Oral Answers to Questions

Michael Dugher Excerpts

Tuesday 21st March 2017 Commons Chamber

[The Minister of State, Department of Health (Mr Philip Dunne)]

As my hon. Friend will have heard from the Secretary of State earlier, a number of areas are competing to secure a new medical facility. One of our criteria will involve encouraging doctors to be trained in areas where there are shortages, and I am sure that Lincoln University will take that factor into consideration.

[Michael Dugher (Barnsley East) (Lab)]

The British Medical Association said recently that the funds for sustainability and transformation plans that were announced in the Budget would be completely inadequate for the task. Health trusts throughout the country are being forced to consider rationing treatment and ending or downgrading local services such as A&E, which will result in even longer waits and journey times to access care. Why do the Government not call STPs what they really are—secret Tory plans to decimate the national health service further?

[Mr Hunt]

This is a year in which funding for the NHS has risen by £3.8 billion in real terms. I do not know how the hon. Gentleman can say what he has said, given that in 2015 he stood on a platform to give the NHS £1.3 billion less this year than it is receiving under the Conservatives.

Mental Health and NHS Performance

Michael Dugher Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

I can assure my hon. Friend that that is happening. Indeed, one of the key metrics by which we will judge STPs is their progress on delivering our mental health targets. She is absolutely right to say that ambitions need to turn into action, but she will find that, because of the comments that she and many other hon. Members have made over the past few years, there is much more understanding in the NHS that mental healthcare is a big priority, and more understanding that we need to stop resources constantly being sucked into the acute sector, as has happened over many years.

[Michael Dugher (Barnsley East) (Lab)]

The Secretary of State recently announced that the Government were pressing ahead with significant cuts to the community pharmacy budget in the Department of Health in the face of huge opposition from Members on both sides of the House, members of the public and healthcare professionals. Given the evidence that one in five people who would usually see a pharmacist for medical advice say that they will make a GP appointment if their local pharmacist is closed—in areas of higher deprivation such as mine, it is four in five—and with the risk that many of those people in desperation will turn up at the local hospital, are the Government in danger of making an appalling crisis in the NHS even worse?

[Mr Hunt]

As with all parts of the NHS, we have to ask the pharmacy sector to make efficiency savings. Some 40% of pharmacies are clustered in groups of three or more, and it does not make sense for the NHS to continue to subsidise pharmacies that are very close to other pharmacies. Our reforms are designed to ensure, however, that where there is only one local pharmacy that people can access, that pharmacy is protected.

Child Cancer

Michael Dugher Excerpts

Monday 28th November 2016 Westminster Hall

[Ben Howlett]

I pay tribute to the work the hon. Gentleman has been doing in this area and I completely agree with him. The health benefit analysis that is at the heart of the Department of Health in a number of areas is under review—it is constantly under review—but it needs a much more holistic understanding of the costs, not just in economic terms but in terms of societal issues, including mental health and ongoing support for a child’s family for, hopefully, the rest of their life.

I welcome the Government’s focus on improving earlier diagnosis, as it makes it more likely that patients, including children with cancer, will receive effective treatment. Additionally, it is good news that the Government have committed to implementing all the recommendations of the cancer taskforce, including that by 2020 everyone referred with suspected cancer will receive either a definitive diagnosis or the all-clear within four weeks.

[Michael Dugher (Barnsley East) (Lab)]

I thank the hon. Gentleman for setting out the arguments so well. Will he join me in paying tribute to the many good organisations and charities in the field, in particular Be Child Cancer Aware, which does fantastic work on the need for early diagnosis, gives wonderful support to families and runs campaigns, including in memory of my nephew, Oliver Shaw, who died of leukaemia in 2011?

[Ben Howlett]

I will come on to awareness later. I join the hon. Gentleman in congratulating that charity and the others around the country that do huge amounts of work, often with limited resources in these difficult times.

Returning to early diagnosis, I wish to ask the Minister about the four-week all-clear or definitive diagnosis period and whether it is being performance managed and adhered to. I am sure it is. I welcome the good news that NHS England has the funding necessary to improve cancer services over the next five years, including up to £300 million by 2020 to support earlier diagnosis of cancer, and £10 billion of real-terms increases in NHS funding by 2020-21. I also welcome the recommendations in the taskforce report that give direction on where the funds should be targeted. When it comes to NHS England, performance management is crucial, just as it is in the rare diseases space. We need to know that funding will be spent on the ground on the people who really need support, particularly children who are suffering on an almost daily basis. Campaigners rightly point out that significant progress is still to be made on childhood cancer. Will the Minister confirm that the work undertaken by NHS England will routinely be performance managed on the basis of what has been said by many organisations in the sector?

Childhood cancer is, thankfully, not common, with children accounting for only 1% of cancer patients. Unfortunately, that constitutes a tiny market for pharmaceutical companies, so there are often far too few incentives for child drug development. The pharmaceutical industry generally targets the largest markets for its research and development and it wants its latest drugs to go into front-line use as quickly as possible, to gain maximum benefit from the patent protection. Although many of the genetic abnormalities in childhood cancers also occur in adults and both adults and children can be treated with the same drugs, paediatric drug development trials and availability always lag many years behind. I urge the Government to do more to encourage pharmaceutical companies to invest in research and development for life-saving paediatric drug development. Will the Minister highlight what she will do to encourage NHS Improvement to focus on that market?

Access to cross-border trials is particularly important for rare diseases such as childhood cancers, as there are often not enough cases in a single country to make a trial viable. The European Union’s new clinical trials regulation will come into force in October 2018, and will hopefully make it much easier to carry out cross-border trials, by requiring that a single application be submitted to a central point rather than one in every country. I seriously ask the Government to consider how we can remain party to that system as we exit the European Union.

The overall survival rate for children with cancer is 82% in England and Wales, but the rate varies considerably according to the different types of cancer, and by age and gender. One thing we all know about the chances of survival is that the earlier cancer is caught the more likely it is to be beaten, and the same applies to cancer in children, so I will now talk about the importance of awareness campaigns.

Awareness campaigns can be aimed at and useful to a wide variety of people. It is not just parents and family members who can benefit from improved campaigns. One of the most important things the health system can do is give a child a diagnosis as early as possible, with swift treatment where necessary. However, CLIC Sargent, the childhood cancer charity, states that parents often explain that their journey to diagnosis was far from straightforward. For example, children are disproportionately diagnosed through emergency medical care, with 53% of children aged nought to 14 diagnosed through A&E or emergency referral compared with 20% of adults. There must be something causing that large disparity. I think two issues need to be addressed.

First, there are some excellent national awareness campaigns for many of the more common adult cancers. This month is dedicated to prostate and testicular cancer for example, not just to raise funds but to highlight what men should be looking out for. There are also multiple campaigns encouraging women to regularly check their breasts and to encourage their friends and family to do so. Those campaigns must be applauded and they should be learned from and replicated for other cancers, including childhood ones. If parents are aware of and sensitive to the various early warning signs, we might see a decrease in the number of emergency diagnoses and an increase in diagnosis by GPs, who often know a child’s history far better.

Secondly, GPs need to be educated about some of the less well known symptoms, so that they can be alert when examining children. CLIC Sargent is working with the Teenage Cancer Trust and the Royal College of General Practitioners to produce an e-learning module on children and young people’s cancers for GPs across the country. I thank those bodies for their work and I encourage other organisations to collaborate similarly, to get the crucial awareness messages out there. I am sure that the Minister agrees that continuing professional development is vital for GPs and all medical professionals. If GPs are more aware and more ready to carry out further tests, we might see an improvement in childhood cancer survival.

Last year, the National Institute for Health and Care Excellence addressed non-site-specific symptoms of concern for children and young people, recommending that GPs take into account the insight and knowledge of parents and carers when considering making a referral for a suspected cancer. NICE noted that more lives could be saved each year in England if GPs followed the new guidelines, which encourage GPs to think of cancer sooner and lower the referral threshold. I ask the Government to support some of the excellent childhood cancer campaigns and charities in their aim to achieve national coverage for awareness campaigns and to reach parents and doctors through a variety of means.

Every year in the UK about 3,800 children and young people are diagnosed with cancer, 1,600 of whom are aged nought to 14. For young people, when the doctor says “cancer” normal life stops. It is a devastating experience for the whole family. The petition highlights the huge impact that cancer has on families across the country and the need for more investment, research and awareness. I urge the Government to consider how we can increase engagement with charities to encourage awareness campaigns that garner national attention, develop greater incentives to increase research and development into lifesaving paediatric drugs, and improve early diagnosis for child cancer patients.

I thank colleagues for their attendance today and in particular I thank the petitioners for highlighting this incredibly important issue. I look forward to hearing the comments of other Members and the Minister.

Community Pharmacies

Michael Dugher Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Michael Dugher (Barnsley East) (Lab)]

It is a pleasure to follow the right hon. Member for North East Bedfordshire (Alistair Burt), who tried to be extremely helpful to the current Minister—most ex-Ministers have ex-Ministeritis and tend to be extremely unhelpful to current Ministers, but not so the right hon. Gentleman. However, he did use that figure of 3,000 pharmacies—one in four—facing closure. He has attempted to qualify it now, and his defence seems to be that he made the estimate without properly thinking it through. To that extent, there is remarkable continuity with his successor, who makes a number of assertions without remotely thinking them through. However, if we are now told that we have to disregard what the previous Minister said, why on earth we should believe what the incumbent says? Who is to say that, in a year’s time, after some reshuffle, the Minister’s successor will not come to the House and tell us at the Dispatch Box, “You don’t want to pay any attention to what the fellow before me said. He never knew what he was talking about.”?

The Government’s impact assessment is worth closer examination, because it states:

“the potential impacts…are assessed on the basis that there is a scenario where no pharmacy closes”—

not one. That scenario is not shared by anyone else. Even the Minister, when asked how many would close, told the House, “I do not know.” The impact assessment goes on to concede:

“There is no reliable way of estimating the number of pharmacies that may close as a result of this policy.”

The Department literally has no idea. According to the impact assessment, the Department is officially clueless as to the impact on pharmacies.

[Anna Turley]

Does my hon. Friend agree that an impact assessment of the knock-on effects for the NHS more broadly would have been useful? One in four patients will probably seek with a GP an appointment they would have sought with a pharmacist. We have heard nothing from the Government about what the knock-on effect would be or what investigation they have done into that.

[Michael Dugher]

My hon. Friend makes an excellent point. It would have been helpful to have had an impact assessment as the basis for debate, rather than having something that was published on the day of the announcement.

My hon. Friend alludes to the fact that the impact assessment on community pharmacy says that cuts to community pharmacies will increase patient health benefits

“by reallocating savings from community pharmacy funding to other uses”—

a point the Minister made—

“ensuring that patient health is unaffected”.

Yet, polling commissioned by Pharmacy Voice shows that one in four patients would make an appointment at a GP if their local chemist was closed—a figure rising to four in five in more deprived communities such as my own in Barnsley.

There is no consideration whatever in the Government’s assessment of the potential downstream costs to other parts of the NHS budget, such as the pressure on GPs and A&E. The Department’s impact assessment does say that these cuts are

“expected to lead to reductions in the employment of pharmacists, pharmacy technicians and other pharmacy staff”,

so the Government are clear at least that local pharmacists—the people many of our constituents rely on—will go because of these cuts.

The impact assessment predicts that there will be a “corresponding increase” in other NHS employee numbers, so there will be “no net effect” on the NHS. That is completely without foundation. Are the Government really trying to tell us today that, for all their talk about the importance of community pharmacies and all the evidence about the pressures that will result on GPs and A&Es, which are already overstretched, the work of pharmacists in our local communities will, and should be, taken up by a corresponding increase in other NHS staff?

The impact assessment says:

“the modelling does not take any account of potential reduction in opening hours which may also affect access.”

You bet! New research published today and carried out by the National Pharmacy Association shows that, when faced with the Government’s budgetary cuts, 86% of community pharmacies are likely to limit or remove the home delivery of medicines to housebound patients; 77% of chemists say they will probably become more retail focused to deal with funding shortages—exactly the opposite of what the Minister hopes to achieve; and 54%—more than half—are likely to reduce their opening hours, which will limit patient access and put more strain on our already overstretched GP surgeries and A&E departments.

To sum up, the Government’s own impact assessment, which is well worth a read, if only for comedy value, reads as though it was written in haste on the back of a cigarette packet. The Government—rather like the Minister—are making up the policy as they go along. What Ministers are actually asking us to do today is to make a leap of faith: to turn a blind eye to all the evidence; to disregard all the warnings; to ignore the unanswered questions, the contradictory statements and the glaring omissions in the Government’s own case; to brush away expert opinion; and to dismiss the concerns of the public. Based on the Department’s own impact assessment, how can any right hon. or hon. Member possibly support the Government in the Lobby today?

Community Pharmacies

Michael Dugher Excerpts

Monday 17th October 2016 Commons Chamber

[Michael Dugher (Barnsley East) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the budget for community pharmacies in 2016-17 and 2017-18.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

Members will have seen media coverage over the weekend about our consultation on the community pharmacy contractual framework. I shall set out the current position, the process going forward and how the final decision will be announced to the House.

In December 2015—10 months ago—the Government set out a range of proposals for reforming the community pharmacy sector. Our intent was to promote the movement of the sector towards a future based on value-added services, together with much stronger links to the general practitioner sector.

We proposed ways in which to make a reduction to the £2.8 billion currently paid to the sector. Part of the rationale was the increase of 40% in the budget and an increase of 18% in the number of establishments in the past decade or so. Each establishment now receives an average £220,000 of margin over and above the cost of drugs disbursed. Many of the establishments are in clusters.

The 2015 spending review reaffirmed the need for the privately owned community pharmacy sector to make a contribution to the publicly owned NHS efficiency savings that we need to deliver. We are confident that the changes proposed will not jeopardise the quality of services required or patient access to them, but some services will be delivered differently, which is why we have set aside £112 million to recruit a further 1,500 pharmacy professionals to be employed directly by the NHS in GP practices.

The Government have consulted on the reforms since December 2015. On 13 October this year, the Pharmaceutical Services Negotiating Committee rejected our proposed package and sent a list of remaining concerns. We are now in the process of considering its final response, and expect to be in a position to make an announcement to the House shortly.

[Michael Dugher]

Thank you, Mr Speaker, for granting this urgent question. Community pharmacies play a vital role in frontline healthcare. Nearly 12,000 communities in England provide free advice to patients, and more than 1 billion items were dispensed in the community last year—an increase of 50% on 2005. Reports in recent days, however, make it clear that the Government are determined to press ahead with massive cuts to community pharmacies in this and the next financial year.

Serious questions remain about the impact of those cuts. When will Ministers finally publish an impact assessment of the proposed plans? How many pharmacies will close? Which regions will lose the most? Will they be in clusters or not? What will be the rate of loss in urban, as opposed to rural, areas? Will the Minister confirm that only about one in 10 community pharmacies will be helped by the pharmacy access scheme?

Community pharmacies and the cuts to them are a complete false economy for the NHS. They can only add further pressures to our already overstretched A&E units and GP surgeries. What is the Minister’s assessment of the downstream costs to other parts of the NHS as a result of cuts to the community pharmacy budget, especially given the evidence from Pharmacy Voice that one in four people who would usually visit a pharmacy for advice would instead make a GP appointment if their local pharmacy was closed? In areas of higher deprivation, such as those in my constituency, the numbers are much higher.

We have seen massive opposition to these cuts, not just from pharmacies and voices on both sides of the House, but from the 2.2 million people who have signed the biggest petition in healthcare history. To conclude, Ministers have, to be frank, been all over the place. We have had mixed messages and false hope. The Government announced a pause to the cuts. Is not there now a compelling case for that pause to be made permanent?

[David Mowat]

The hon. Gentleman has not had any mixed messages from me. A pause was announced because the original consultation gave the intent to go ahead with this on 1 October. Given the change of Government and of Prime Minister, and given the new Chancellor and new Ministers, we took the opportunity to look at it again, to make sure that we get it right for patients, the NHS and the pharmacy sector itself, and that is what we intend to do.

The hon. Gentleman asked several questions, but first he said that the pharmacy sector is vital, and we agree with him. In some instances, however, there are as many as a dozen pharmacies within half a mile of each other. That is not an isolated occurrence. Each of those pharmacies receives £25,000 per annum, and it is our job to consider whether that money could be better spent in other parts of the NHS.

I am not in a positon today to announce the final format or shape of the GP access scheme.

[Michael Dugher]

It is in the newspapers.

[David Mowat]

That is speculation. We continue to look at the most recent communication that we have received from the negotiating body of the PSNC. I remind the House that 60% to 65% of these pharmacies are owned by public companies or private equity. The fact of the matter is that the Government have a responsibility to make sure that that money is spent effectively, and that is what we are going to do.

Finally, the hon. Gentleman said that GP access needs to remain good. I confirm and repeat the point that I made earlier: 1,500 additional pharmacists will be recruited into the GP sector by 2020. That is a massive investment, and it will make a big difference.

Budget for Community Pharmacies

Michael Dugher Excerpts

Tuesday 24th May 2016 Commons Chamber

[Michael Dugher (Barnsley East) (Lab)]

I am grateful for the selection of this debate on the budget for community pharmacies, which the Government announced in December would be cut by £170 million in 2016-17—a cut of 6%.

I thank all right hon. and hon. Members, from both sides of the House, who attended the parliamentary event today organised by the Pharmaceutical Services Negotiating Committee, Pharmacy Voice, the National Pharmacy Association and the Royal Pharmaceutical Society to stress the importance of safeguarding a strong community pharmacy sector. I also thank the cross-party delegation of Members of this House and the other place, as well as patients and pharmacists, who came together to deliver a petition to 10 Downing Street today against the Government’s planned cut. The petition was signed by more than 1.8 million people, making it the most signed petition on any health issue in history.

It is clear, therefore, that there is massive opposition out there to the Government’s planned cuts, and it is entirely right, given the huge public interest, that we should have this debate today. The Government must now listen to the public and consider the mounting evidence showing that the cuts will be bad for many of our local communities, the pharmacy sector, public health and the wider NHS. Just yesterday, Pharmacy Voice published a comprehensive analysis of the merits of community pharmacies. The report, “Dispensing Health Equality”, found that community pharmacies

“are not just an invaluable community asset, dispensing medicines and vital public health services, they are potentially a key to unlocking deep-rooted health inequalities.”

[Keith Vaz (Leicester East) (Lab)]

I congratulate my hon. Friend on securing this debate. Instead of cutting the budget for pharmacies, we could use them much more effectively—for example, in combating diabetes. Rather than getting GPs to test patients for diabetes, pharmacies could do it more efficiently and effectively.

[Michael Dugher]

My right hon. Friend is absolutely right. Given the success of community pharmacies, we should be doing far more with them, not cutting them. I shall come to some of the arguments for that during my remarks.

In the course of this campaign, I have been lucky enough to visit some excellent community pharmacies in almost every part of my constituency, campaigning with local councillors, listening to residents who rely greatly on the services these pharmacies provide and meeting staff who are among the very best healthcare professionals in the country.

[Bill Esterson (Sefton Central) (Lab)]

I congratulate my hon. Friend on securing this debate. Like him, I have visited several pharmacies in my constituency. They make the point that we are short of GPs and that, in that environment, it makes no sense to cut a service that can provide the support necessary to make up for the challenging circumstances that GPs face. Pharmacists can often provide advice and support to those who otherwise would go to their GP. In the absence of those GPs, pharmacies are essential.

[Michael Dugher]

My hon. Friend is of course absolutely right. One of the successful community pharmacy operators in my own constituency, Lo’s pharmacy, which has 20 community pharmacies across Yorkshire, was set up by a fantastic individual, Mr Steve Lo, who was brought up in Hoyland Common in my constituency and remains the firm’s managing director. Of the Government’s proposals, he told me:

“There is a real and present danger that these cuts will make many pharmacies unviable. That can only mean a longer trip, not just for your prescription, but for free advice on minor ailments or medicines as well as a number of other NHS led services, and is only going to put more pressure”,

as my hon. Friend just said,

“on GP surgeries and Accident and Emergency departments.”

I wholeheartedly endorse his comments.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate my hon. Friend on securing this timely debate. Pharmacists have become very much like GPs—they are part of the community. This Government are always telling us all how they are taking big government out to the communities, but here they are again cutting another community facility, as well as cutting local government facilities.

[Michael Dugher]

My hon. Friend is right. A modern community pharmacy of the type he referred to has so much to offer patients—from free medical advice and dispensing prescriptions to, crucially, reducing strain on other NHS primary care services.

Community pharmacies are of growing importance. Figures from the Health and Social Care Information Centre show that since 2005, the number of prescriptions dispensed has risen by 50%, with over a billion items dispensed in the community last year. There have been increases in the number of items dispensed every year for the last decade, as community pharmacies have become more important for public healthcare. Staff at community pharmacies, trained pharmacists, technicians, dispensers and counter assistants are often the first port of call for an unwell patient or indeed a carer. Some 1.2 million health-related visits are made to community pharmacies across the country every single day—more than to any other primary care provider. The average person visits a pharmacy 14 times a year, and there are 11,500 community pharmacies across England.

[Holly Lynch (Halifax) (Lab)]

Where we have seen quite serious reorganisations of NHS services and A&E departments downgraded, part of the justification for it has been the role of pharmacies in delivering the “care close to home” agenda. If we see anything in the region of 3,000 pharmacies close across the country, that will raise very serious questions about how we have reorganised our existing NHS structures.

[Michael Dugher]

My hon. Friend is exactly right. I know what a formidable campaigner she has been on this issue in her local community. I pay tribute to her, and not simply because she is also my Whip and occasionally allows me to go home—though I would not rule it out as a contributing factor!

The community pharmacy network is made up of trusted local chemists who are rooted in the communities they serve. I do not doubt that the Minister and his Department share with me an understanding of the vital importance of community pharmacies. Indeed, in the Government’s own letter last December to the Pharmaceutical Services Negotiating Committee, which announced the cut, it was stressed that community pharmacies must be at the “heart of the NHS”. The letter went on to praise the excellent work of community pharmacies

“in prevention of ill health; support for healthy living; support for self-care for minor ailments and long-term conditions; medication reviews in care homes; and as part of more integrated local care models.”

That is all true, so why on earth are the Government pressing ahead with a massive arbitrary budget cut for community pharmacies that will, by the Minister’s own admission at a meeting of the all-party pharmacy group in January, potentially force up to 3,000 local chemists to close?

A properly funded and well-resourced community pharmacy sector is vital for enhancing public health, reducing risk to the public and mitigating downstream costs to the NHS. This is the key argument. In his response, the Minister will no doubt rightly draw on the financial pressures facing the NHS, but is not this cut in the community pharmacy budget a false economy? By contributing to improved public health—frankly, by heading off some people at the pass—our community pharmacies prevent patients from resorting to visits to the GP surgery or the local hospital.

The Government’s timing could not be worse We need our community pharmacies more than ever, given that we have an NHS that is so self-evidently in crisis. A&E departments are under enormous pressure on the Government’s watch. In the three months to March this year, only 87.9% of patients visiting them were seen within four hours, which missed the Government’s own target of 95%. Despite the brilliant efforts of NHS staff in my own area—which was visited recently by my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders), in his capacity as shadow Minister—the figures were even worse, and, indeed, were going backwards. Just 86.7% of patients were seen within four hours in Barnsley Hospital’s A&E department, down from 87.2% in February and 89% in January.

Cutting the budget for community pharmacies will do nothing to alleviate the crisis. In fact, Ministers risk deepening the problems that face our A&E departments by removing access to the medical advice that those pharmacies offer before patients feel the need to go to hospital.

[Sue Hayman (Workington) (Lab)]

Allison’s chemist in Cockermouth, which is in my constituency, provided a very important resource for local people after the floods. Rather than people going to hospital because they needed care, Allison’s visited them in their homes or where they were staying. This cut means that we shall risk losing that kind of important support.

[Michael Dugher]

My hon. Friend has given a compelling example of the contribution made by community pharmacies—not just those in her constituency, for there are similar stories in many other parts of the country.

Another argument for arguing against the proposed cuts is the crisis relating to GP access. Millions of people are waiting longer for appointments: 14.2 million patients had to wait for a week, or were not given an appointment at all, when they last tried to see their doctors in 2015. The truth is that the GP access crisis can only be made worse by the Government’s plan to cut the community pharmacy budget.

The findings of new research carried out by YouGov, commissioned by Pharmacy Voice and published in the report yesterday, show that one in four people who would normally visit a pharmacy for advice on common ailments would instead make an appointment with their GP if their local pharmacy faced closure. The report also states that the impact of the cut would be much more severe in areas of higher deprivation, such as my constituency, and that as many as four in five people would visit their GP if their local pharmacy closed. According to the National Pharmacy Association, that would mean approximately 1 million extra people per month using GP and alternative local NHS services.

In a recent letter to the Pharmaceutical Services Negotiating Committee, the Government said that they wanted

“a clinically focussed community pharmacy service that is better integrated with primary care. That will help relieve the pressure on GPs and Accident and Emergency Departments”.

I could not agree more, but how can an arbitrary cut—because that is what it is—in community pharmacies on such a scale possibly do anything other than make a bad situation in our NHS even worse, and how do the Government plan to introduce a “hub and spoke” dispensing model against a backdrop of thousands of closures in the sector?

Particularly in recent days and weeks, the Government have tried to argue that this is not the arbitrary cut that we all know it to be, and that it is not a raid on the community pharmacy budget in the Department. They now say that it is all about making the pharmacy sector stronger by eliminating what Ministers call “clusters” of chemists. However, in response to a written question on 4 May in which I asked the Government to

“make an assessment of the effect of the budget reduction for community pharmacy in 2016-17 on high street vacancy rates”,

the Government conceded that they could not accurately assess the impact of the cut. They could not say how many community pharmacies would close, or, indeed, where they would close. The Minister said that the Government were

“not able to assess which pharmacies may close or what the effect on high street vacancy rates might be because we do not know the financial viability of individual businesses or the extent to which they derive income from services commissioned locally by the NHS or local authorities or have non-NHS related income.”

As I have already highlighted, the Minister previously said that he estimated that up to 3,000 community pharmacies—a quarter of all those in the country—could close as a result of this cut. However, with no planning, no strategy and no impact assessment, it is painfully obvious that the Government have not the faintest idea which community pharmacies are at risk of closure. It could be a chemist that is located in a so-called cluster, but it might well not be.

[Kevin Barron (Rother Valley) (Lab)]

Does my hon. Friend agree that the petition that went to Downing Street today was not just about 1.8 million people being concerned about their local pharmacy? Those 1.8 million people are also taxpayers who feel that this efficiency drive is going to have a negative effect on what they believe to be an important part of their communities.

[Michael Dugher]

My right hon. Friend makes an interesting point. I have seen the cuts to community pharmacies described as a Treasury-led process. A lot of people are paying their taxes, including the 1.8 million who have already signed the petition. I pay tribute to my right hon. Friend for the leadership he has shown as chair of the all-party parliamentary pharmacy group.

This is not a clear, well-thought-through strategy. It is a reckless leap into the unknown, and it is the NHS, patients and every community in the country that will pay the price. For those of us who were here during the last Parliament, this is painfully reminiscent of the process involved in the passing of the Health and Social Care Act 2012, with the Government making things up as they go along and ending up in a situation where things are worse for the NHS and more money is once again wasted.

I implore the Minister to listen to Members from both sides of the House and from the other place who have voiced their real and sincere concerns. I urge the Government carefully to consider the overwhelming body of evidence from our healthcare professionals who do so much to serve our local communities and our NHS. The Government must now listen to the unprecedented 1.8 million people who have signed the petition, which states:

“We, the undersigned, believe that local pharmacies are a vital frontline health service and part of the fabric of communities across England. Under new Government proposals, many pharmacies could be forced to close—depriving people of accessible medicines, advice and other valuable support from trusted professionals. It would also put more pressure on GPs and hospital services. In the interests of patient care, we urge the Prime Minister and the Health Secretary to abandon plans that put pharmacy services at risk.”

The Government must now think again.

Meningitis B Vaccine

Michael Dugher Excerpts

Monday 25th April 2016 Westminster Hall

[Ben Howlett]

I thank the hon. Lady for her intervention, and I agree. Without giving away what I am about to say, I think that the evidence is quite clear on that, and I hope that the JCVI will look at that in due course. The fact is that Harmonie-Rose and many other children see their lives dramatically changed, or even cut short, by this tragic and awful disease, and it is time that we did something about it, here and now.

The petition that led to the debate was started by Lee Booth, who was told that his eight-month-old child was too old to qualify for the meningitis B vaccine. Lee was quite rightly uneasy about that, as the group most susceptible to contracting the disease are babies under the age of one. I am sure that we were all pleased when the Government made the unprecedented announcement that from September 2015 all newborn babies would be given the vaccine, making the UK the first country in the world to make that provision.

[Michael Dugher (Barnsley East) (Lab)]

On behalf of colleagues from all parties in the House, I thank the hon. Gentleman for the eloquent and passionate way that he is leading this important debate. He is aware of the heartbreaking case of Mia Barton, who tragically passed away last month after contracting meningitis B. Her courageous parents, my constituents Rebecca Barton and Matthew Bright, are campaigning incredibly hard, even in the midst of such awful grief. Does the hon. Gentleman agree that, at the very least, the JCVI should be open to reviewing its recommendations to the Government, and that the tragic death of Mia Barton underlines the need to look again at the age requirement for the national vaccination programme?

[Ben Howlett]

I thank the hon. Gentleman for his intervention, and my condolences go to Mia’s family, because obviously anybody who is lost to this tragic disease is a loss overall, and it is horrendous what Mia’s family have had to go through; I have seen that with the family of my own constituent, and as MPs no doubt we have all seen that. There is a question around age, and I will come on to that shortly. Like Mia’s family, Lee Booth is calling for the Government to extend vaccinations up to the age of 11, and I think that we need to review some of the evidence today.

Health and Social Care Bill

Michael Dugher Excerpts

Tuesday 13th March 2012 Commons Chamber

[Mr Lansley]

I do not think the right hon. Gentleman should quote Cromwell to a Cambridgeshire MP; I think I know more about Cromwell than he does. [Hon. Members: “Ooh!”] I might also tell him—

[Michael Dugher (Barnsley East) (Lab)]

What do you know about the health service?

[Mr Lansley]

What do I know about the health service? I have been at the Government and Opposition Dispatch Boxes for nearly nine years speaking on behalf of the national health service. Before that I was on the Select Committee on Health, looking out for the interests of the health service, and before that my father was working—[Interruption.]

NHS Reorganisation

Michael Dugher Excerpts

Wednesday 16th March 2011 Commons Chamber

[Mr Lansley]

My right hon. Friend was busy in Sheffield over the weekend, but he might have heard me say on Sunday that where there are legitimate concerns, founded in reality rather than myth, about how we will secure the NHS and its modernisation for the future, we will listen. We have listened and changed the policy before the Bill was introduced. We have already amended the Bill during the course of its passage so far and will always look to clarify and improve it as it proceeds.

[Michael Dugher (Barnsley East) (Lab)]

Will the Secretary of State give way?

[Mr Lansley]

I will give way to the hon. Gentleman, and perhaps he can explain why the Labour party leading the Welsh Assembly Government will cut the NHS by 5% while we are going to increase the budget by £10.7 billion.

[Michael Dugher]

I might be new to Parliament, but we ask the questions and he is supposed to answer them. The Secretary of State knows full well that patient groups, health charities, doctors and nurses oppose the Bill—even that shower opposite opposed it at their conference. Is it not just arrogance on the part of the Government—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. The hon. Gentleman needs to moderate his language. I would grateful if he withdrew the word “shower” and thought of another way to make his point that uses parliamentary language.

[Michael Dugher]

I withdraw “shower”.

Is it not just arrogant for the Government to think that everybody else is wrong and they are right—

[Madam Deputy Speaker]

Order. It was not an opportunity to ask another question, either.