Autumn Statement 2022

Baroness Cumberlege Excerpts

Tuesday 29th November 2022 Lords Chamber

[Baroness Cumberlege (Con)]

My Lords, my interests are in the Lords register. I will be brief.

I wish to focus on the NHS expenditure that was a feature of the Autumn Statement, specifically on one element that requires attention. I am pleased that the Chancellor was able to find additional funding for the NHS in England. His action means that NHS spending will rise in real terms by 2% over the next two years. That may sound modest, but it is billions of pounds, and it has been warmly welcomed by NHS England. It will make a difference in these challenging times.

The one specific part of the NHS that I wish to focus on is community pharmacy. I do so because pharmacies are facing unprecedented problems and the answer lies in sensible funding decisions. I have just three points that I wish to make.

First, community pharmacies are the most accessible part of our health service. Six million people visit a pharmacy every day—not once a week, but every day. No other part of the NHS sees that huge number of people each day. Community pharmacies are a linchpin in the system. They provide billions of prescription medicines every year safely and promptly. They can intervene with advice on good health, diet, exercise, how to stop smoking and so on. They provide millions of flu jabs and Covid vaccinations. They also do much more, but without people having to make an appointment. That is crucial in the NHS. The fact is that we and the NHS would be in real trouble if pharmacies were not there.

That brings me to my second point. There is a real risk that pharmacies will not be there unless action is taken urgently. Community pharmacies have seen a decrease of 25% in the funding that they get from the Department of Health and NHS England since 2016. Many are now running at a loss, forced to cut back on services and opening times—precisely the opposite of what we need them to be doing. That is not sustainable; the situation is getting worse week by week. Many will face permanent closure if we do not act now.

This financial crisis in pharmacy is caused by a funding model that is out of date and not fit for purpose. Pharmacies are providing 65 million consultations to the public every year, and yet the funding model does not pay for that. They are dispensing many medicines at a loss because the funding model does not properly recognise the real costs. Because of staffing shortages, they have had to use locums, but the cost of a locum has increased by 50% since 2019, and the funding model does not pay for that.

Can my noble friend ask her DHSC colleagues to intervene before it is too late? In the short term, a modest but fair uplift is urgently needed, so that pharmacies can keep their doors open and continue to serve those millions of people who rely on them day in, day out. In the medium term, we need a new funding model that is realistic and provides stability.

My final point is that, having stabilised the situation through fair funding, we should be making more use of community pharmacies. In Scotland, there is a service called Pharmacy First. It funds pharmacies to be the first port of call to treat health issues such as sore throat, earache and urinary tract infections—conditions with which people would otherwise visit their GP or even A&E. We do not have such a service in England, but we need one. It will free up capacity so that GPs and hospitals can see those patients that they really need to see. The Pharmaceutical Services Negotiating Committee estimates that it will save £640 million a year. In the context of the NHS budget of over £160 billion, the cost of Pharmacy First would be a drop in the ocean. I hope that my noble friend the Minister agrees and that she will encourage DHSC Ministers to move at pace in putting this service in place.

If we do those things, we will ensure that community pharmacies continue to be the wonderful resource that they are and the public’s entry point into healthcare. We will be spending a relatively modest amount of money very wisely, improving services to the public and helping the NHS in the process. We cannot afford to ignore them. For many cities, towns and villages, their place is in the heart of the communities that they serve, essential to the health and well-being of the local population.