Community Pharmacies

Rachael Maskell Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Derek Thomas]

That is absolutely superb—my next line is: “Community pharmacies have a vital role in giving advice and in diverting patients from GPs and emergency departments,” exactly as my hon. Friend said. In tourist areas such as Cornwall, they take their share of the extra demand during the height of the season. Most recently, my local community pharmacists administered flu jabs to increase uptake. Pharmacies regularly get prescriptions to patients out of hours when no alternative is otherwise available, and Cornwall has led the way, with ground-breaking work in enhanced services. That is an example of how community pharmacists are very much part of the solution to integrated community health provision.

Healthwatch Cornwall recently surveyed Cornish residents about access to community pharmacies. Some 69% of participants said that they regularly visit their pharmacy, and 74% of those felt comfortable talking to the pharmacist about their health, while 78% felt well informed by their pharmacists when taking new drugs and 93% said that the pharmacist was polite and helpful.

One constituent of mine, a retired doctor, Professor Dancy, wrote to me as follows:

“I am a warm supporter of Nigel, our local pharmacist, and proud to be so. He is always ready to help when I forget (as one does at the age of 95) to re-order a medicament, and when my doctor is unavailable, or just pushed for time, I do not hesitate to ask Nigel for advice, which I follow with a confidence that is always rewarded.”

Community pharmacists are highly trained and trusted healthcare professionals, qualified to masters level and beyond. Their knowledge base covers far more than just drugs, making them the ideal healthcare professionals to relieve pressure on GPs and other areas of the NHS. Equally importantly—perhaps even more importantly—community pharmacists are welcoming change and embracing new clinical opportunities.

However, the proposed funding cut will not sustain the transition from a supply-based service to the more clinically focused service that the Government desire and our patients deserve. Cuts will discourage progress and can only result in small, independent and much-loved businesses failing, at the expense of patients, the public and the wider NHS.

[Rachael Maskell (York Central) (Lab/Co-op)]

In York, the local authority has made cuts to smoking cessation services, as well as NHS health checks, and the community pharmacists I have spoken to have said that they see their future role as filling some of those gaps. However, with further cuts to community pharmacy itself, where are people meant to go—back to queues in GP surgeries?

[Derek Thomas]

I thank the hon. Lady for that intervention. That is exactly why we are having this debate. I want the Government to examine the value of community pharmacists and to consider how they can do some of the work—in fact, a large part of the work—that would save money for NHS acute services.

I am well aware that there is a need to secure better value for money in areas of the NHS. Over the weekend, I met four community pharmacists and they all talked of the opportunities to make savings that they have identified. They are willing and able to see more patients. Pharmacists give free, over-the-counter advice to thousands of people every day, promoting self-care and diverting patients from GP and urgent care services. However, it is estimated that £2 billion-worth of GP consultations a year are still being taken by patients with symptoms that pharmacists could treat.

Pharmacists want to have a greater role in prescribing drugs, so as to reduce waste. Last year in Cornwall alone, £2 million-worth of unused drugs were returned to community pharmacists to be destroyed. Pharmacists are best placed to reduce this waste. They want to do more to support people with mental illnesses; they are keen to provide continued care of people with diabetes and other long-term conditions; and my local community pharmacists want to work with the Department of Health to improve services, engage in health and social care integration, reduce drug waste and improve access to records, in order to support the giving of prescriptions.

--- Later in debate ---

[Kevin Barron (Rother Valley) (Lab)]

I congratulate the hon. Member for St Ives (Derek Thomas) on securing this debate.

I am the chair of the all-party group on pharmacy in Parliament and I have been for more than five years. I have a keen interest in public health and lifestyle issues, and I have quite enjoyed chairing the group. After the letter of 17 December, the all-party group—three Members of this House and one from the other place—met the Minister, on 13 January. We had what I described afterwards as “straightforward talking” about the letter—a letter that posed more questions about the future of pharmacy than it gave answers. The Minister was straightforward, and he said that one issue was that, in October of this year—so just for the second half of the financial year—£170 million will be taken out of the community pharmacy budget. That leaves a number of questions to be answered, including that of what will happen in a full financial year.

The Government make great claims about putting an extra £8 billion into the national health service, but the truth is that that £170 million, which is part of the £22 billion of efficiency savings, is being taken out of the NHS, so it is hardly new money. It is not the £8 billion—that comes in a few years’ time. We are talking here about major cuts to vital services.

Since the publication of that letter, it has become clear that as many as 3,000 community pharmacies could close in England alone—a quarter of them. How would that happen? Would it be by stealth, which is suggested in the letter and in the consultation currently coming out of the Department, or is there some sort of plan? We have seen in the letter, and in others, that if there is a 10-minute walk between pharmacies, that might be looked into, but there seems to be no plan whatsoever.

What we have to accept—I put to this to the Minister in that meeting on 13 January—is that pharmacists do not work for the national health service, yet more than 90% of community pharmacies’ income comes from the NHS. The idea that we could change that mechanism and close community pharmacies is outrageous. The pharmacists may not work for the national health service, but their income depends massively on it—I wish it did not.

For many years I have been promoting lifestyle issues and the idea of pharmacists getting paid for doing things other than just turning scrips over, but that is how it works at the moment and there needs to be some serious talking. What happens if someone who has a 10-year lease on a property they took over to run the local pharmacy is forced out of business? All those questions remain unanswered, yet there is the threat of up to 3,000 pharmacies in England closing.

[Rachael Maskell]

I am following the argument that my right hon. Friend is putting forward. Does he agree that, instead of cutting services, we should be looking at opportunities for community pharmacies to extend healthcare further into their communities? It should be about investment at this time, particularly in prevention, which is all about saving money further down the line.

[Kevin Barron]

I agree with my hon. Friend. That is one of the reasons I took over as chair of the all-party group more than five years ago. I believe that our pharmaceutical services should be taking that route of travel.

It would help if the Government provided details of how they will ensure access to pharmacy services in remote or deprived communities. If the market will drive closures, there will be chaos, and something substantial needs to be in place.