Budget for Community Pharmacies

Debate between Michael Dugher and Baroness Hayman of Ullock

Tuesday 24th May 2016 Commons Chamber

[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.