Community Pharmacies

Debate between Greg Mulholland and Alistair Burt

Wednesday 2nd November 2016 Commons Chamber

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

It is a pleasure to follow the right hon. Member for Rother Valley (Kevin Barron), who runs the all-party parliamentary group extremely well. I agree with much of what he says about the value of community pharmacy.

I start my brief remarks by thanking the people I was involved with in pharmacy for their immense courtesy at all times, even though we were talking about some very difficult things. Those people included my local pharmacists, Arif and Raj in Wootton; Graham Phillips of Harpenden, who spent a large amount of time showing me his shops and is still very engaged with me; those on Bedford local pharmaceutical committee, who invited me at a most difficult time to launch their healthy living pharmacies in the area; and of course my team in the Department of Health.

Instead of repeating the Minister’s statement and his commitment to pharmacy, I shall say a little about why we are where we are and what I found when I was dealing with pharmacy, and look ahead to the future. This is the sort of debate where the previous Minister finds that, owing to pressing parliamentary business, he is not able to attend and he is somewhere else because all this is now nothing to do with him, guv. I thought that would be most unfair and I wanted to be here to support my hon. Friend and to give a little background.

The process started with the settlement made in 2015 between the Department of Health and the Treasury. In that settlement, extra money was released for the NHS, particularly in my portfolio—adult social care, mental health and primary care—but as was mentioned by the hon. Member for Leicester South (Jonathan Ashworth) in speaking for the Opposition, efficiency cuts were required throughout the NHS, as advocated by Simon Stevens. Part of that involved £170 million off the £2.8 billion for pharmacy. I thought that this was appropriate and that, once it was announced, we could work through it.

I regret the 3,000 figure that I gave to the right hon. Member for Rother Valley at a meeting with the APPG. It was a worst-case estimate, taking no account of what changes pharmacies might make to accommodate any reductions in finance, and therefore it was absolutely top-end. The reason that I gave it in conversation with colleagues—it was open and public and I have no objection to the figure being used—was to indicate that I was aware of the difficulty and that we wanted to work very hard to mitigate it, which we then started to do. But the 3,000 figure took on a life of its own. With hindsight, it might have been wiser if I had stuck to exactly what the Minister says, which is that we do not know because the Government do not have a plan to close pharmacies. They are not in a position to do that and we do not know what will happen.

I do not believe for an instant that the outcome will be as dramatic as Opposition Members have suggested, because businesses do adapt. One of the things that I found when I arrived, as several Members have said, is that 18% growth had taken place in 10 years. Pharmacies are a business and pharmacists will make adaptations to their business to cope, so we will have to wait and see what happens. I would not use the 3,000 figure again.

[Greg Mulholland (Leeds North West) (LD)]

As Health Minister, the right hon. Gentleman said that 3,000 of the 12,000 pharmacies could close. That has come from pharmacies, not from politicians, so does he not accept that that is the real situation, as he said himself?

[Alistair Burt]

No. I said it, so I know why I said it. I said it because it was an estimate, and it took no account of any business change that people might make. It was a top-end estimate and I said it to indicate that I was aware that there might be closures and that we accordingly wanted to mitigate the effects. With hindsight, I would not have given that figure, because everyone has said that the Minister said that so many pharmacies would close. No, I did not. That figure does not represent the pharmacies that will close. They might have done if we had not had mitigating measures and if businesses had not made changes themselves. I wanted to put that on the record.

Let me say what I found when I took on the role. There was a discussion in pharmacy about its future. There were plenty of voices in pharmacy which said that the funding model that values volume and establishment but not necessarily quality of service was not the right way for pharmacy to go. The pharmacy profession wanted to see some changes. I thought that was relevant. There were differing voices in pharmacy. The Pharmaceutical Services Negotiating Committee represents some, but there are other voices.

The integration fund we suggested as a way to look at how pharmacy was changing to come into GPs’ surgeries was warmly welcomed. There were innovations all over the country in pharmacy in general. There was a growing move towards healthy living pharmacies providing more services. All this was going on at the same time as we were talking about what changes we needed to make to provide the extra funds for the NHS.

So where are we going to go in the future? I think that we will get through this process. I remember saying to stakeholders in December 2015, “The future of pharmacy will not be decided by this letter. The future of pharmacy in 2020, 2025 and 2030 is still to be decided. It won’t all rest on this; it will rest on changes and progress to be made.”

First, the PSNC consultation process needs to be changed; I am not sure whether it works well when other voices are excluded, and that should be looked at. Secondly, the differing voices in pharmacy should find a way to get together and present a view beyond what is happening on the high street to show where pharmacy is going.

Thirdly, the integration of the NHS could be done better. Why are there not pharmacists on every single clinical commissioning group? There should be more commissioning of services; the hon. Member for Central Ayrshire (Dr Whitford) was absolutely right that we need to do more, but the NHS needs to do more, with better commissioning and pharmacists being involved.

Fourthly, there needs to be a thorough review of what pharmacy can do and provide in the future, and that should be a springboard. Sometimes innovation comes out of pressure, not out of great resources, which we would love to see in a perfect world. Finally, we should ensure there is long-term support for a locally based network—there are models that would remove more from the locally based network that we should all resist—and such an approach would be the start of a good future for pharmacy.

Southern Health NHS Foundation Trust

Debate between Greg Mulholland and Alistair Burt

Tuesday 3rd May 2016 Commons Chamber

[Alistair Burt]

Today, I met departmental officials and spoke to the regional director responsible for NHS improvement and, as I mentioned earlier, the deputy chief inspector of the CQC who is responsible for this report. I can assure my hon. Friend that, in so far as it is up to me or the Department, that change will be adequately delivered with a sense of urgency, because, as she rightly says, patients and families have, in some cases, waited much too long for this. If warm words are to mean anything, we must show that delivery follows.

[Greg Mulholland (Leeds North West) (LD)]

The failure of care for people with mental health issues, learning disabilities and autism has been shocking and the board should go. Equally shocking is the fact that, 11 months before Connor Sparrowhawk’s tragic and unnecessary death, failures had been identified but not acted on. What can the Minister do to ensure that, as part of a robust inspection regime, when failures are identified they are acted on and done so very quickly to prevent such failures again?

[Alistair Burt]

Over the past 12 months I have met a number of families who have been victims in similar circumstances—some had children who had been placed badly in an inappropriate place, and, in one or two cases, death had been the result. My colleagues and I are determined to do whatever we can to break down those situations where people feel that they have to fight for everything, and where they find doors closed against them when they want to challenge something. All too often in mental health, when people are challenged, they respond defensively. The whole transforming care process stems from Winterbourne View and the determination of the NHS and the board that monitors and oversees that process, including those who have mental health issues themselves and their advocates. The concerns that have been expressed in the past will not go completely, but I am sure the system is better placed now to deal with them and to listen to people more seriously than was the case, tragically, in the past.

Oral Answers to Questions

Debate between Greg Mulholland and Alistair Burt

Tuesday 9th February 2016 Commons Chamber

[Alistair Burt]

I thank my hon. Friend for her question, and the Royal College of Psychiatrists for its work on Lord Nigel Crisp’s commission, which we have supported. The report and recommendations have only just come to us, but they certainly travel in the direction in which the Government are already going. We want to reduce out-of-area placements. The NHS is already committed to that, and is working on moving to a definitive target to reduce the number of them and, I hope, eventually to scrap them. I was up in Hull last week to look at problems in that particular area. The recommendations on waiting times are very important. As we all know, this area has been undervalued in the past. It is under greater scrutiny, and more investment and support are going in through the Government. Today’s report will help us in relation to that.

[Greg Mulholland (Leeds North West) (LD)]

rose—

Oral Answers to Questions

Debate between Greg Mulholland and Alistair Burt

Tuesday 13th October 2015 Commons Chamber

[Alistair Burt]

It is not possible for me to talk about what may emerge from the spending round and settlement, but I can say to the hon. Lady that local authorities were given extra finance to implement the Care Act 2014. Some £5.3 billion is available to local authorities to work through the new integrated social care and NHS budget. So we are very conscious of the pressures on local authorities, which need the resources to provide the social care we all expect.

[Greg Mulholland (Leeds North West) (LD)]

The coalition Government agreed a policy of a cap on care costs, and the Conservative manifesto in May said that no one would have to sell their homes to pay for care. Some £100 million has been wasted on this delay, which has betrayed our older people and has simply ducked one of the biggest crises facing this country. Will the Minister and the Department now apologise?

[Alistair Burt]

There was a consultation on the coalition proposals, which began at the beginning of this year and ran through the election period. The consultation included a very strong representation from the Local Government Association, which said that it did not want to implement the care cap now and wanted extra time. Therefore, the decision has been taken not to cancel, but to delay. It is of course a change from the position we set out. I fully accept that, but we listened to stakeholders and we are now going to use the extra time, at the request of the LGA and others, to find a way through to implement the policy and to use the time for extra financial products.