Local Pharmaceutical Services

Jamie Reed Excerpts

Tuesday 3rd March 2015 Westminster Hall

[Mr Jamie Reed (Copeland) (Lab)]

It is a pleasure, as always, to serve under your chairmanship, Mr Howarth, and not for the first time. I extend my congratulations to the hon. Member for Romsey and Southampton North (Caroline Nokes) on securing the debate. She made an excellent case, and I could not disagree with a word that she said. I thank my right hon. Friend the Member for Rother Valley (Kevin Barron) for his typical insight. He will be reassured to know that I understood every single word.

With access to treatments under increasing pressure, with more people waiting in A and E and with GP appointments fully booked, it is right that we devote parliamentary time to discussing how we can increase the role of local pharmacy services in our communities, so I commend the hon. Member for Romsey and Southampton North on bringing the matter to the House. If we were not four weeks away from a general election and on a one-line Whip, I am sure that the Chamber would be packed. It is a shame that we are discussing a matter of such importance to colleagues from all parts of the House in this environment, because the subject is important to everybody who understands and cares about what is happening in their local health economy.

On 31 March 2015, as we have heard, the Local Pharmaceutical Services (Essential Small Pharmacies) Directions 2013 will be revoked. As a result, on that date, the essential small pharmacies scheme will come to an end. In contract negotiations in 2004-05, the Department of Health and the Pharmaceutical Services Negotiating Committee agreed that essential small pharmacies should be contracted under the local pharmaceutical services provisions. In discussions, NHS England has confirmed that it and the PSNC cannot negotiate a new arrangement to replace the existing contracts. Instead, that must be done locally. An NHS England document published in January this year states that contractors have two options available to them:

“1. To rely on any right of return to a Pharmaceutical List maintained under Regulation 10 of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (“the Regulations”); or

2. To submit a proposal to provide Local Pharmaceutical Services (“LPS”) under Part 13 of the Regulations.”

In effect, they can either receive standard pharmacy funding as set out in the drug tariff, which would result in reduced incomes, or they can agree a new local pharmaceutical service contract with the local area team. The report by NHS England neglects to mention a third possible outcome, which is that pharmacies may be left with no option. Pharmacies on reduced incomes may no longer be viable, and they would have to cease to provide pharmaceutical services. The PSNC states that pharmacies that face having to close down will not have to give notice, because NHS England is aware of the termination of the contract, although it recommends contacting local area teams. I am sure we all agree that that could have a devastating impact on local services. Many people rely on their local pharmacy, and I am genuinely concerned that as a result of the plans, those people could be left without the pharmaceutical services that they need and rely on.

Can the Minister outline any transitional arrangements that have been made to ensure that pharmacies are not forced to close unnecessarily? Are any contingency plans in place to cope with difficulties? I would be grateful if she could outline the discussions that the Government had with industry representatives when the plans were drawn up. Notwithstanding any transitional issues, can she provide an estimate of how many pharmacies may be forced to close under the new arrangements? Pharmacies play a crucial role, especially in rural and remote communities such as mine. Pharmacies often provide key services, and the average person will visit their pharmacy more often than their family doctor—I certainly do. Such engagement is crucial in maintaining good health and well-being. My right hon. Friend the Member for Rother Valley spoke at length about the fact that community pharmacies provide services such as smoking cessation and dietary advice, and those services must be maintained.

I am sorry to disappoint my right hon. Friend, but I will mention the Health and Social Care Act 2012, because the Government’s NHS reorganisation has forced intense pressure on all parts of our NHS. That can clearly be seen, as I said at the outset, in the waiting rooms of our GP surgeries and in our A and E departments. According to the most recent GP patient survey, almost 6 million people could not get a GP appointment the last time they tried, and a further 7.8 million waited a week or more. GPs are under severe strain, and pharmacies can play a critical role in alleviating that pressure and expanding access. We also know from the GP patient survey that some 1 million patients went to A and E because they could not get a GP appointment.

More than 1 million people per day—I think the figure is 1.6 million—in England visit their local pharmacy, and the average person will visit their pharmacy 14 times a year. The GP patient survey has shown that GPs and A and E departments already struggle to cope with patient numbers, so they would simply not be able to manage if pharmacies were forced to turn patients away. The Government must make it clear that that will not happen under the new regime.

In a White Paper published in 2008, Labour made it clear how pharmacies can deliver more services to ease pressure on primary care. Pharmacies have a huge role to play in our NHS, and the service simply cannot afford for pharmacy not to play a key role. To address pressures in primary care, the Government should implement measures such as improving links between pharmacy and the NHS 111 service so that care is better co-ordinated. Can the Minister explain what steps the Government are taking to utilise pharmacy better within the NHS?

With those points in mind, I would be grateful if the Minister could outline how the Government will ensure that service coverage and access to pharmacies are not compromised by the upcoming changes. Further to that, will she explain how the Government will ensure that pharmacies provide more services to alleviate pressure on other parts of the system? That is a particular issue in remote, rural and isolated areas, as the hon. Member for Romsey and Southampton North has said, where there are no bus services worthy of the name and no other public transport. The hon. Lady made the case exceptionally well. Isolated health economies are already struggling and frequently achieving sub-optimal outcomes. Reducing access will only worsen those outcomes and increase acute service pressures. Many people rely on those services, and they will be worried that they could lose them. I hope that the Minister can address those concerns, and if my fears are misplaced, I hope that she will explain why.

I am reminded of the roll-out of NHS 111. That has nothing to do with the Minister, because she was not in post at the time, and she knows that I hold her in the highest regard. However, I ask the Government not to repeat the failings of the 111 roll-out when it comes to small pharmacies. Independent academic studies showed Ministers that 111 was not fit for purpose and not fit to be rolled out. Members from all parts of the House warned the Government that the 111 pilots had not worked. I warned the Government before the roll-out of NHS 111 that the scheme was not ready, but they ignored all the advice and rolled out a service that they knew was misfiring and that contributed to the worst A and E performance in more than a decade. That deterioration in patient care was avoidable. I urge the Minister not to repeat those mistakes, but to listen to, accommodate and respond to all the concerns raised today.