Community Pharmacies

Oliver Colvile Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Derek Thomas]

I thank the right hon. Gentleman for that intervention. What I have learned from many patients and from the pharmacists themselves is that patients see pharmacists as the first port of call for health, so there is no doubt that there will be times when pharmacists are picking up things that otherwise would have to be picked up in A&E.

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

Does my hon. Friend agree that it is important not to confuse the role of pharmacists with the number of pharmacies? It is vital that we protect the pharmacists, who are very important in delivering in the national health service.

[Derek Thomas]

That is exactly right: it is pharmacists’ skills that we must be careful to maintain and develop.

I know that you have concerns about this matter as well, Mr Streeter, especially concerning the pharmacy in Modbury in your constituency, so I appreciate your support on this issue and the way you are chairing this wonderful Westminster Hall debate.

--- Later in debate ---

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

May I say what a pleasure it is to serve under your chairmanship, Mr Streeter. I have been involved in the whole business of pharmacies since 10 to 15 years ago, when I worked commercially on the campaign for resale price maintenance. Members may remember that the then Government were seeking to get rid of resale price maintenance on many prescription medicines. So I have been following the area closely.

I congratulate my hon. Friend the Member for St Ives (Derek Thomas) on securing the debate. Members should be aware that I am the Government’s pharmacy champion, as well as the vice-chairman of the all-party pharmacy group. The right hon. Member for Rother Valley (Kevin Barron) is the chairman.

Just before Christmas, the Government announced that they wanted to review community pharmacies, and I very much welcomed that. The Government’s consultation process on community pharmacies needs to ensure that health service money is targeted better on where it can deliver the best results. The consultation process has highlighted that there is an oversupply or clustering of pharmacies in specific locations. The other day, I was driving back to London from my constituency, and I noticed that there were three or four pharmacies within two or three minutes’ walk of each other. To my mind, that has to be looked at.

The issue is how we ensure that the changes to the funding mechanism ensure the desired results, namely, the reduction of clusters while ensuring that we do not damage key parts of the pharmacy network. Using funding to make the changes is potentially a blunt instrument, and it will impact on smaller volume pharmacies in rural areas in particular. They are a part of the network that is desperately needed. What mechanisms are envisaged to achieve those goals? I understand that some large pharmacy groups might be willing to give up the leases on some of their shops, but they want to know whether the Government will give them an assurance that the leases will not be handed over to another chain of pharmacies. Perhaps my right hon. Friend the Minister will explain what approach the Government will take to ensure that that does not happen.

Pharmacies, particularly community pharmacies, are undergoing unprecedented changes. They want to expand and to assist in meeting primary care demand, diverting activity from A&E to support more patients with self-care and in the prevention of ill health. Pharmacy is increasingly seen as a large part of the solution to the shortage of doctors and nurses in primary care. We are watching the spiralling demand for practices and community pharmacies, which are about delivering that patient care.

We need to support the innovation in roles to facilitate change in the infrastructure: information exchange, organisation, and working practices. Current investment in the innovation fund will probably not provide the level of investment needed, and access to transformation funds for this purpose seems unlikely. The change is needed to manage demand more effectively, but, unless supported, we place the system and the patients it serves at high risk. Can we therefore ensure that higher priority is given to ensuring that the changes are effectively supported?

[Stephen Pound]

On the subject of changes, and bearing in mind that the increase in prescribing is about 2.5% per annum, does the hon. Gentleman honestly believe that the Government’s proposal for a hub-and-spoke prescribing model, breaking the link between the patient and the pharmacist, represents value for money, or even sanity?

[Oliver Colvile]

There are two things. First, it is important that the consultation process reaches a conclusion. For us to try to premeditate on that would be unhelpful. Secondly, there are examples of where the Government have been able to make sure that money is better focused and better used. They can make budgets sweat quite well, and we should certainly take that into account.

I very much welcome the review, as I believe that community pharmacies should have a much wider role than simply dispensing prescriptions. They can take the pressure off hectic GP surgeries and our hard-pressed accident and emergency units. Such venues should provide alternative services such as help with mental health conditions, smoking cessation and suchlike. The Government need to ensure that pharmacies are the first point of contact when patients are looking for minor help, such as flu jabs. We also need to make sure that patients in our rural villages have access to pharmacies, although in urban conurbations, such as my Plymouth, Sutton and Devonport inner city constituency, there should not be a plethora of chemists just for the sake of having them. We need to make sure that patients’ safety is paramount when pharmacies are dispensing medicines.

Over the past five years I have consistently campaigned for the Government to decriminalise dispensing errors made by pharmacies. At present, GPs can only be struck off if they make a prescription error, whereas pharmacists can be sent to prison for exactly the same thing. We need a level playing field. Despite being the Government’s pharmacy champion, I am going to be slightly critical of the Government over this issue. We hoped that it would be sorted through secondary legislation before the general election. During a debate on the Access to Medical Treatments (Innovation) Bill, which was promoted by my hon. Friend the Member for Daventry (Chris Heaton-Harris), I questioned the Department of Health’s decision to delay the necessary legislation until after the devolved Assembly elections and the new Executives and Governments had had a chance to introduce their own legislation. This means it is unlikely to be introduced before the summer, so English pharmacists are now dependent on legislation being passed for other pharmacists. So much for fair devolution. When my right hon. Friend the Minister sums up, will he explain why English pharmacies have to wait until the Welsh, Scottish and Northern Irish Assemblies have passed the necessary legislation?

I understand that the Government are keen for pharmacies to be able to share summary care records to ensure that they are fully informed of patients’ medical history when giving medical advice. What progress is my right hon. Friend’s Department making?

Yesterday, I met the General Pharmaceutical Council, the pharmacy regulator since 2010. Various issues were raised by the GPC, especially the Pharmacy (Premises Standards, Information Obligations, etc.) Order 2016, which was in its Grand Committee stage in the House of Lords yesterday. I welcome this section 60 order, as it will bring much-needed transparency to the GPC’s reporting on inspections. There must be transparency. The section 60 would also allow the GPC to take proportionate action when pharmacies fail to meet essential standards. This is just one of the reasons why I support the section 60 order.

Pharmacy has the potential to play a huge part in community healthcare in Britain. However, we need to address the fundamental flaws in the system so that our communities are better served by pharmacy and our healthcare system is used responsibly.

[Mr Mark Williams (Ceredigion) (LD)]

I note the time, Mr Streeter, and your stipulation about when Front-Bench speeches will start. I thank the hon. Member for St Ives (Derek Thomas) for initiating this important debate. As I look around the Chamber today, I see that Members from Wales, Scotland and Northern Ireland are outnumbered, which is appropriate, given the letter that was sent and the cuts that pharmacists might endure. In Wales, the issue of health is almost entirely devolved, so much of what is being discussed today will be different in Wales from in England. However, the community pharmacy contractual framework is an England and Wales arrangement, so what happens in England could impact on Wales.

The hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile) mentioned the issue of devolved Administrations and delays. Our understanding is that the consultation will conclude, the Minister will reflect, and an announcement will be made during the Assembly election campaign period. We will not have a health Minister in Wales if decisions made in Whitehall impact on the delivery of services in Wales. I think that it has something to do with the respect agenda and waiting for a health Minister to be in place.

[Oliver Colvile]

Does the hon. Gentleman recognise that if there were delays in Wales, Scotland or Northern Ireland, the English pharmacies would end up waiting behind that queue?

[Mr Williams]

The hon. Gentleman should address that question to the Minister. The timing represents an unfortunate mismatch, for which pharmacists in England might pay the price. The timetable is of the Government’s making, not mine, so the Minister needs to reflect on that.

I want to talk about two facets of this debate that have been touched on by the hon. Members for St Ives and for Bexhill and Battle (Huw Merriman): the issue of rurality and the impact of the cuts. The consultation document stated:

“40% of pharmacies are in clusters of 3 or more meaning that two-fifths of pharmacies are within 10 minutes walk of 2 or more other pharmacies”.