

Lord Rennard Excerpts

Tuesday 18th October 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

As I said, we are encouraging all NHS trusts to take up the multidisciplinary approach. We are disappointed in the take-up, and we think there are several reasons for it. The Department of Health and Diabetes UK are working together on ways to improve the take-up of structured education and considering more diverse provision in this area. It is also important to remember that a lot of people, when they go to see the doctor, do not say that they have a problem with their feet. We need to educate healthcare professionals to be able to ask the right questions, one of which should be not, “Have you got any problems?”, but, “Do you have a problem with your feet?”. A lot of people are embarrassed to say that they have a problem, so education could be done on both sides.

[Lord Rennard (LD)]

My Lords, the Minister will be aware of the importance of community pharmacies in supporting people with diabetes in relation to their foot care. Does she accept that the planned significant reduction in the budget to support community pharmacies will force many people who have foot complications to try to go to overcrowded GP surgeries, adding to the problems there? That could mean more long-term complications being treated later in hospital, in the secondary sector. The planned reductions are a completely false economy that should not be made if they are going to force more people to seek treatment other than in their community pharmacy, as at present.

[Baroness Chisholm of Owlpen]

I think the noble Lord was in the House yesterday when I repeated an Answer to an Urgent Question on this subject. We have to think of the most effective ways to save money in the NHS. We are not suggesting that any pharmacies close, as the noble Lord knows. We are suggesting savings for pharmacies over the next two years. That is not to say that there will be any pharmacies closed, but we need to make them more efficient. There are some places where there are three pharmacies in one high street, which is slightly ridiculous. However, we are ensuring that rural pharmacies will be in place.

Community Pharmacy

Lord Rennard Excerpts

Monday 17th October 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I thank the noble Lord for those questions. The decision on the impact assessment has obviously not been made yet because the Government are thinking about the problems that have just arisen due to the PSNC not accepting the decisions that we thought had been made. There is no reason why this package should in any way affect the efficiencies of pharmacies at the moment. It is important to remember that the Government fund community pharmacies to the tune of £2.8 billion, and the average pharmacy receives £220,000 per year in NHS funding. We believe that the sector, which is made up of private companies that are often densely clustered together, can withstand this, and that the quality of services provided to patients will not be affected as a result. We know that 40% of pharmacies are in clusters of three or more, which means that two-fifths of pharmacies are within 10 minutes’ walk of two or more other pharmacies.

[Lord Rennard (LD)]

My Lords, the Minister will be aware of the report, commissioned for the Pharmaceutical Services Negotiating Committee and published last month, which showed that in 2015 community pharmacies provided 75 million minor ailment consultations and 74 million medicine support interventions. Does she not think that reducing the provision of community pharmacies may make it even harder for many people to see their GP and will add to the already considerable problems at many A&E units?

[Baroness Chisholm of Owlpen]

The Government are modernising the pharmacy sector and are investing £112 million to deliver a further 1,500 pharmacies in general practice by 2020. We are ensuring that no area is left without access to community pharmacy due to the pharmacy access scheme, and as the Minister for Community Health and Care announced on 13 October we are also introducing the pharmacy urgent care programme, a pilot scheme which will embed pharmacy into the urgent care pathway by expanding the service already provided by community pharmacies in England for those who need urgent repeat prescriptions and treatment for urgent minor ailments and common conditions. The move means that, in pilot areas, patients who need urgent repeat medicines will be referred from NHS 111 directly to community pharmacies. NHS 111 will develop and evaluate a new approach that will ultimately enable the service to refer patients with urgent minor ailments such as earaches to community pharmacies.