Community Pharmacies: Devon and the South-west

Sadik Al-Hassan Excerpts

Tuesday 17th December 2024 Westminster Hall

[Sadik Al-Hassan (North Somerset) (Lab)]

It is a pleasure to serve under your chairship, Mr Betts.

Over the past two decades I have had the privilege of working in a range of community pharmacies across the south-west and elsewhere. I thank the hon. Member for Tiverton and Minehead (Rachel Gilmour) for the best birthday present I could ask for: an opportunity to talk about a passion that has defined my life and that I am still proud to practice today. I started my journey in community pharmacy studying at that pearl of south-west education, the University of Bath, more birthdays ago than I care to admit. From there, I went on to work in community pharmacies across the region, from Bideford in north Devon to the heart of Bristol, and even in Clevedon—a town I am honoured to represent as its Member of Parliament.

During my time working in village pharmacies, town pharmacies and even online pharmacies, I was witness to the irreplaceable value that pharmacies and their teams provide to some of the most vulnerable in our society. I am sad to say that I also experienced many of the challenges that the sector now faces. Indeed, it was living with those challenges and seeing the unnecessary suffering caused by the decline of community pharmacies that prompted me to run for Parliament earlier this year.

Over the past two decades working in community pharmacies across the south-west, I have seen at first hand the consequences of 14 years of pharmacy neglect by the previous Government, not least through their bad Brexit deal. By weakening our co-operation with our nearest neighbours, we have cut off the supply of pharmacists coming from Europe, we have greatly exacerbated our supply chain issues, resulting in medicine shortages, and we have contorted the Medicines and Healthcare products Regulatory Agency into a role it was never designed for and has since failed to live up to.

Undoubtedly the worst thing the previous Government did for our industry was freeze the funding settlement for 10 years, resulting in a 40% reduction in real terms. With ever-growing demands on prescribing and the introduction of the new role for pharmacists with Pharmacy First, the Conservatives prescribed pharmacy a tough pill to swallow and it will take years to undo the side effects. That is why we must not waste any more time. We must stabilise the sector today with a fair funding settlement while we begin the arduous task of reforming the role of pharmacy and the role it plays in our healthcare system.

Pharmacy First was a good step but, with only seven conditions eligible for treatment, it falls far short of Wales’s 27 and Scotland’s 30, with the scheme in England fraught with issues, not least in payment. Although the obvious priority is to expand Pharmacy First and relieve pressure on GPs, we must first expand pharmacies’ capacity, which can be done only by finally implementing the hub-and-spoke legislation that was inexplicably shelved in September without warning or explanation.

Hub-and-spoke model 1 would allow smaller independent community pharmacies finally to take advantage of the technologies that larger chains have been using for decades, thereby greatly increasing their efficiency and freeing up time previously spent on dispensing to be used for the delivery of clinical services to patients under an expanded Pharmacy First scheme.

I am eager to see this Government avoid the mistakes made during the past 14 years that have brought the sector to crisis point. I thank the hon. Member for Tiverton and Minehead for securing the debate, and the Minister for listening to our concerns. We have a once-in-a-generation opportunity to rewrite the story of pharmacy, which has a long and rich history of healthcare provision in this country but now faces an uncertain future, with some in the sector concerned that we might not survive past 2039.

The prescription for pharmacy is an immediate funding settlement for this year to stabilise the sector with a sticking plaster while we look at the longer-term changes the industry needs. Having been on the ground for the past 20 years, I am here to say that pharmacy has cut every ounce of fat that can be cut, and all that is left is bone. Without advancing the modernisation agenda, the sector has no more efficiencies to make. For that to happen, we need the Government to commit to implementing the hub-and-spoke model to increase capacity, and to expanding Pharmacy First to use that capacity. Pharmacy has an important future role to play in relieving pressure on other parts of our healthcare system, but it can play that role only if we proactively engage with the sector, rather than leave it out in the cold for another 14 years.

--- Later in debate ---

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Betts, particularly because I speak after the hon. Member for North Somerset (Sadik Al-Hassan) indicated that it may be his birthday, which means that he and I share our birthday with the Pope.

[Sadik Al-Hassan]

I congratulate the hon. Member on having the best birthday.

[Vikki Slade]

I thank the hon. Gentleman for that intervention.

Like my colleagues, I get a lot of correspondence about community pharmacies, which comes from my constituents and also from the pharmacists of Mid Dorset and North Poole. One of my constituents, Ruth in Wimborne, visited Quarter Jack Pharmacy for me at the weekend to get some data. I asked her to get some examples of drugs for which the price differential between what was paid and what was reimbursed was particularly high. The pharmacist gave her a whole list of drugs for which the money received was substantially less than what he got. He said that the precise amount varied from week to week, including for apixaban, which is prescribed to prevent strokes and which presumably saves the NHS a lot of money. Does the Minister agree that that is unacceptable? What commitment will he give to update the contract urgently?

On the medicines shortfall, I cannot tell Members how many people have told me about having to go around the county to try to find the medication they need. Patients with epilepsy, attention deficit hyperactivity disorder, Parkinson’s and sight loss have all contacted me worried about their health. David explained his issue with epilepsy, which is that stress can increase the chance of seizures. I have a personal example: my husband Paul also has epilepsy, which is controlled by drugs, but if he has one seizure, he will lose his driving licence again. He has just got it back after two years and I really do not want to be driving him around. The idea of people being unable to work or drive is mad. The list of medicines available under prescription includes epilepsy, but not Parkinson’s. Does the Minister agree it is high time that the list was updated, given that it was last changed in 1968?

There has been a recent consultation on allowing non-pharmacists to give out bagged medication, and on pharmacists being allowed to give approved persons the right to issue medication. I wrote to the Minister to ask when we were going to get a result and was told that it was still being considered, so I really hope that, today, he might give us a timeline for when we can expect that for our pharmacists.

Finally, in one of my local villages the GP dispenses out of a side window of the surgery, with patients expected to wait in the cold. When I asked why they could not reduce this inconvenience for patients, who are often out there for 45 minutes, I was told it was because they cannot make up prescriptions for three months instead of one because they get paid per prescription and not for the drugs, so the GP would be out of pocket if they made the prescription for three months. That seems outrageous. If it is true, will the Minister urgently review how that works so that dispensing GPs and pharmacists are not out of pocket for providing a better service to their patients?