Community Pharmacies

Nicholas Dakin Excerpts

Wednesday 2nd October 2019 Westminster Hall

[Nic Dakin (Scunthorpe) (Lab)]

It is a pleasure to serve with you chairing today, Sir David. It is also a pleasure to speak in a debate in which the contributions so far have been full of knowledge and experience of the grassroots. I congratulate my hon. Friend the Member for Halifax (Holly Lynch) on securing it and on setting out at the start, from her own personal experience, the strength and importance of community pharmacies in their communities. They really are at the heart of communities.

My right hon. Friend the Member for Rother Valley (Sir Kevin Barron) spelled out clearly the potential of community pharmacies. I think the Government recognise that potential in their NHS long-term plan, but as my hon. Friend the Member for Halifax pointed out, they do not provide the funding to deliver on that potential.

Every day in this country, 1.6 million people visit a community pharmacy, so it is not surprising that the 2016 petition to save community pharmacies was one of the largest ever seen in this House. It demonstrated the commitment of communities across the country to their community pharmacies.

In visiting local community pharmacies across Scunthorpe, Bottesford and Kirton in Lindsey, I have seen the huge range of work that they do: dispensing medicines, dealing with minor injuries, administering flu jabs, and, as has already been said, being at the sharper end of drug shortages. Making sure that the drugs are there is a massive job and needs a lot of resource to ensure that it is done. As other colleagues have said, community pharmacies are a core part of the public health network, doing important work.

Community pharmacies are at the heart of communities and keep an eye on people, arranging their medicines in trays and delivering them free of charge to people’s doors. However, as my hon. Friends the Members for York Central (Rachael Maskell) and for Heywood and Middleton (Liz McInnes) have said, what is now developing is a drug delivery tax, which threatens the survival of this service. That is because the very people who most need it are the very people who will not use it—that is the nature of the loneliness and other challenges in these communities, as my colleagues have said.

As the hon. Member for Westmorland and Lonsdale (Tim Farron) said, pharmacies are very important in rural areas, but they are also crucial in areas such as Westcliff, which is in the heart of the urban part of my constituency. There, the community pharmacy is the only health service that is close to the local community, which has many health needs.

A local community pharmacist contacted me recently, and I will use his words to describe what it is like at the sharp end. He points to

“Huge shortages and price hikes by suppliers of generic drugs from July 2017 onwards”,

and says that the Department of Health is

“not reimbursing us for even the cost of drugs, let alone giving us a purchase margin”—

something my hon. Friend the Member for York Central talked about in great detail and with great clarity. He says his pharmacy has been losing £10,000 a month since July 2017. He has not been able to afford to replace the two dispensers who have left in the past three months, so local people are losing their jobs as a result of the cuts, and the pressure on those remaining, although they continue to work really hard—I know because I visited them recently—is beginning to take its toll.

He says:

“The government has agreed to a five year funding package with no annual increase to the funding package. I would have at least expected an index linked funding package with index linking to NHS pay rises. The DHSC has given pay rises to all the other sectors of healthcare like GPs and Dentists but has chosen to effectively give a 9% cut over 5 years to community pharmacies.

As you know, community pharmacies are still struggling from the impact of the £250 million cut announced in December 2016. Since then, I have struggled…and…I have had to borrow hugely just to keep afloat. The net result is that my business is in danger of defaulting on the bank loans/overdrafts and might be potentially looking at bankruptcy. I have 20 employees who are mostly Scunthorpe residents and they are unlikely to find any work quickly if we were to go under.”

That pharmacist asks me to ask the new pharmacy Minister, who I congratulate on her appointment—she has shown since she came into this House her commitment to this area of work, and I can see from the way she is listening to the debate that she wants to make a difference—several questions. They are:

“why the Government chose not to give community pharmacy a pay rise given to other primary care health sectors…why the funding was not index linked…how the Government expects us to invest in our staff and premises with what is essentially a cut”

and

“how community pharmacy is expected to be part of Primary Care Networks when our sustainability is in jeopardy.”

That is from the frontline, from a man who is delivering excellent service to my local community and to patients locally and who wants to carry on doing so. The Government recognise the value of community pharmacies. If they want community pharmacists to continue to deliver, they need to give them the ability to do that, and not to speak nice words, without delivering. As well as talking the talk, the Government need to walk the walk on community pharmacies.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Sir David. I thank each and every right hon. and hon. Member who has contributed. Most importantly, I thank the hon. Member for Halifax (Holly Lynch) for securing this debate and allowing us to discuss the challenges and celebrate the opportunities that lie ahead in community pharmacies, as well as how we best deliver to patients. The right hon. Member for Rother Valley (Sir Kevin Barron) and the hon. Members for Scunthorpe (Nic Dakin), for York Central (Rachael Maskell), for Heywood and Middleton (Liz McInnes), for Great Grimsby (Melanie Onn), for Strangford (Jim Shannon), for East Londonderry (Mr Campbell) and for Westmorland and Lonsdale (Tim Farron) all made excellent speeches that gave food for thought, as did the contributions from the hon. Members for Motherwell and Wishaw (Marion Fellows) and for Washington and Sunderland West (Mrs Hodgson). They celebrated exactly what community pharmacies can do if they are embedded in the heart of their communities and what untapped potential there is for moving forward.

I am pleased to have the opportunity to set out the vision for community pharmacy at a pivotal time for the pharmacy sector. As we have discussed, the past three years have been challenging, but there is a new pharmacy sector agreement. I am continually inspired, as everybody has been—we heard about the experience of the hon. Member for Halifax of working in a pharmacy—by the compassion, dedication and commitment of those who work in the NHS family. I saw that myself last week when I met pharmacists and the chief exec of the Pharmaceutical Services Negotiating Committee at the local pharmaceutical committee conference. That underlined to me again what an essential part of the NHS the pharmacy is, working day in and day out on improving outcomes for patients and for the community, which lies at the heart of what they do.

We have heard about the challenges of different communities. The hon. Member for Westmorland and Lonsdale made his point very well, as did other Members who represent rural constituencies. The hon. Members for Strangford and for Motherwell and Wishaw mentioned that the challenges are slightly different in rural, dispersed communities. We hope that the new contract will not be one size fits all but will give additional help to rural pharmacies to help them deliver, because we know that they are an important and integral part of their local community. Ensuring that we maintain a good level of access in England and support pharmacy where there are fewer pharmacies is important and built in.

Community pharmacy always has been an integral part of our communities. We have 11,500 community pharmacies delivering. I pay tribute to the right hon. Member for Rother Valley for his work in chairing the all-party group on pharmacy. He explained clearly how pharmacies are close to 96% of people, who can get to one by foot or on public transport in 20 minutes. The key thing for me was when he said that the majority were in areas of high deprivation. That is hugely important as the contract moves forward, because we are determined to double down on health inequalities, and we know that the pharmacist is a key frontline expert who can help deliver in those communities. Pharmacy can play a greater part in helping people to stay well in their communities.

Today’s debate is timely because the new landmark arrangements for pharmacy—a five-year deal for pharmacies—came into force yesterday. I have heard the deal criticised as flat, but the PSNC said that it wanted certainty; it wants to be able to use its skills better and further, and we have determined the deal in collaboration with it. The deal is the beginning of a programme to transform the sector and to see community pharmacies play a much expanded role in the delivery of health and care across prevention, urgent care and medicine safety. Those new arrangements will support the pharmacy team to utilise all its extensive clinical expertise, further developing new roles and providing the community with the knowledge, skills and support to prevent ill health, manage minor conditions and stay happy and healthy for longer. We have heard from virtually every Member who has spoken about how much that goes on. The hon. Member for Great Grimsby told a moving story of how intimate the relationship is between the community pharmacist and the community that he serves.

The deal sets a programme of work that the Department, NHS England, NHS Improvement and the PSNC have collaboratively developed and agreed—we have worked together to get there. Our direction of travel is clear, and we will continue to work together on the detail, strengthening the role of community pharmacy and the delivery of health and care year on year for the next five years and beyond.

[Nic Dakin]

The Minister is setting out the aspiration well, but does she recognise that having no increase—even by inflation—for five years is a desperately big challenge for community pharmacies?

[Jo Churchill]

On the matter of reimbursement, which was also raised by the hon. Members for York Central and for Westmorland and Lonsdale, we seek to ensure a fairer system of reimbursement for pharmacy contractors and value for money for the NHS. I am sure we would all agree that that is the challenge that we face the whole time. That is why, in July, we launched a consultation on community pharmacy drug reimbursement. We have engaged widely with pharmacy stakeholders and have had an excellent response. We will consider all those responses fully and set out plans for the fairer system in due course. I appreciate that the response will be, “But it’s needed now,” but a pharmacy is a private business, and reimbursement is not pharmacies’ only form of income. What I am talking about will take a shift. There is an acknowledgment that that shift—that transition—will need to be assisted. There is also an independent funding stream from the flu vaccine, for example. I would like to see—and have been discussing with officials—whether a broader vaccine programme could be rolled out through pharmacies as well, and reimbursed. We know we need to do better.