Community Pharmacy

Debate between Lord Low of Dalston and Baroness Chisholm of Owlpen

Monday 17th October 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I thank my noble friend for that question. On the last part, I may have to get back to him, because I do not know the answer to that. It is important to remember that the proposals that the Government have been consulting on are part of a wider package of reforms to ensure that the NHS funds are allocated in the most efficient way possible, while promoting a high-quality community pharmacy service which is fully integrated with primary and urgent care and which makes better use of pharmacies’ valuable skills.

[Lord Low of Dalston (CB)]

Does the noble Baroness agree that one of the most valuable services provided by pharmacies is the delivery of medicines to people who are elderly and housebound, and that it is vital that the funding proposals that the Government come up with do absolutely nothing to undermine that service?

[Baroness Chisholm of Owlpen]

The noble Lord is absolutely right. That service will not be undermined and it is extremely important that it carries on—again, particularly in rural areas.

Local Democracy in the United Kingdom

Debate between Lord Low of Dalston and Baroness Chisholm of Owlpen

Thursday 28th January 2016 Lords Chamber

[Lord Low of Dalston (CB)]

My Lords, I thank the noble Lord, Lord Shipley, for bringing this debate. We have already heard two fine maiden speeches and I am very much looking forward to a third, from the noble Baroness, Lady Scott of Bybrook. The central thrust of the noble Lord, Lord Shipley, was that if we are serious about local democracy, we need to take the devolution agenda seriously. I want to talk about the importance of local government’s role in sustaining vigorous and strategically co-ordinated local advice services for enabling access to public services, so I hope I am very much on the same page as the noble Lord.

For a while this morning, I felt a bit out of place among all these luminaries of local government, but then I recalled that I actually once worked in local government—in the GLC, no less. My interest here, which I declare, comes from chairing my eponymous commission on the future of social welfare advice services such as Citizens Advice, law centres and other advice bodies.

Local authorities are closer to social problems than Whitehall, and so are often better placed to design responses to those problems. Local government is also often better placed to join up public services and ensure that they are managed and delivered in an integrated way from a one-stop shop, so to speak, that enables users to access the right help and support in the community from different sources, whether that comes from social care, health, benefits, housing, education and skills, or the justice system.

As the LGA argues, by planning public services locally, it is possible to focus on prevention and to take the needs of the local economy into account. I therefore applaud the work of the noble Lord, Lord Heseltine, on city deals, regeneration and other initiatives which attempt to bring local public and voluntary sectors together into effective delivery structures for their area, based on the needs of that area. This builds on my noble friend Lord Bichard’s work on place-based or community budgeting. It needs local leadership to take this forward: creative local solutions cannot just be imposed.

However, I have concerns for some areas of universal service provision and for the role of the voluntary sector in spreading learning about what works nationally. As many council leaders have said, austerity often presents local councils with choices they would rather not have to make. In particular, have the Government assessed the implications of halving the revenue support grant for discretionary services that do not have statutory protection but are still regarded by the public in most communities as essential, not just optional extras?

Advice agencies have lost legal aid funding, the lottery’s advice services transition fund has been wound up and the Government have withdrawn as a public funder in other areas of welfare advice. To a large extent, advice agencies exist now only by dint of local authorities’ good will for the work they do. However, good will alone towards the voluntary sector is not a sustainable funding model. We have seen relentless cuts in different networks of local charities that work with the most vulnerable groups at risk of exclusion, such as young people, ex-offenders and adults with learning difficulties. This is now cutting into mainstream services. For example, Citizens Advice Newcastle could face closure as the city council winds down its funding. Social welfare advice on the problems of everyday life—debt, benefits, housing or employment—is a vital tool in addressing the complex clusters of problems experienced by troubled families, persistent offenders and disadvantaged young people in marginal communities. Not only do these problems disrupt everyday life, they undermine social cohesion and militate against efforts to build resilient, self-sufficient and sustainable communities. Advice offers a universal approach that can support hard-working families in avoiding problems in the first place or dealing with them as early as possible. It helps ensure correct entitlement to benefits and eases the transitions around welfare reform, resolving problems without resort to lawyers or the courts.

Part of the devolution debate must therefore be about asking how these services can be maintained by local government when they are strictly discretionary. The DCLG and the LGA should encourage local strategies to maximise local sources of funding and provision, drawing on resources across a range of national programmes—for example, troubled families, universal credit support, the better care fund and the Money Advice Service, as well as Big Lottery projects, working in partnership with privately paid-for legal services, legal expenses insurance and pro bono provision. This would reserve scarce and valuable resources for those least able to help themselves and most likely to become a continuing burden.

Other resources that could be tapped might include housing associations, clinical commissioning groups, charities, the Big Lottery Fund, lawyer fund generation schemes and trusts and foundations. In some areas, it might even be possible to see devolution going further. Rather than letting—

[Baroness Chisholm of Owlpen (Con)]

I am sorry, but the noble Lord is out of time.

[Lord Low of Dalston]

I am on my last sentence. Rather than letting the MoJ cut legal aid endlessly by taking areas of law out scope, why not devolve what remains of the budget to local commissioners to determine the priorities in their area without such restrictions, and get more bang for our buck by joining it up with other funding?