Draft Human Medicines (Amendments relating to Registered Dental Hygienists, Registered Dental Therapists and Registered Pharmacy Technicians) Regulations 2024

Debate between Richard Fuller and Andrea Leadsom

Tuesday 21st May 2024 General Committees

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I beg to move,

That the Committee has considered the draft Human Medicines (Amendments relating to Registered Dental Hygienists, Registered Dental Therapists and Registered Pharmacy Technicians) Regulations 2024.

It is a pleasure to serve under your chairmanship, Mr Hollobone. The Government are proposing changes that would improve patient access to medicines in both dental practices and pharmacies.

First, hon. Members will know the vital role that pharmacies play in communities across our country, and I am sure that they will join me in expressing enormous gratitude and appreciation for the incredible work of brilliant pharmacists up and down the country. Of course, pharmacists dispense prescription medicines to the public, but for many people they are also the first port of call for healthcare advice. Pharmacies can provide a number of different services, including vaccinations, blood pressure checks and contraception, and that takes pressure off hospitals and GPs while playing an essential role in safeguarding the nation’s health. Pharmacists are fully trained and qualified, and pharmacies in hospitals are a key source of advice for doctors, nurses and other clinical staff. As well as supplying basic healthcare products, they support the management of complex medication regimes.

Pharmacies are a priority for this Government, and of course for the Prime Minister personally. Indeed, I do believe that the Prime Minister’s own mother was a pharmacist—colleagues may have heard that. [Interruption.] Have they? I think they have. I thank her for her lifetime of service, and pay tribute to every pharmacist who is helping us to deliver for the British people by taking NHS appointments, day in and day out. In recognition of the clinical expertise and knowledge that pharmacists have to offer, this Government have invested in pharmacy as part of our primary care recovery plan. We have made significant funding available for more blood pressure checks and more contraception consultations, as well as for Pharmacy First, which launched in January 2024, enabling community pharmacies to supply prescription-only medicines for seven common conditions without a prescription from a GP. Together with the investment in more blood pressure checks and oral contraception consultations, Pharmacy First will save around 10 million GP appointments once fully rolled out. The sector has embraced Pharmacy First, with over 125,000 consultations delivered in February, which was the first month of the service. Data on Pharmacy First delivery will start to be published from the end of this month.

Secondly, hon. Members will be only too aware of how important dental practices are in local communities. Dentistry is a top priority for this Government, and that is why we published our dental recovery plan in February. I am delighted that the plan is already delivering results on the ground, with nearly 500 more dental practices now open to new NHS patients. Dentists not only deal with emergencies, of course, but play a critical role in prevention.

Although the draft statutory instrument covers two very distinct professions, it will enable both to use their full range of skills to supply patients with the medicines they need in a timely manner. Legislation already allows some registered healthcare professionals to supply or administer certain medicines as part of their usual clinical practice. These are called exemptions. Our proposed changes will put exemptions in place for dental therapists and dental hygienists to supply or administer a range of medicines that are already a part of their day-to-day jobs. The changes will mean that they can supply or administer those medicines to patients without first having to refer to a dentist, so that they can deliver care without the need to organise additional appointments or interrupt dental colleagues who are already busy with other patients. These sensible, common-sense measures will free up precious time for clinicians and patients alike. The medicines are listed in the draft regulations. Seven of them are topical or local anaesthetics, three are fluoride products, and there is one antibiotic gel and one antifungal medicine.

Healthcare professionals have a responsibility to carry out care only where it is safe to do so and they are competent to do so. Many already have extensive experience of using these medicines, but of course we will not be compromising on safety one inch. Dental practices will continue to be responsible for making sure that clinicians undertaking the procedures have the knowledge, qualifications and skills to carry them out safely, and training will be made available for all those who want to make use of the exemptions. That will help dental practices to safely deliver more care for their patients as part of our dental recovery plan.

Our proposals will allow pharmacy technicians to supply or administer medicines to patients using mechanisms called patient group directions, or PGDs, which are written instructions that allow some healthcare professionals to supply or administer specified medicines to patients with certain conditions, without the need for a prescription. They are developed by experts from a range of fields, who thoroughly kick the tyres of every PGD before they are passed. Pharmacy technicians will be responsible for assessing whether patients fit the criteria. Once implemented, PGDs are carefully monitored to check they are being used appropriately on the ground. It is up to local healthcare organisations to decide, following national guidelines, whether a PGD route is appropriate for a clinical service. Local clinical managers are responsible for permitting healthcare professionals to work under PGDs, while making sure they are trained to use them safely.

Hon. Members might have come across pharmacy technicians in their local hospitals without necessarily realising who they are or what they do. However, pharmacy technicians are well placed to take on these roles. In fact, they already carry out a wide range of tasks in many healthcare settings, including hospital and community pharmacies, GP practices, care homes, prisons, our armed forces and the pharmaceutical industry. In recent years, their roles have given them opportunities to work face to face with patients, making them highly adept at answering questions about medicines.

We are making changes to training for pharmacists that will soon mean they can graduate as fully qualified prescribers.

[Richard Fuller (North East Bedfordshire) (Con)]

I fully support what the Minister proposes, but I have a maths question for her. I know that she did not prepare the impact assessment herself, but she probably reviewed it. It states:

“We have discounted benefits to patient health and the NHS at 1.5% per annum and all other benefits at 3.5% per annum.”

Of course, that lower discount rate has the effect of making the later benefits look better—they are not discounted to a lower level now, so we can spend more money for the same amount of benefits later on. Is the Minister comfortable with those discount rates? Given where interest rates are now, will she put some questions to the people who made the impact assessment about why those particular discount rates were used?

[Dame Andrea Leadsom]

As always, my hon. Friend makes a very good point about the finances. I cannot answer his question immediately—I would have to refer back to the impact assessment—but perhaps I can write to him on that point. It is vital that we look at the longer-term impact of any change that we make. Without addressing his specific point, I can say more generally that in introducing these further flexibilities for pharmacy technicians, we are increasing capacity in the very important sectors of dentistry and pharmacy, and doing so will benefit patients and the national health service alike.

Let me conclude by pointing out that, together with the proposals we are debating, all these measures will expand capacity in pharmacies for the prescribing, supply and administration of medicines, providing patients with access to a wider range of clinical services delivered by healthcare professionals with the right skills, at the right time. That supports the Government’s ambition to improve outcomes for patients while reducing demand on other parts of the service. I commend the regulations to the Committee.

Oral Answers to Questions

Debate between Richard Fuller and Andrea Leadsom

Tuesday 5th December 2023 Commons Chamber

[Richard Fuller (North East Bedfordshire) (Con)]

Will the primary care Minister join me in congratulating the Conservative Mayor of Bedford borough for proposing council money to invest in primary care facilities in Great Barford, Wootton, Wixams and Kempston? Will she condemn Labour and Liberal Democrat councils for voting it down?

[Dame Andrea Leadsom]

I am glad that my hon. Friend has raised this issue. He is absolutely right; in local authorities we need mayors and integrated care boards supporting primary care and not listening to the Opposition, who talk it down the whole time. The 50 million more GP appointments is something to celebrate.

Bankers’ Bonuses and the Banking Industry

Debate between Richard Fuller and Andrea Leadsom

Wednesday 25th February 2015 Commons Chamber

[Andrea Leadsom]

I am glad that my hon. Friend has raised that point, and I am happy to reiterate my remark that the financial services sector employs up to 2 million in this country, most of them outside the City and many of them doing regular jobs in banks and call centres, or even in places such as a new dealing room that has been set up outside Birmingham, which I recently had the pleasure of visiting. All those people are as mortified as the rest of us at the behaviour of a few, so it is always important to remember that we are talking about the behaviour of a few, not of the many.

The third thing that the Government have done is to improve the accountability of bankers. I hope hon. Members will agree that the vast majority of people in the financial sector are decent people who have played by the rules and just want to get on with providing a valued and trusted service to their customers. We must have high standards in banking, because that is what will help the UK to continue to thrive as a leading and trusted financial centre. The sector remains a huge asset to the British economy, contributing almost an eighth of the total tax receipts and giving us a trade surplus of £16 billion last year.

Banking oils the wheels of the economy, helps our businesses grow, fosters investment and boosts aspiration. When bankers get it right, it is a driver of this country’s growth. When they get it wrong, the damage is consequentially enormous, because it threatens the livelihood of millions of people in this country, as we saw during the financial crisis.

The public will want to know that this Government have made reckless misconduct leading to bank failure a criminal offence, and overseen banks being fined heavily for their worst excesses. There have been £450 million of fines for the disgraceful rigging of LIBOR and £1.1 billion of fines for the manipulation of foreign exchange rates—disgusting and unacceptable behaviour. I know that all Members will be reassured to know that the Serious Fraud Office has opened investigations into a number of individuals in relation to the manipulation of LIBOR and forex. Of course, many firms have sacked and dismissed staff found guilty as part of their own internal investigations.

[Richard Fuller]

My hon. Friend is now stressing one point that the everyday people feel is most important about the reform of our banking system—that when bankers do wrong, they should face criminal prosecution and the prospect of jail. Is she satisfied that we now have the right measures in place—measures that the last Government did not put in place—and will she assure the House that she will ensure that the Government use all their powers to enforce the regulations as far as possible?

[Andrea Leadsom]

That is an important point. This Government have taken every step we can think of to ensure accountability, prevent future wrongdoing and improve standards in banking. We are always open to new suggestions, but it is our genuine belief that we have fundamentally changed the underlying systems that banks work with. I can certainly reassure my hon. Friend that when I speak to the chief executives of banks, as I do regularly, they assure me that they, too, take the matter extremely seriously and have put in place checks so that they can indentify wrongdoing and punish the offenders under their own steam, as hon. Members will have seen in the press today.

Public Service Pensions Bill

Debate between Richard Fuller and Andrea Leadsom

Monday 29th October 2012 Commons Chamber

[Andrea Leadsom]

The hon. Lady makes an extremely good point. I am not advocating that we reduce public sector pensions to the private sector level, but this does, of course, absolutely bear comparison. This Government are not reducing public sector pensions to the pitiful state the Labour Government left private sector pensions in when they left office. That is precisely the point I am trying to make. We are proud of the fact that our public sector pensions will remain among the best in the world. That is something to be very proud of, and the Opposition should be congratulating the Government on having achieved that at this extraordinarily difficult time.

Let me disabuse Members of one final myth. The Opposition like to say that private sector workers earn more, so private sector pensions make up for the shortfall in salaries. That is not the case. The Institute for Fiscal Studies calculates that on average hourly public sector wages are 7.5% higher than hourly private sector wages, even when we take into account an individual’s education, age and qualifications. That is a very important point. Public sector pensions do not subsidise lousy working rates—quite the opposite, in fact. Those in the public sector rightly have a good deal in their employment and in their pension. That is what we wanted to achieve and I commend those on the Front Bench for doing so.

The most important aspect is sustainability, because what we had was unsustainable. Over the past decade, public sector pension costs increased by a third in real terms. Between 1999-2000 and 2009-10, the amount of benefits paid from the five largest public service pension schemes increased by 32% in real terms. In five years’ time, we are set to spend £33 billion a year on public sector pensions—more than on police and transport combined and 1.8% of GDP.

[Richard Fuller]

On that point about overall fairness and sustainability, does my hon. Friend believe that the Government could have gone further in ensuring sustainability by looking to move towards a fully funded form of public sector pension scheme? There is still an exposure for the public purse in the future. and although the Minister is putting in some cost control, we could have gone further, could we not?

[Andrea Leadsom]

Of course, my hon. Friend is quite right: we could have gone much further. Across Europe, public sector pensions and terms are being cut with immediate effect to deal with the appalling debts that countries have run up, whereas this Government are putting in place measures that are entirely fair and sustainable both for the taxpayer and the public sector worker.

Let me conclude by saying again that it is an unmitigated good thing that people are living longer, healthier lives, and that we should celebrate our public sector workers and the job they do. They do a fantastic job for us of which we are very proud and we want to ensure that they are fairly rewarded, in a way that is sustainable for the public purse for many decades to come.