Oral Answers to Questions

David Mowat Excerpts

Tuesday 20th December 2016 Commons Chamber

[Lyn Brown (West Ham) (Lab)]

7. What steps his Department is taking to work with community pharmacies to reduce (a) waste and (b) the cost of medicines.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

NHS England has a range of initiatives for waste and medicine cost reduction. We estimate that there is a prize of up £150 million a year to be realised across the system on waste. Community pharmacies have a significant role to play in that, partly through their existing duty to review prescriptions when repeat dispensing and partly through the separately commissioned medicine use reviews.

[Lyn Brown]

The Minister is absolutely right to say that community pharmacies have an important role to play. On 17 October, he told the House:

“We do not believe that any community pharmacies will necessarily close as a result of these cuts.”—[Official Report, 17 October 2016; Vol. 615, c. 597.]

However, the impact assessment published by his Department just two days later described a possible scenario in which 1,000 pharmacies close. Will the Minister confirm that nobody in Britain will have to travel further to get to a chemist as a result of his cuts?

[David Mowat]

The impact assessment set out an upper range, which we do not believe represents an accurate reflection of what will happen. The facts of the matter are that we need our community pharmacy network to move towards services and away from dispensing. Paying every community pharmacy in the country, or 91% of them, £25,000 just for having an establishment does not achieve—[Interruption.]

[Mr Speaker]

Order. The hon. Member for West Ham (Lyn Brown) should not chunter from a sedentary position in an attempt to hector the Minister, who should glide seamlessly above the attempted provocation. Minister, continue.

[David Mowat]

The Minister has finished.

[Mr Speaker]

He has finished his answer. Very well; I call Alistair Burt.

[Alistair Burt (North East Bedfordshire) (Con)]

To ensure not only that unnecessary costs are reduced, but that the best community pharmacy services are provided, will the Minister do all that he can to make sure that clinical commissioning groups engage as effectively as possible with pharmacies? Preferably, that would be by getting more people on CCG boards to ensure that the crucial connection between the provision of health services and pharmacy is absolutely at the heart of what we do.

[David Mowat]

My right hon. Friend is right; CCGs are variable in the extent to which they commission pharmacy services. However, we have set out the minor ailments scheme, it will be rolled out nationally by April 2018 and we expect every CCG to take a part in it.

[Sir Kevin Barron (Rother Valley) (Lab)]

As chair of the all-party group on pharmacy, I have seen many examples of drugs that have been prescribed and not used, as I am sure we all have. Should we not renegotiate the national contract, which currently pays community pharmacies more than 90% of their income through prescribing? Surely we can do things differently.

[David Mowat]

The right hon. Gentleman rightly says that we must change the contract to move away from 90% of the income coming from dispensing. Far more must come from services, which are separately commissioned by CCGs and others. The Murray review, which he will be aware of from his work on the all-party group, sets out a road map for that, and NHS England is determined to implement it.

[Mr Stewart Jackson (Peterborough) (Con)]

May I pay tribute to the excellent work of pharmacies in my constituency? Last night, “Look East” demonstrated the pressure that urgent care centres in the east are under because of extra patient footfall. Will the Minister give me an undertaking that he will put in place guidelines to CCGs to encourage them to work much more closely with pharmacies to reduce that footfall?

[David Mowat]

My hon. Friend raises an important point, and he is right to say that we must move the community pharmacy network away from just dispensing and into services, which will include minor ailments and repeat prescriptions. I will be encouraging CCGs to do that.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

Community pharmacies, which were developed in Scotland 10 years ago, are there for minor ailment, chronic medication and public health services. Although the Minister has expressed admiration for the Scottish system, does he not recognise the need to work with the pharmacy profession to develop the full potential within community services?

[David Mowat]

I have mentioned on previous occasions that Scotland has, in some respects, gone further and faster than we have in England so far on community pharmacies. The £300 million that we have set aside in the integration fund for the rest of this Parliament is going to be used to do just the things that the hon. Gentleman has mentioned, in terms of minor ailments and repeat prescriptions. We are determined to make that happen.

[Julie Cooper (Burnley) (Lab)]

Over the festive period, in every town and city in the UK, community pharmacies will be open to dispense emergency prescriptions, and to provide specialist services and professional advice. Does the Minister appreciate that service, which not only helps the public, but takes pressure off other parts of the NHS? Will he join me in thanking community pharmacies and their staff for the work they do? Will he commit to reconsider budget cuts that will lead to a reduction of this valuable service, and instead meet the Royal Pharmaceutical Society and the National Pharmacy Association to discuss extending the role of community pharmacies, to deliver savings for the NHS?

[David Mowat]

I have met the royal college of pharmacies on a number of occasions, and indeed it has worked with us on the Murray review, which is an essential road map that sets out how we are going to move the community pharmacy network away from a remuneration model based just on dispensing and on to services as well. I agree with the hon. Lady that the 11,000 community pharmacies across the country all provide excellent services, and we expect that to continue.

[Conor McGinn (St Helens North) (Lab)]

8. What plans his Department has to help the NHS deal with pressures on services in winter 2016-17.

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[Rob Marris (Wolverhampton South West) (Lab)]

13. How many patient days of delayed discharge attributable to the levels of suitable social care available at the Royal Wolverhampton NHS Trust there were in (a) 2010 and (b) 2016.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

Directly comparable figures are not available, but it is clear that in the past two years there has been a substantial increase in delayed discharge figures attributable to social care at the trust, which this year were among the worst currently being recorded across the NHS.

[Rob Marris]

Sadly, those figures are no surprise, despite the well-managed New Cross hospital, because central Government have cut Wolverhampton City Council’s total income by almost 50% in the past six years. The primary care vertical integration pilot in Wolverhampton is a redesign of services so that a single organisation—the hospital trust—deals with patients from initial contact to ongoing management and end-of-life care. What steps is the Department of Health taking to support vertical integration as one potential way to improve care and lessen hospital admissions and delayed discharges?

[David Mowat]

The hon. Gentleman is right that budgets are part of the issue, which is why last week’s announcement about increased funding is important. However, funding alone does not explain the delayed transfers in Wolverhampton, which are five times worse than those of Telford, which is just down the road; twice as bad as Sandwell, which is very close; and, indeed, 30 times worse than the best performing councils, such as Newcastle, Knowsley and St Helens. With regard to his specific point about the vertically integrated pilot, this is a very exciting project and I commend the people of Wolverhampton for doing it. It is based on a model from Spain that has produced big results. We are watching it carefully and will support it as required.

[Natalie McGarry (Glasgow East) (Ind)]

15. What assessment he has made of the potential effectiveness of introducing (a) a ban on price-cutting promotions on unhealthy food in supermarkets and (b) restrictions on advertising of unhealthy food during family television programmes in reducing childhood obesity.

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[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

T7. As my hon. Friend is aware, last week the Murray report was published. When is he likely to consider it, and when will he make a statement?

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

I thank my hon. Friend for that question and commend him for his work as a pharmacy champion. The Murray review was indeed published last week, and NHS England will respond to it in detail early in the new year. It is a very important document because it sets out in some detail how we intend to transform the community pharmacy network into a service-based profession along the lines that my hon. Friend likes.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

T3. Last week, a 76-year-old man with diabetes in my constituency took a fall and had to wait almost two hours for an ambulance. I then wrote to the Health Secretary after it emerged that not a single ambulance trust in England met its response time targets in October, including for the most critical of cases. Will he explain the reasons for these unacceptable ambulance delays and what he intends to do as we approach Christmas?

--- Later in debate ---

[Mark Pawsey (Rugby) (Con)]

My constituent Marie Bingham administers a drug at home using pre-filled syringes, but she is unable to dispose of the used needles, partly because they are in 2.5 litre sharps tubs rather than 1 litre sharps tubs. It is a ludicrous situation. Is the Minister aware of the problem, and are there any steps he can take to deal with it?

[David Mowat]

As my hon. Friend says, pharmacies are commissioned, on such occasions, to dispose of these needles. I was not aware of the particular issue about the 2.5 litre tubs that seems to exist in Rugby. I will investigate that and revert to him.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

TB rates are currently higher in bits of Ealing than in Rwanda. Could the Government better the bilateral innovation fund to which they have committed with China and go for the O’Neill report recommendation to work towards a truly global fund, in conjunction with other nations, to fight antimicrobial resistance?

[Tom Pursglove (Corby) (Con)]

A fortnight ago, I visited the pharmacy at the Corby urgent care centre to thank the dedicated staff for all that they do all year round, and to have a flu jab as part of the ongoing campaign. Does the Minister agree that exactly that sort of proactive working is crucial in trying to tackle winter pressures?

[David Mowat]

I do agree with my hon. Friend. I am particularly pleased that this year, the pharmacy network has done more flu jabs so far than in the entire period last year. I had my flu jab, and it is holding up well.

[Mr Speaker]

It is always useful to have a bit of additional information. We are greatly indebted to the Minister.