Community Pharmacies

Sharon Hodgson Excerpts

Wednesday 2nd October 2019 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir David. I thank my hon. Friend the Member for Halifax (Holly Lynch) for securing the debate, and for her excellent opening speech. For their contributions early on this cold Wednesday morning, I also thank my hon. Friend the Member for Heywood and Middleton (Liz McInnes), my right hon. Friend the Member for Rother Valley (Sir Kevin Barron), the hon. Member for Strangford (Jim Shannon), my hon. Friend the Member for York Central (Rachael Maskell), the hon. Member for Westmorland and Lonsdale (Tim Farron), my hon. Friends the Members for Scunthorpe (Nic Dakin) and for Great Grimsby (Melanie Onn), and the hon. Member for Motherwell and Wishaw (Marion Fellows), who speaks for the Scottish National party.

It is clear that community pharmacies are valued across all our constituencies. On Friday I will be visiting Davy Pharmacy in Castletown in my constituency. I will hear once again at first hand how my constituents benefit from community pharmacies, and the impact that their services are having.

I welcome the new Minister to her role. I look forward to hearing from her today and to shadowing her in the months to come. I know that health is very important to her, and that it is one of the reasons why she stood to be a Member of Parliament. We previously worked together as officers of the all-party parliamentary group on breast cancer.

I will begin with one of the first things that springs to all our minds when we think about community pharmacies: prescriptions. As my hon. Friend the Member for Leicester South (Jonathan Ashworth), the shadow Secretary of State for Health, announced in Brighton last week, the next Labour Government will introduce free prescriptions for all. We believe that prescription charges are a tax on sickness. When as few as 5% of patients actually pay for their prescriptions and many of them struggle to pay, surely it is time that the charge was scrapped.

The £9 per item prescription charge results in some patients on low incomes reducing their medication or going without, which is dangerous and can impact on a patient’s long-term health. It can even be fatal, as in the heartbreaking case of 19-year-old Holly Warboys, who died of an asthma attack. Holly did not have a full inhaler because she could not afford one. Nobody should have to pay to breathe.

A large proportion of the 5% of people who pay for their prescriptions budget for them by taking advantage of prepayment certificates, to reduce what they have to pay to the equivalent of about one and a half prescriptions per month. When all the costs of administering the fines and prepayment certificates, and the whole kit and caboodle around charging, are taken into account, it seems eminently sensible, fair and cost-effective to extend free prescriptions to all.

Research backs that up. A study from the University of York has shown how beneficial free prescriptions can be as a means of prevention. When patients suffering with Parkinson’s disease, for example, were given free prescriptions, hospital admissions were reduced by 11.4%, patient day care was reduced by 20.4%, and accident and emergency attendances were down by 9%. I am sure that the Minister will see that the policy will improve patient outcomes and save precious NHS resources. I know that she is new to her post, so she might want to make a bold announcement today. Will she match Labour’s commitment to ending this tax on sickness? The subject was definitely on the radar of one of her predecessors on the health team, the hon. Member for Winchester (Steve Brine), as I had conversations with him about it.

As we have heard, filling prescriptions is only the tip of the iceberg of the services that our community pharmacies provide. There is the potential for the expansion and development of a whole range of services. For example, I would like to see an expansion of pharmacists being able to prescribe, especially basic medications, in order to relieve pressure on our GPs. I understand that that service is very successful where it currently happens. Community pharmacists are the most accessible healthcare professionals, and community pharmacies are a genuine hub for the delivery of a diverse range of health and wellbeing services. The Government’s television campaign advises people to ask their pharmacist, because it really is an easy thing to do. That is especially true for traditionally hard-to-reach people who benefit from the barrier-free access to healthcare that community pharmacists provide.

In some circumstances, if there is a high turnover of GPs in an area, the community pharmacist is the only one providing continuity of care, which builds invaluable trust and the capacity for important health interventions. It is therefore a natural and sensible progression to allow basic prescribing, especially if it is coupled with a sort of triage service that is linked to an ability to make appointments for people with more serious concerns directly with their GP.

As we have heard, community pharmacies have long provided a range of services in addition to the provision of medicines, including minor ailment schemes, smoking cessation services, blood pressure testing, support for asthmatics and diabetics, emergency hormonal contraception and monitored dosage systems. Despite that, community pharmacies are in many ways the NHS’s best kept secret. They are invaluable in a health service that is overwhelmed by increased demand.

There is so much untapped potential in community pharmacies, as well as some excellent examples of best practice across the country that could be rolled out nationwide. For example, when patients phone the Central Gateshead Medical Group with a minor illness such as earache or a sore throat, they may be offered a referral to one of 13 community pharmacists in the Gateshead area for a same-day booked consultation, which creates capacity for GP appointments for patients who need to be seen by a GP. The patient’s referral details are sent to the pharmacy using a secure NHS mail account. Patients are then sent a text message to confirm the details of the appointment with the community pharmacist. Community pharmacists are already doing some great work and they have a huge role to play at the heart of every primary care network. The Government are failing to recognise that if they do not try to roll that out.

I welcome the Government’s commitment to prevention, but they must put their words into action, for example by reversing the terrible cuts to local authority public health budgets and by recognising the importance of community pharmacists in particular and the role that they can play in prevention. As we have heard, thousands of people—millions, actually—visit their community pharmacy every day. Every one of those presents an opportunity for a positive health or wellbeing intervention. In the words of Simon Stevens, “Make every contact count”.

The profession and its representatives, the Pharmaceutical Services Negotiating Committee and the National Pharmacy Association, have offered to deliver more services. The recently negotiated new pharmacy contract begins to recognise what the NHS has been missing for so long. There are many welcome features, including the new community pharmacist consultation service, which will take patient referrals from NHS 111 and will be extended for referrals from other parts of the NHS, such as GPs and A&E. Similarly, the new Medicines reconciliation service will ensure that medicine prescribed in secondary care is appropriately implemented on discharge to the community, which will reduce the number of unnecessary hospital readmissions. Those changes will be not only convenient for patients, but enormously important in relieving pressure on GP surgeries and A&E departments, which is what we all want to do.

That is why we need a shift to service-based remuneration in the context of a five-year agreement. If community pharmacies, with their huge potential, are to remain viable, the remuneration must be adequate. Can the Minister tell us today what the new funding settlement will look like? I hope that, in her response, she will celebrate the work of community pharmacies—I am sure she will—and set out what the Government will do to utilise their potential.