Community Pharmacies

Oliver Colvile Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Jonathan Ashworth]

I should like to make a bit of progress, if I may. As I said earlier, I am extremely conscious that other Members wish to speak.

As we have heard, the former Health Minister said that 3,000 community pharmacies could close. When pressed about the figures last month, the current Minister said

“no community will be left without a pharmacy.”—[Official Report, 17 October 2016; Vol. 615.]

I hope he will confirm that he still stands by that statement. He also claimed:

“Nobody is talking about thousands of pharmacies closing”. —[Official Report, 17 October 2016; Vol. 615, c. 602-3.]

He obviously did not receive the memo from the right hon. Member for North East Bedfordshire. But what did he say when he was pressed by my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) about the number of closures? What soothing, reassuring words did he offer to all our constituents? He said, “I do not know.”

I am sorry that the Minister has not got a clue, but I hope that when he winds up the debate he will be able to tell us how many pharmacies will close as a result of these cuts. If he is not prepared to tell us that, will he tell us how many services will be cut?

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

rose—

[Jonathan Ashworth]

I will give way to the vice-chair of the all-party parliamentary group on pharmacy, but then I must make progress.

[Oliver Colvile]

Is the hon. Gentleman aware that the number of pharmacies has increased by 18% over the past 10 years?

[Jonathan Ashworth]

I know that the hon. Gentleman works tirelessly as a champion for pharmacies, but he knows that these proposals will mean cuts in many services.

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[Mr Speaker]

Perhaps the hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile) could detach himself from his device for a matter of seconds. It is very good of him to drop in on us and to take a continuing interest in our proceedings. They certainly interested him greatly a few seconds ago.

[Oliver Colvile]

Thank you, Mr Speaker. I was just trying to find something that was going to inform my intervention. Is my hon. Friend the Minister aware that in Devon, about £5.5 million is wasted on unused medicines? We need to do something about that.

[David Mowat]

I do realise that, and I mentioned the fact that the King’s Fund is looking into medicine reviews.

As I have said before in the Chamber, the model that is adopted for pharmacies in Scotland has a lot to commend it, even though we might not adopt it in its entirety. I hope that we will get a chance to discuss that later.

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[Paul Scully (Sutton and Cheam) (Con)]

During the past year, I have visited a number of local, independently run community pharmacies across Sutton. They add much to our local healthcare provision, and they have the potential to add so much more, as we have heard. We therefore need to tread carefully when looking at changes to funding and configuration. When I spent time in those pharmacies, I saw a steady stream of customers. The pharmacist knew most of them by name, as well as their background and wider circumstances. Such a special relationship takes time to build, but it can be so valuable in assessing health needs and pre-empting any problems. We need to look at how we can develop community pharmacies further as a neighbourhood health and wellbeing hub, so that they become the go-to destination for support and advice and act as a gateway for other healthcare services.

As a number of hon. Members have done, I have been to A&E and seen people who have not had an accident or do not appear to be an emergency, so it is right to look at how we push people towards GP services. However, there seems to be less discussion in public about encouraging people to look to their pharmacist, rather than to their GP, for healthy lifestyle advice, minor ailments care and routine support. The all-party parliamentary group on pharmacy heard some great evidence from the LloydsPharmacy group about its diabetes foot service and inhaler check service, which enable people to get the most out of their treatment and can make their medication far more effective. Those kinds of extra services make community pharmacies incredibly valuable.

[Oliver Colvile]

Does my hon. Friend recognise that we need to make greater use of things such as opticians as well?

[Paul Scully]

My hon. Friend makes a very good point.

Independent pharmacies in Sutton conduct medicine reviews, which we have heard about, and often deliver to their patients’ homes. They therefore see people in their own environment, rather than in a GP surgery. They get to see what is left in the bathroom cabinet, forgotten about or set aside. Ignoring or forgetting to take prescribed medicines causes such a lot of waste. There is an estimated £300 million a year that could go to other front-line services. By seeing the patient in their own environment, the pharmacist can make an assessment based on the patient’s everyday life, rather than just a snapshot, which might be affected by things such as white coat syndrome.

Consultation room services, such as sexual health, smoking cessation and minor ailment services, have to be a good thing for the NHS and should be encouraged. From what I have seen in pharmacies, there is still too much of a disconnect in the exchange of patient information between GPs and pharmacists. If advice and treatment are to work, they must be done in full knowledge of the patient’s background and medical history.

I understand the concerns that have driven the review and the changes that we are debating. The current funding system encourages pharmacy companies to open numerous low prescription volume sites, especially with the guaranteed fixed payment of £25,000 a year, regardless of size, quality or local demand. Some 40% of pharmacies are in clusters of two or more, with 20% being within 10 minutes’ walk of at least two others. That is reflected in Sutton. There are three in Worcester Park, four in north Cheam and six in and around Sutton High Street.

My concern is that any closures that result from these changes are more likely to come from the independent portion—those pharmacists who go beyond the corporate approach, often offering services at no cost or at a loss, because it is the right thing to do; those who prioritise the service that patients need, rather than shareholder value. Responding to customers on a personal basis allows independent pharmacists to consider savings such as generic substitution. We talk about a seven-day NHS, but pharmacists need to be set free to offer a high street NHS.

The Government’s changes recognise much of what pharmacists’ bodies have been raising. The changes seek to move pharmacists away from being reliant primarily on dispensing income, which is more vulnerable in the long term, towards services. Repeat prescriptions and those who come in via the 111 service will be directed to pharmacies, rather than out-of-hours GPs. For the first time, pharmacies will be paid for the quality of the services they provide, not just the volume. There is much to be welcomed, but I urge the Minister to keep the impact of the changes on independent pharmacies, which are often family run, under constant review.

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[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

The first time I became involved in this area of policy was in the 1990s. I was working commercially for pharmacies on the Community Pharmacy Action Group resale price maintenance campaign. One of my very great friends who was very much involved in that campaign, Sharon Buckle, is on the English Pharmacy Board and has been incredibly helpful in providing me with advice. I am vice-chair of the all-party pharmacy group and the Government’s pharmacy champion, which is a great honour and privilege.

My concern is that we seem to be discussing buildings and pharmacies, rather than talking about how we can protect pharmacists. I understand that the Department of Health and Keith Ridge, the chief pharmaceutical officer, are very keen to ensure the pharmacists, the people who serve and have the expertise, are looked after, rather than the buildings. That is very important. We need to ensure there is significantly better integration between the NHS and pharmacies, including on summary care records, when the Government will deliver on decriminalisation for dispensing errors and so on.

Finally, if the likes of Boots will be expected to release their leases, could they kindly have a condition that those leases cannot be re-let to other pharmacies? What we do not need is to end up replacing one form of pharmacy with another. If that is not possible, it is very important that those leases are given to independent community pharmacies rather than the big boys.

I represent a constituency with real deprivation. There is an 11-year gap in life expectancy between one part of my constituency and another. I therefore know at first hand what the issues are. We need to ensure that pharmacies work more closely together, so they can work together on delivering medicines.