Community Pharmacy Closures
Debate between Baroness Merron and Lord Fowler(2 weeks, 5 days ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
Some 98% of pharmacies are signed up to Pharmacy First and I am glad about how it is developing. On the noble Baroness’s very real points, the majority of recent closures were the result of large pharmacy chains optimising their portfolios. As she is aware, community pharmacies are private businesses, although they earn most their income from the NHS. Those business models vary significantly.
Local authorities are required to undertake a pharmaceutical needs assessment every three years to assess whether the population is being served. Integrated care boards have to give regard to those needs assessments when they review applications from new contractors and seek to fill any gaps. This continues to be work in progress to which we must be alert, but it is also important to look at some of the reasons for the closures.
Lord Fowler (CB)
My Lords, is it not true that we have not used community pharmacies in this country to their full potential? That impression was confirmed for me when I was chairman of such a group. Should our policy not be to develop community pharmacies so that they make an even bigger contribution to public health in this country? Would it not be better if pharmacists’ income came from that kind of effort, rather than from asking them to rely on the sale of cosmetics and other over the counter, commercial products?
Baroness Merron (Lab)
Commercial over the counter products will have a part to play. However, I take the point that the noble Lord makes. I am sure it is true that their vital role, and the opportunities that they offer, were not exploited as much as they could have been—when I say “exploited”, I mean that in a positive way. The Minister for Care, Stephen Kinnock, issued a press release today. In his last point he says:
“I am committed to working closely with Community Pharmacy England to agree a package of funding that is reflective of the important support that they provide to patients up and down the country. I am confident that together we can get the sector back on its feet and fit for pharmacies and patients long into the future”.
NHS: Dentistry Provision
Debate between Baroness Merron and Lord Fowler(2 months, 3 weeks ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
My Lords, the Government are investing around £3 billion in dentistry each year. As the noble Lord will be aware, I cannot yet confirm 2025-26 dentistry budgets, but they will be confirmed in planning guidance published by NHS England in due course. I know that the noble Lord will be aware that, despite the tough fiscal circumstances the Government have inherited, the Budget set out a big increase in day-to-day spending for health and social care. Regarding the process, and our planning, it is entirely normal that we set out matters in planning guidance. We are, of course, keen to reform the dental contract with a shift to focusing on prevention and the retention of NHS dentists. That work is immediately under way.
Lord Fowler (CB)
My Lords, no one fought harder for the elimination of dental deserts than Lord Colwyn, who died recently and whom most of us in this House remember. Would not the best memorial to Lord Colwyn be to place a new priority on dental services particularly for children? As well as making that a priority, and to show that it is, should we not allocate it a budget?
Baroness Merron (Lab)
I would like to associate these Benches with the comments made by the noble Lord about the late Lord Colwyn, whose contribution was indeed considerable. I agree that that would be a very appropriate legacy to his memory. The fact is that we are in the position that the previous Government’s dentistry recovery plan did not go far enough and, as we all know, there are too many people struggling to find an NHS appointment. As part of our 10-year plan we are working to assess the need for more dental trainees in areas including the east of England, which the previous noble Lord referred to, because many people continue to struggle. This cannot go on, not least because prevention is absolutely crucial as we move towards making an NHS fit for the future.
NHS: Independent Investigation
Debate between Baroness Merron and Lord Fowler(4 months, 1 week ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
I do not recognise the description of taking autonomy away; I appreciate that that is the noble Lord’s opinion. The National Health Service is so key to not just our health and well-being but the economic health of this country. In my opinion, it is something of a backbone of the country. It is right that the Government have made this an absolute priority and have commissioned a very honest report—I hear his criticisms of the report; they are not ones that I share—and that the Government are held accountable. That does not mean taking away autonomy from the NHS. I accept the noble Lord’s point that it is outcomes that matter, and perhaps I should have put that better because by output I mean things not just being done but actually being effective. I thank him for that point.
On frameworks and meeting obligations, one of the points made not just in the Darzi report but elsewhere is on how many of the standards are not being met. We will return to a number of the standards to ensure that people can feel that they know what they are going to get and within what timeframe, and that that will be absolutely possible. We are interested only in what works. We are not interested in scoring points; we are interested in improving the health and well-being of the nation, and I hope noble Lords will want to join with that.
Lord Fowler (CB)
My Lords, I say straightaway that I entirely support the concept of an independent inquiry into the National Health Service. Indeed, it was something I advocated to the previous Government —not with notable success. I also pay tribute to the excellent National Health Service treatment and care I received when recovering from a recent heart attack. It was excellent in every way, from the ambulance service right through to the hospital treatment itself. In that context, does the Minister agree that the Government’s description of the National Health Service as “broken” is both unjust to the staff and an altogether false generalisation? It takes the language of the recent election into healthcare, and I would have thought that was one of the things we needed to avoid now.
Baroness Merron (Lab)
I am very pleased to see the noble Lord in the rudest of health and to hear of his positive experience. Of course, there are many positive experiences every single day, and the noble Lord is quite right to remind us of that and of the need to thank the whole NHS staff team who make that happen.
On the point about the NHS being broken, I understand the noble Lord’s view. However, I think it is important that we lay it bare and say what we have found. Having read the report by the noble Lord, Lord Darzi, I find it hard not to conclude that there are fundamental points within the National Health Service that are just not working. Of course there is good practice and there are brilliant outcomes in some areas, but it is not universal and that is what drives us to make that point. I hear what the noble Lord says. However, it is important to be honest, and that is what we have said we will be, uncomfortable though it might be at times.
HIV Care: Access
Debate between Baroness Merron and Lord Fowler(5 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
My Lords, Ministers have already commissioned officials for advice on how to progress the development of a new HIV action plan. On the very tragic case that the noble Lord refers to, he will be aware that since April 2022, NHS England has funded emergency departments in London, and in areas of very high diagnosed HIV prevalence, to provide routine blood-borne virus testing for HIV as well as for hepatitis B and hepatitis C in everyone aged over 16. That attention at the point of contact is crucial in this area.
Lord Fowler (CB)
My Lords, I declare an interest as an ambassador for UNAIDS. Is it not a fact that we have been extremely successful in developing the means to combat HIV and AIDS, but we still face the obstacle of stigma around the whole subject, which is a serious deterrent for treatment and continuing treatment, as the noble Lord, Lord Black, suggested? Will the Government make the fighting of stigma around HIV a priority, so that we can become one of the first countries to be absolutely AIDS free?
Baroness Merron (Lab)
The noble Lord’s campaign in this area is very well regarded, and for good reason; I certainly agree with him. The fact is that engagement in care is strongly affected by a number of factors, including a person’s well-being and quality of life, discrimination and, as the noble Lord says, stigma. That, alongside accessibility of service, will define how successful we are. I am keen that our new plan will absolutely take account of stigma.