Local Pharmaceutical Services

Kevin Barron Excerpts

Tuesday 3rd March 2015 Westminster Hall

[Kevin Barron (Rother Valley) (Lab)]

I think that this is the first time I have spoken when you are in the Chair, Mr Howarth. I hope that I do not receive a yellow card from you, given the rumour that is going around at the moment that the refereeing system from soccer will be brought into this place.

I do not have a constituency interest to declare inasmuch as the hon. Member for Romsey and Southampton North (Caroline Nokes) does. I thank her for securing this debate, but I represent urban Rotherham, which is a little different from some of the other constituencies represented here. My interest is that I chair the all-party pharmacy group, as I have done for nearly five years in this Parliament. I also have a personal interest in pharmacy and its development.

I am sure that most of us know that pharmacies provide services that are vital to some patients. Without financial support, we could lose them and patients would not be easily able to access other health services. The current system ensures that the benefits of access to pharmacy networks are spread widely. Furthermore, if small pharmacies have to close, local patients may find it harder to access and receive advice on medicines and support for healthy living services, such as stopping smoking or weight loss, that pharmacies have begun to offer.

The lack of a pharmacy in many areas could lead to additional strain on other parts of the NHS. The hon. Lady mentioned GP surgeries and A and E. We all know about the pressure on A and E: I think nationally 50% of people who attend A and E get no treatment whatsoever. Some of them may not need treatment, but what they should get could be provided by a pharmacy or dentist, not by the local hospital. I think last year we had 76 people turn up at Rotherham’s A and E with toothache. Quite frankly, we need to start educating the population a bit more about where they should go, but clearly the pharmacy has a major role to play.

Two of the four organisations who support the all-party pharmacy group are the PSNC and Pharmacy Voice, which have been highlighted by the hon. Lady, and I have talked to them briefly about this issue. The all-party group has not looked at that in the past four years, but we have looked at lots of issues and had many meetings with both Ministers and civil servants about pharmacy developments. Those organisations tell me that they certainly believe that sufficient funding is available in the NHS to support pharmacy, as has already been said, but they are concerned about the responses that some contractors have received locally.

PSNC has pressed NHS England to give this matter urgent attention, stressing the impact on contractor and patients of any delay. As was pointed out well, there are four weeks to go and there must be deep concern in areas where matters have not been settled that pharmacies may go under. Those two organisations also believe that NHS England needs to consider and confirm its position on each of the pharmacies urgently. The overwhelming majority have strong cases for continued funding.

There are many reasons why a pharmacy is a vital component of a community. Indeed, pharmacies lie at the heart of a community. Community pharmacies are the most accessible health care locations in the country: they are the more than 11,500 places in England where people can go to get their prescriptions dispensed and receive advice from experts on medicines and support to help them make lifestyle choices. Many community pharmacies offer extended opening hours and weekend services. Unlike many GP services, they are more available to the population than ever before.

In one of the last two meetings of the all-party group, we looked at the new medicine service that pharmacists are deeply involved in to help patients to adjust, if need be, to the medicines prescribed to them. Then, just last week, we had a round-table discussion with many organisations representing patients with mental health problems on whether issues such as mental health should come under that new service. That debate is ongoing, but it shows the potential for pharmacists to help people.

Community pharmacy also helps to prevent ill health and protect the public. The provision of smoking cessation services, which has already been mentioned, as well as health checks and, here in London, seasonal influenza vaccination programmes and emergency hormonal contraception are all examples of how pharmacies help to reduce public risk and mitigate potential downstream costs for the NHS.

This winter, the all-party group looked deeply at influenza vaccines. London is contracted to do that, unlike many other parts of the country, which is another area where we can take the burden off GP services. I have no doubt that we all read the e-mails we get constantly from the British Medical Association about the pressure on GP services, and measures such as professional pharmacists giving influenza jabs seem to be common sense to most people. We should look at expanding the London contract.

Committed, trained, competent pharmacists, pharmacy technicians, dispensers and counter assistants are often the first point of contact for the public. More than 1.6 million visits a day are made to community pharmacies, which is more than to any other primary care provider. Many years ago, I saw the real strength of pharmacies. I took my family of young children to Spain. One of them fell ill and I said in the hotel, “We may need a doctor,” and they said, “Well, just go up to the local pharmacist.” I have to say that I was impressed, not just that they could understand my Yorkshire accent—or English, if that is what it is—but by the advice we got, with no need to go and bother anyone else. It was clear that, years ago, other parts of Europe were using pharmacists as the great pillars of strength that they are. We now do that, but we should continue to do so. Indeed, that is one of that major reasons why I took over the chair of the all-party group.

At a time when the England’s high streets are under siege, it is important to remember that pharmacies employ local people and help to bring variety over and above betting and charity shops—another vital issue—with a network of premises reaching out into communities, especially deprived ones. There is no evidence to show that simply reducing the number of pharmacies will improve care for patients. Central to the future development of community pharmacies is supporting them to become hubs for health care in local communities, to be the first port of call for health advice to help people to manage their health and well-being, both in self-limiting common conditions and in supporting greater self-care in the management of long-term conditions.

We do have healthy living pharmacists up and down the land now. About 10% to 12% of pharmacists give people advice on lifestyle issues on a daily basis. I do not want to encourage the Front-Bench Members to start having a go at one another about the Health and Social Care Act 2012 that went through earlier in the Parliament. I did serve on the Bill Committee, and as the Minister has heard me say before, I supported some of the changes, particularly moving public health back into the community.

There are two things in that Act that have not been on people’s lips since. One was reducing health inequalities. It is essential to have local pharmacists, working in areas where we have known inequalities. The other one was population health. Again, we do not seem to be talking about not looking just at people who are ill. I have often said that the national health service has been a national ill health service in reality: it responds to people who are ill.

If we are to get public health right and improve health in this century, we must move away from the idea that the NHS is here as an ill health service and towards being proactive. Lifestyles are a bigger threat to public health than anything else. Population health is crucial and I see no better primary health care practitioners with better numerical access to the population than local pharmacists. Although that is not about the potential threat to pharmacies, which should be protected—quite right, too, in the circumstances—that will be a growing issue and pharmacies should become a proactive health service in years to come. To lose pharmacists through these changes, if they happen, will not help in any way whatsoever.

I will be interested to hear what the Minister has to say to some of the questions asked by the hon. Member for Romsey and Southampton North, particularly on the ticking clock, which stands at four weeks. If I was running a business such as a pharmacy now and I had got as close to that time as that, I would be deeply worried, as I would be for the people who work in the pharmacy with me.