Mental Health: Pharmacists

Lord Beamish Excerpts

Wednesday 25th October 2017 Commons Chamber

[Mr Kevan Jones (North Durham) (Lab)]

I wish to use tonight’s Adjournment debate to raise the sad case of my constituent Alison Stamps, a 33-year-old pharmacist who sadly took her own life on 25 May 2015. I will outline the circumstances of the case, but will also raise wider concerns that I and her family have around the operation of Boots UK and how it dealt with her death, as well as my broader concerns concerning pharmacists and mental health issues.

Alison was clearly an exceptionally bright and talented individual. After finishing at Pelton Roseberry comprehensive school in my constituency in 2000, she went on to study—

--- Later in debate ---

Motion made, and Question proposed, That this House do now adjourn.—(Rebecca Harris.)

[Mr Jones]

Alison went on to study biology at Durham University and graduated in 2003. She then began work as an audit and accounting technician at Sunderland city hospital before choosing to return to university—the University of Sunderland—to study for a four-year masters degree in pharmacy. While she was at Sunderland, Alison was awarded the prize for the best overall student in the first year, before going on to be awarded the Royal Pharmaceutical Society’s award for the best student on a masters degree programme in 2012. Her achievements were remarkable, and clearly she was dedicated to public health and the pharmacy profession.

Alison began work at Boots’ Tindale store in Bishop Auckland in August 2013. Her parents tell me that she enjoyed the work but increasingly complained about the long hours and demands it placed upon her. By mid-December 2014 she was clearly overwhelmed by what she was having to do. Her store manager noticed that she was losing weight and looking unwell. Following a conversation with the store manager, Alison expressed how down she felt. The store manager provided her with a phone number for an independent counselling service and encouraged her to speak to her GP and her family. Like many people in Alison’s position, she felt she could not speak to her family or strangers about her situation. Still concerned, her manager arranged an appointment with a GP for Alison and even attended the appointment with her. I understand that the GP indicated that she should take antidepressants, but Alison did not wish to do that. The GP gave her a crisis number to ring and also suggested some other coping mechanisms.

At this point, I would like to commend the actions of the store manager, who I think genuinely tried to help Alison. I understand that she reported her concerns about Alison to her area manager, and I have had it confirmed by the director of human resources at Boots that this case was referred and flagged up with the firm’s central HR department. It appears that all that happened, however, is that the store manager was advised about what counselling was available, but no alarm bells rang in Boots’ central HR department that one of its pharmacists was in a crisis situation and no action seems to have been taken. Instead, it was left to the store manager to do her best to assist Alison in her time of crisis.

This raises serious concerns about how Boots as a company handled the case. Having been made aware of Alison’s situation, no attempt seems to have been made centrally or high up in the organisation to intervene directly. This was a young woman not only holding down a responsible job dispensing medicines but who was clearly in a severe mental health crisis. Throughout this time, the store manager was also aware that Alison was self-harming—she had confided in her that she had cut her legs. For six months, Boots was aware of Alison’s situation but simply left it to the store manager to deal with it, although I put it on the record again that she did a great job in trying to help, and she did it to the best of her ability.

Sadly, on 25 May 2015, Alison took her own life in a room at the Hardwick Hall hotel, having taken an overdose of prescription medication. At the coroner’s inquest, it was determined that Alison had taken her own life while suffering from depression. Her parents, Mr and Mrs Stamps, attended the inquest. So did representatives from Boots, who made no attempt whatsoever to offer sympathy or speak to the family. The coroner invited those present to introduce themselves, but because it was a public hearing, the Boots representatives chose not to do so. Mr and Mrs Stamps felt, I think understandably, that their attitude was very legalistic—that they were concerned with their fears about the possibility of a legal case as a result of Alison’s death, rather than with having a compassionate understanding of how her death had occurred.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on raising an issue in which he takes a great interest, as is clear from other occasions when he has spoken in the House. I believe that this very sad case highlights for all of us the need to ensure that those in the workplace are given adequate training to offer support to workers with depression or other mental health issues. Does the hon. Gentleman agree that the Government must initiate, or make available, courses for all small and medium-sized enterprises, which would be free of charge and which would provide tools for employers that would enable them to help such staff members?

[Mr Jones]

As I have said on other occasions, I think that mental health in the workplace is one of the big issues that we do not talk about. I think the hon. Gentleman’s suggestion should be considered, but what struck me about this case was that it involved not a small employer but a huge multinational company, which should have had the capacity within its organisation to provide assistance.

[Liz Twist (Blaydon) (Lab)]

Does my hon. Friend agree that all employers could benefit from having policies to support staff when they are at work, and when, sadly, an employee dies by suicide? Should not employers be encouraged to take up programmes such as those developed by the Samaritans, Business in the Community and Public Health England for the benefit of staff?

[Mr Jones]

I agree with my hon. Friend. I know that she is involved with the Samaritans, and I congratulate her on the work that she does. Yes, there are a lot of tools out there for companies to use, but they must take them seriously rather than treating them as a tick-box exercise. Policies of this kind must actually be used in the workplace, and people must be trained so that if they encounter a case like Alison’s, they do take it seriously. That is what I would have expected from a large company such as Boots.

Anyone who has looked at the details of this case cannot but be moved by its tragic nature, and by the failure of Boots to exercise its duty of care at a national level. Mr and Mrs Stamps are certain that the long hours and the workload that Alison faced were a contributory factor in her death. I have spoken to representatives of the pharmacists’ trade union, the Pharmacy Defence Association. They made it clear that there are increasing demands on pharmacists, not only in terms of workload but as a result of staff cuts. Last year an article in The Guardian highlighted the situation at Boots, including many emails from Boots’ pharmacists claiming that profit was being put in the place of pharmacists’ health, and that they were increasingly being asked to hit targets for medicines use reviews—the company is paid £28 per review by the NHS—rather than concentrating on dispensing and the care of patients.

Those pressures are putting an increasing strain on pharmacists who work for companies such as Boots, but, like Alison, many choose not to complain, because they fear that if they do so they will lose their jobs or their professional qualifications will be withdrawn. That is a particular issue in the context of mental health, and in professions such as pharmacy. People remain silent for fear of the consequences of speaking up. I think that pharmacists need a system like the one that has been introduced for GPs. Many GPs also do not want to talk about their mental health problems because they fear that they will be disciplined. I think that that was Alison’s fear: she feared that if she raised issues relating to her mental health, she would be taken down the disciplinary route and lose her job.

I suggest to the Minister that that needs to be looked at. Pharmacists should have a system similar to that for GPs. I have done some work on this with GPs. The NHS has the GP health service, which is a confidential service for both GPs and trainees. I have met some of its staff, and it works very well in allowing GPs to self-refer confidentially. The GP health service can help doctors with anything to do with mental health, including stress and depression. The effort that has been made to ensure that there is GP support needs to be replicated for pharmacists, because I can say from a personal point of view that, with the best will in the world, giving someone with depression a helpline to ring is not the answer. People do not ring them; I can say from personal experience that I would not have done so when I suffered from depression. The work done for GPs offers a way forward that I ask the Minister to explore.

I also have to raise questions with the Minister about the role of the General Pharmaceutical Council. Following Alison’s death and Mr and Mrs Stamps coming to see me, I wrote to the GPC asking for its opinion of the case. It wrote back saying that its role was to protect patients by

“setting and upholding standards for individual pharmacists and pharmacy technicians.”

I understand that the GPC has been aware of complaints concerning Boots’ working practices for pharmacists, but has taken no action against that company or—so far as I can see—any other company about how pharmacists were being employed. That raises the question of what this regulator is actually doing.

It is also disappointing that the regulator sees itself as a peripheral player on the issue of workplace pressure and stress, and the pressures put on pharmacists. This stance by the regulator allows employers such as Boots to preside over poor working conditions without any threat of sanction. It says that its job is to protect patients, but if a pharmacist has a severe mental health problem that is being created by workplace pressures and stress, that must be putting patients at risk. The potential danger of mistakes being made will be heightened if pharmacists are under such pressure.

In response to Alison’s death it seems as though Boots was most concerned about its own reputation. At the time, its main concern appeared to be whether any controlled drugs were missing from the pharmacy where she worked. It would appear that the drugs that Alison took to end her life came from the unused drugs that were returned to the pharmacy by patients. Although there is a register of these drugs, I wonder whether there should be tighter regulation because it is up to individual pharmacies whether the drugs are recorded. There should be a process of monitoring how the drugs are collected, registered and ultimately destroyed.

While doing the research for this debate I tried to find statistics on mental health problems and suicide among pharmacists. I am not aware of any statistics being held centrally that show this information. We might look into collating such figures to inform this debate, which is clearly ongoing.

Alison Stamps’ death is a tragedy, not only for her family but for us all as citizens, as we have lost a bright, conscientious young lady with much to offer. Her life was, sadly, cut short by circumstances she thought she could not face. It is quite clear that lessons need to be learned and that changes need to be made, not just in the way we regulate pharmacists but in the way we employ them and treat them in the workplace. Alison’s employer, Boots, should take stock not only of how it is dealing with her case but of how it employs other people within its organisation. It would be right to finish with something that Mr and Mrs Stamps said in a letter to me when they first raised the case with me. They said:

“It is clear that Alison was a victim of corporate greed and collateral damage by an uncaring company intent only on its own agenda.”