Covid-19: Community Pharmacies

Jackie Doyle-Price Excerpts

Thursday 11th March 2021 Westminster Hall

[Jackie Doyle-Price (Thurrock) (Con)]

I beg to move,

That this House has considered community pharmacies and the effect of the covid-19 outbreak.

It is good to have you in the Chair for this important debate, Sir Graham. It is an honour for me to chair the all-party parliamentary group on pharmacy, not least because so many colleagues are big fans of the pharmacy sector. I am pleased to be introducing this debate this afternoon and to see so much support from Members who recognise the huge contribution that our community pharmacists have made during the pandemic. They are the front door to the NHS, and their doors have never been closed throughout the last year. We are all very grateful to them.

That contribution has not been without consequences for pharmacists, both financially and in terms of their own personal wellbeing. This debate is a chance for me to make a plea that the Government and the NHS fully appreciate the contribution made by our community pharmacists and ensure that they are recompensed adequately for it. Pharmacists can play a much fuller contribution to primary care, as they have shown over the past year, and they should be supported to do so.

Let us look at some figures. According to the Pharmaceutical Services Negotiating Committee, community pharmacists dispense 1 billion prescription items every year. They deliver healthcare advice at a rate of 48 million consultations a year. To put that in context, that saves nearly half a million GP appointments and 57,000 A&E visits every single week. That, by any stretch, is a service that is offering good value for money, and it deserves better support from us.

Community pharmacies are part of the NHS family. We often talk about “our NHS,” but what do we actually mean by that? Quite often, people think of our hospitals, and the doctors and nurses who work in them. For me, the NHS is every single person who works in dispensing health services, be they a nurse or paramedic working in a hospital trust, or somebody working independently, either as a GP or a pharmacist. We must ensure that whoever they are and wherever they are employed, if they are delivering NHS services, the NHS should ensure that they are adequately recompensed for it.

I am pleased to see the Minister in her place. I am preaching to the converted, frankly, as she is a huge supporter of pharmacists. I know that the contribution made by the sector over the last year has not gone unnoticed by her. Those working in the sector have also felt well supported by the recognition they have received from the Secretary of State for Health and Social Care and the Prime Minister. It is a level of support they are not used to and they are grateful for it, but perhaps now is the time to look beyond words of thanks and see that reflected in deeds.

I am sad to say that while the sector is getting that support from Ministers, it does not always get it from the machinery of the NHS or from the Department of Health and Social Care. The truth is that there are some people in our health establishment who view pharmacists as nothing more but glorified retailers. They are not. They are medical professionals who go through a substantial amount of training, and they do not all work for Boots and Lloyds. Most of them work independently, in small shops on our high streets, in the heart of our communities, and for those, 90% of their income comes from the NHS.

I am sad to say that I attended a discussion in which a DHSC representative asked, “Why can’t pharmacists earn money from other sources?” My answer to that is, “Why should they?” They are providing medical services. We have a contract with society that the NHS will meet the cost of those services, and the pharmacy sector should not be expected to go scrabbling around for other business to subsidise work that is done for the NHS. That is not the deal, and I think we need to properly take that on. Their fundamental business is the dispensing of prescriptions, which is an integral part of delivering an NHS that works for all patients. The NHS therefore has a duty to ensure that it is supporting a functional community pharmacy sector. It is not the job of independent providers in our pharmacy sector to be subsidising their NHS work through what they can sell. That is fundamentally not the ethos of our national health service.

As such, I am very clear that we need to put our pharmacists on a more secure financial footing if we are to maximise the use of this sector in delivering good primary care services, and we need to look at how it is supported and how it sits with GP services in our primary care system. My challenge is for DHSC and the NHS to look properly at whether, and how, they can make sure that pharmacies get a fair deal. It is fair to say that our pharmacies are held in very high esteem by the patients who use them. That has been especially true during the pandemic, when patients often found that their pharmacy was the only ready source of advice.

Our 11,500 community pharmacies have been open every day for every single one of us, but that has not been without real costs, as I mentioned. Our pharmacists today are facing debts simply because they stayed open. They had to supply their own personal protective equipment. They had to invest in keeping their shops covid-secure. They had to deal with staff absence due to sickness or self-isolation, and they had to deal with the increased wholesale prices of medicines.

To be fair, like most of the NHS, community pharmacies did receive funding to ensure that they could remain operational, but that was only ever advanced as a loan that needs to be paid back. That is now threatening the operation of some of our pharmacy businesses—as many as one in five, as estimated by Ernst and Young. It simply cannot be right that, in stepping up to the challenge posed by the pandemic, some pharmacies have unwittingly crippled their businesses, as the additional costs are not being properly reimbursed.

The covid pandemic has highlighted that we are long overdue a conversation about the role of pharmacy and its place in the NHS, and the all-party group stands ready to play its part in having that debate. Central to this will be the following principles. First, pharmacies can play a fuller role in primary care. GPs will face additional pressures as we come out of the pandemic. Pharmacies can give that support, but they should be properly supported in doing so.

Secondly, we will be living with covid forever, and it looks as if regular vaccination will become as big a part of our lives as the flu vaccine. I really want to see pharmacists fully engaged in that. There has been disappointment with the number of pharmacists engaged so far, which I think is due to constraints on the supply of the vaccine, but I hope that will be properly addressed as we go forward.

Thirdly, we need a plan to deal with the £370 million loan to the sector. To be brutally frank, when we look at the sums given to other areas of the economy, and indeed to the NHS, our pharmacies can be forgiven for feeling a little hard done by. It will mean curtains for some businesses that acted in good faith after being promised that the NHS would receive all the money it needed to fight the pandemic. No pharmacist should be out of pocket for stepping up to this challenge, and we really do need to look very closely at this. Fourthly, we need to make this sector understand that it is valued, and we should encourage people to work in it.

To end, I can advise the House that the all-party parliamentary group on pharmacy held an inquiry in December in which we surveyed the opinions of pharmacists. We found an overstretched workforce responding heroically to the challenge of a pandemic, with an attitude of doing what needed to be done, and I salute them for that. The survey also told a story of businesses being saddled with debt for doing the right thing, and it found a workforce who felt undervalued and burnt out by the professional pressure they faced. Let us have a conversation about how we secure our finances for the future. Let us properly thank pharmacists for everything they have done to support us in the last year. If we do not, we will miss them when they are gone.

--- Later in debate ---

[Jackie Doyle-Price]

No one watching this debate could be left without the impression that our pharmacists are regarded with huge respect and affection, not just by Members of Parliament but by our constituents. We heard the Chancellor say that the NHS will get everything it needs to fight the pandemic, but it is fair to say that some of us feel that pharmacists have perhaps not been treated as fairly as they should be. I recognise that that is fully connected with the future sustainability of pharmacy, and I look forward to having this debate again in due course.

Question put and agreed to.

Resolved,

That this House has considered community pharmacies and the effect of the covid-19 outbreak.