(5 years, 2 months ago)
Commons ChamberI am grateful to my right hon. Friend, who is right to highlight the work for his local hospital by our hon. Friend the Member for Hertford and Stortford (Mr Prisk) and by the right hon. Member for Epping Forest (Dame Eleanor Laing) who, given the nature of her office, may not speak but works incredibly hard for her constituents on this. My right hon. Friend the Member for Harlow (Robert Halfon) has a strong track record of campaigning successfully on a range of issues, so I suppose he will be pleased that yet again he has secured a victory for his constituents and his area. I join him in paying tribute to Lance McCarthy and the entire team at the hospital and the trust.
Every day, our NHS staff go above and beyond everyone’s expectations in whatever buildings, to make sure that they deliver first-class care for all our constituents and, indeed, for us all. I will happily write to my right hon. Friend setting out the process in more detail. I believe that my predecessor in this role was due to visit on the day on which he was reshuffled, so I very much look forward to taking up that invitation if it is extended and coming to see my right hon. Friend.
It is said in the House that the vote follows the voice. On NHS infrastructure, it seems that the cash follows the camera. On that basis, may I ask the hon. Gentleman to pop round to Ealing Hospital, where he will be welcome? In his statement, he referred to staffing as well as infrastructure, so is he prepared to be asked about the current situation on nursing bursaries? Would he care to share his thoughts with the House?
I am grateful to the hon. Gentleman for his question, asked in his inimitable style.
It was one of his better ones. I will happily take up the hon. Gentleman’s invitation to visit his local hospital, which, as I recall, he told me was opened by Lord Patrick Jenkin. I am always happy to visit hospitals with colleagues, and when I do so I am always happy to talk to any staff members who want to talk to me about anything that is of concern to them. The hon. Gentleman is absolutely right to highlight the importance of adequate supplies of nurses for our NHS, both in the recruitment and training of new nurses. We also need to focus to returnees, whatever the reason they left the profession, and tempt them back. He is absolutely right, and I look forward to seeing him in his hospital.
My hon. Friend is right that persistence does pay off, and it certainly has done so in his case on behalf of his constituents. He is right to highlight the importance of the sustainability of services, which is what we are seeking to do with the investment, and also ensuring that services are designed to reflect the geography and needs of the local population, to ensure that they have access to the healthcare that they need when they need it. He kindly invited me to visit. I suspect that it is a little easier to visit Ealing than Devon, but I shall endeavour to do so.
Order. The words “cheeky chappy” could have been invented to describe the hon. Gentleman, and I am sure that that is something in which he takes great pride, among many other things.
(5 years, 10 months ago)
Commons ChamberMay I say that north-west London salutes north-west Glasgow? I was honoured and proud—not that I had much choice in the matter—to support the hon. Member for Glasgow North West (Carol Monaghan) when she applied for the debate. Her influence clearly spreads much further than Whiteinch, because only last week the Scottish Government launched their national action plan on neurological conditions. Action for ME was not particularly delighted with the plan, but one of the good things to come out of it is the allocation of £90,000 to fund a PhD study on the impact of ME. If that funding was increased proportionately for the whole country, it would be well over £1 million. That is something we certainly look forward to.
We have talked about the individual circumstances of many of our constituents. I want to mention one area that has not yet been mentioned: the provision and allocation of social housing. People with myalgic encephalomyelitis and chronic fatigue syndrome often have very specific housing needs. I think of my constituent Pamela Badhan—she is admirably represented by Councillor Deirdre Costigan—who finds it intensely difficult to live where she is at present because of her condition. The thing about ME is that, even if someone with the condition sleeps all night, they are still exhausted the next day, because the exhaustion is endemic; it cannot be sated by sleep. That is how terrifying the condition is.
I will not go into the details of the research today, but we do need to have the biomedical research. We have moved a little further forward since the dark days of the stiff upper lip, when people were told to take one round turn and two half hitches and then pull themselves together. We have to change attitudes, and that cannot be dictated—we have not had a dictator in this country since Oliver Cromwell. We cannot say what a people will do. What we can do is raise this issue, calmly, objectively and using all the pragmatic skills and data available to us.
I want to say to all those people out there who are suffering from ME; all those people suffering from chronic fatigue syndrome; all those people who have been ignored, belittled and, in many cases, insulted: “This House recognises the reality of your condition. This House will not sit idly by while you suffer. This House will not ignore you. This House will devote its intelligence and resources to research and ultimately resolve and cure this terrible condition, because we respect you, we understand you and we give credit and credibility to what so many people have for far too long denied.” ME sufferers the world over must know that this House and this nation are finally speaking for them.
(6 years, 6 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Gapes. I thank the hon. Member for Glasgow North West (Carol Monaghan) for securing this very important debate.
Merryn Crofts, who has already been referred to in this debate, is one of just two people in the UK who have had myalgic encephalomyelitis recorded as the cause of death. She was my constituent and lived in Norden in the Rochdale area of the Heywood and Middleton constituency. I spoke with her mum, Clare, this week, who told me that the reports about Merryn in the newspapers did not really cover the whole of Merryn’s condition. Clare wanted to be here today to hear the debate, but could not travel to London because of a new baby in the family, so I hope that she is able to watch the debate back home in Rochdale. I send my best wishes to her and to the new baby.
Indeed, from all of us. Merryn met all the diagnostic criteria set by NICE, and the Canadian consensus criteria, for a diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome. Merryn was totally bedbound. She physically could not get out of bed. She suffered so badly from postural hypotension that she blacked out if placed in a sitting position or even if her bed was raised slightly. She was hypersensitive to noise, light, touch and movement. She suffered so badly from pain—head, muscle, neurological and stomach pain—that she could not get out of bed. Her GP had worked in a hospice for 10 years, looking after cancer patients, and said that in that job she could not always take away pain, but she could manage it. In Merryn’s case, the GP said that her pain was unmanageable. Although Merryn was on diamorphine and ketamine, she was still in pain. Any kind of stimulus, even just a nurse walking in to the room, was an exertion to Merryn. She was permanently on syringe drivers and receiving injections. She was permanently nauseous.
The terms ME and chronic fatigue syndrome are often used interchangeably, but Merryn’s mum tells me that fatigue was the least of Merryn’s symptoms. In her view, the use of the term chronic fatigue syndrome should be abandoned, as myalgic encephalomyelitis is about so much more than just fatigue.
Merryn was only 15 years old when her illness started. For the first year, she was not housebound and she used to go out in a wheelchair, but as her condition worsened she became unable to go out. She went from a young girl who loved life, with passions for drama and acting, to a housebound patient, whose family had to do more and more for her, even things like chatting on her behalf on social media—simple things that she was no longer able to do on her own.
I mention social media because Merryn was helped a great deal by the online ME community. Her mum tells me that Merryn always wanted positive support and was very choosey about who she communicated with. She did not want to speak with people who exuded negativity, but she was part of a big online ME community, which included people such as ballet dancers and sportspeople. That raises the issue of whether research should look at the lifestyles of those who contract ME and whether there is a susceptibility that can be exacerbated by leading an active life and pursuing strenuous sports or vocations.
Merryn’s mum is critical of the PACE guidance given by NICE and attributes the worsening of Merryn’s condition to it. She tells me that Merryn thought she could push through the condition and keep going, although her family really wanted her to slow down. Sadly, it was only when the family contacted a private medical practitioner that Merryn was given the advice to slow down and told that she needed to rest. The specific advice given was,
“Whatever you feel you can do, only do 50% of it.”
Merryn’s mum feels very strongly that had Merryn been given that advice when her condition started, she might not have gone on to develop severe ME, and she strongly urges that the NICE guidelines should be reviewed. Merryn’s mum said,
“If the PACE trial were a drug, it would have been banned by now.”
I hope and I am sure that the Minister will refer to that in his response.
Merryn’s family are still very involved in the ME community and they run the “MErryn’s Legacy” Facebook page, which raises money for research and includes fundraising activities such as skydiving and climbing Ben Nevis: impressive feats that are done on behalf of the ME community as representative of the things they would like to do but are unable to because of their condition. The fundraisers do those activities on their behalf.
We need to invest more in research into ME. The best research, as has already been mentioned, is being done in the States. Here it is very much funded by charities and tends to concentrate on psychological issues rather than physical changes such as inflammation of the brain and changes to the central nervous system, and we need to do much more research into the physical aspect.
Nancy Klimas is a major ME researcher based in Miami. She has more than 30 years’ professional experience and has achieved international recognition for her work on ME. She compares patients with severe ME, like Merryn, with those in the terminal stages of HIV/AIDS infection in terms of the levels of pain that they suffer. Many comparisons can be drawn between HIV/AIDS and ME. When HIV was first identified it was thought to be incurable and a certain death sentence, but incredible research has produced advanced treatment with retrovirals, which, although they do not provide a cure, can be used to manage the disease, and it is no longer the death sentence that it was.
In comparison, ME is not seen as a death sentence, but, as Merryn’s case sadly shows, it can be fatal. It is also described as a kind of living death. The work done on HIV/AIDS shows how powerful good research can be. I hope that in future, following investment in ME research, we may also see great advances made in the treatment and knowledge of ME.
We also need to invest more in training for our doctors, especially general practitioners who are the clinicians likely to be the first port of call for those suffering with ME. Our GPs need the skills to recognise the signs and symptoms and to signpost patients to the appropriate specialists. I hope that the Minister might be able to refer to those points in his response. I am immensely grateful to Merryn’s family for sharing so much with me and for allowing me to tell her story.
It is a pleasure to serve beneath your benevolent oversight, Mr Gapes. I am pleased that my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) is on the Opposition Front Bench, and am also pleased to see the Minister. Those two people combine deep humanity with real understanding of how illness is examined, and how stereotypes and stigma can be challenged. Above all, I pay tribute, as everyone who has taken part in the debate would wish to do, to the hon. Member for Glasgow North West (Carol Monaghan). I was one of those privileged to support her in applying to the Backbench Business Committee. It is interesting that sitting with her at the table were members of the Scottish National party, Plaid Cymru, Labour and the Conservative party. There were no Liberals there at the time, but the right hon. Member for Kingston and Surbiton (Sir Edward Davey) was present earlier.
We supported the application for a debate so strongly not only because there is a crying need for some proper authoritative research at last but because of the personality of the hon. Member for Glasgow North West and the way she argued her case. She is not just a great humanitarian, but a scientist. She was a physics teacher, and is a pilot. She understands the importance of empirical evidence and data, and wants to see scientific evidence. On the occasion of our application, someone said that encephalomyelitis is probably the illness with the worst public relations officer ever, because there is no other illness so badly presented, or about which so much nonsense is spoken, or that has so many stigmas and stereotypes. One reason I supported the hon. Lady was that she seeks to cut through all the nonsense, get back to proper, hard scientific evidence, and move away from some of the dismissive, cruel and frankly painful comments that are made.
There are a number of arguments in favour of proper analysis and, subsequent to that, treatment, research and proper therapeutic assistance for what is a ghastly, debilitating illness. There is the economic case. In September 2017 the Optimum Health Clinic Foundation produced a detailed breakdown, in which it was calculated that the illness costs the UK economy more than £3 billion a year. That is an argument that can be made, but I would go beyond Gradgrind, and that sort of desiccated, calculating machine politics, to the humanity.
I want to talk about one particular group—children and young people. I am sure that it has already been mentioned that 21 years ago Dowsett and Colby produced detailed research showing that the biggest cause of long-term school absence was, as Members may guess, encephalomyelitis. Let us imagine the situation. A child at primary school has the symptoms of encephalomyelitis but does not know the name, probably could not pronounce it, and does not know what it is. However, they cannot get themselves to school. I am not talking about the schoolboy, with his
“shining morning face, creeping like snail
Unwillingly to school.”
I mean a child who simply cannot get out of bed or off the sofa or couch, and to school. What happens to such a child? I will tell the House—often they are referred to social services. Child protection referrals are often made because a child misses school. Imagine the impact on that child, family and school. I have known you long enough, Mr Gapes, to know that you have the milk of human kindness flowing through your veins. Can you imagine what it must be like for a primary school-aged child who is suffering from something terrible that they cannot even put into words to be penalised for it—interrogated and asked to prove that they are ill when they can hardly bring themselves even to speak or raise the energy to make their case? How cruel.
In some cases, the parents simply will not know. One reason I am so particularly keen to get some proper empirical data and research is that a family can have four, five or six children, and one suffers but the others do not. Imagine how the one child must feel, and how the other children will react to the one child. Can we imagine anything more brutally cruel than a situation in which a child is trying to pursue their education but is physically incapable of doing so? The great lesson that we learned from Sure Start—and, earlier, from the Jesuits—is that getting things wrong in the first seven years usually means they are wrong for life. If a child is suffering in the way I described, in the first few years in primary school, I despair for their future.
We must cut through all the mist, fog and obfuscation—the stigma, and all the words and insulting expressions—and do some research. Is the condition psychological, physical or psychosomatic? What is it? We know it cannot go unaddressed any longer. We cannot allow another generation to grow up incapable even of giving a name to what they suffer from. If diagnosis is not possible, what is the prognosis and the therapeutic response? What is the health service doing? What of primary care and the GP service? If they do not have the data, they cannot produce a cure. I do not make the economic argument, although obviously it is important. We need productivity and economic activity. However, it is above all the sheer humanity of the case made by the hon. Member for Glasgow North West in her brilliant speech that will have swept along everyone who heard it today. We simply cannot allow this situation to continue any longer. It is too painful, cruel, counterproductive and dangerous, and we are losing young people.
I know that there is mature-onset ME—it is not just children who are affected—but the people it affects have good advocates, and great speeches have been made on their behalf this afternoon. I want to make the case for children, because they can very seldom make that case for themselves. I look to the Minister and my hon. Friend the Member for Washington and Sunderland West. Today is the day when we finally start to take encephalomyelitis seriously and stop condemning people suffering from this ghastly, debilitating disease. Today is the day when we say, “Yes, we understand the pain people suffer. Yes, we are going to do something about it. Yes, we respect you. Yes, we value you. Yes, today we are going to start investing in diagnosis, analysis and, God willing, a cure.”
I shall start where everyone else has started and thank the hon. Member for Glasgow North West (Carol Monaghan), who secured this important debate, very much. She did so along with my right hon. Friend the Member for Loughborough (Nicky Morgan), who has to be in her constituency today to deal with a royal visit—lucky her.
Raising awareness of this debilitating condition is critical, and the hon. Member for Glasgow North West has undertaken significant work in this area over a number of years. Thirteen—lucky for us—Back Benchers spoke in today’s debate. I counted 25 Members present at our peak, which is excellent. I spend a lot of time with the hon. Member for Strangford (Jim Shannon) in Westminster Hall, it must be said, but that is a lot of MPs for a Tuesday afternoon, let alone a Thursday afternoon, so that is excellent.
As we have heard, ME, otherwise known as chronic fatigue syndrome, is an incapacitating condition with a plethora of symptoms, primarily characterised by long-term fatigue, chronic pain and post-exertional symptoms of malaise, to name but a few. There are many more and we have heard some excellent testimony of those from Members on behalf of their constituents.
As so many have said, the underlying causes of the condition, which for brevity I will call ME, are still poorly understood. There is no one diagnostic test to identify it, and although some people can and do improve and recover, there is currently no cure. That is a hard reality to face. Although the severity of symptoms and therefore the impact vary, ME can lead to poor attendance and affect outcomes at school for young people. I have a constituent in exactly that position with whom I am in regular correspondence—I will not name her but she knows who she is and I wish her and her mum well. ME can result in significant or indefinite time off work or job loss in adults; reduction or complete cessation of daily activities, which can lead to isolation and strain within families and the breakdown of marriages; and overall poor quality of life. As my hon. Friend the Member for Stirling (Stephen Kerr) said, it can lead to almost no life for some people and their loved ones.
I am surprised that other than the hon. Member for Bristol East (Kerry McCarthy), nobody mentioned “Unrest”. I know it well. Some constituents came to see me to tell me about the film. It had screenings in Winchester and Chandler’s Ford in my constituency, which were oversubscribed—packed to the gunwales—and there was not a dry eye in the house. I pay great tribute to Jennifer and her partner Omar who made that film. I am sure there were times when it gave Jennifer’s life a great purpose, but I am sure there were times when she wanted to say, “Get that bleeping camera out of my life!” There is a touching moment at the very start of the film when she says that when she was a young girl, she want to eat the world “whole”, because she wanted to see it all and do it all. That went to the heart of her great disappointment that she was so sick.
Jennifer set out very clearly and movingly the sheer ups and downs of this condition. For some, it is almost a constant down. I was struck by watching her at the Princeton University reunion day, during the rather surreal procession through the streets by old boys and girls from Princeton. She so enjoyed seeing old friends that day and looked full of life, but within an hour of it finishing she was absolutely poleaxed on the floor, saying that she felt her eyes were being pushed out of her head from the inside. It was horrible to watch.
It was interesting how the film moved around the different wild and crazy treatments that are out there on the internet. If hon. Members google any condition, they will see lots of wild and crazy treatments, but that is particularly the case with ME. One of the saddest things in it, although it covered it well, was the point that my hon. Friend the Member for Cheltenham (Alex Chalk) raised of the suicides resulting from this condition.
Millions Missing was mentioned by many Members, and I see some people wearing T-shirts in the Public Gallery. The hon. Member for Ealing North (Stephen Pound) is right that it has had some bad PR, but it is getting its act together. Millions Missing is an absolutely brilliant way of encapsulating the problem. A number of Members mentioned the shoes; I was particularly moved by the messages on the shoes. They were outside Richmond House, where the Department of Health used to be, as part of the Millions Missing campaign. The mission was to write what you miss; somebody had written on a pair of ballet shoes, “I miss dancing in these shoes.” That was really moving and a human way of putting it. I might touch on the film again a little later.
I assure the hon. Gentleman that I was not implying any absence of PR skills on the part of the advocates and the people who suffer from this debilitating disease; I was anthropomorphising the actual disease itself. I stole the words of the hon. Member for Cheltenham (Alex Chalk) when we pitched this debate to the Backbench Business Committee, because he was not in Westminster Hall at the time.
That is so unlike the hon. Gentleman. Good clarification.
The stigma quite rightly has been mentioned by pretty much everyone who have spoken today. We recognise that people with ME have encountered significant stigma, in part due to the unfavourable media representations of the condition that not only go back to the 1980s but have continued in recent times. I have seen a clip of Ricky Gervais in one of his otherwise amusing stage shows, when he says of ME, “Yes, that’s the one where they say I don’t want to go to work today.” Ricky Gervais is a very talented comic, but given that he is quite active on Twitter, perhaps he could retract that and apologise to the ME community today. Perhaps he could put #ME so we can look out for it.
My right hon. Friend the Member for New Forest West (Sir Desmond Swayne) made a very good point about mental health; it is totally wrong and insulting to say it is all in the head, but it also goes against the grain of what we are talking about in modern-day healthcare: the parity between mental and physical health. There must be a parity, and to suggest that that somehow lessens it is wrong. His intervention was timely and good.
The physical impacts of the condition have an impact on mental health, as other hon. Members have said. I am also the Minister with responsibility for cancer, so I speak in lots of debates in Westminster Hall and we talk about the mental health impact of cancer—the hon. Member for Washington and Sunderland West (Mrs Hodgson) knows all about them. A recent example was when we talked about the mental impact of blood cancer. People with ME often report that the legitimacy of their symptoms has been questioned by family, friends, employers, healthcare professionals—yes—and society as a whole. Lest hon. Members did not understand it from my opening remarks, let me clear that Ministers—especially this one—are not among that group of people.
That stigma can and does play a part in the development of the co-morbid symptoms of depression and anxiety, particularly for young people—I will come on to them in a minute—who keenly feel the consequences of the resultant social isolation at that moment of their development. As we have heard, suicide is not unheard of. We know that those who experience stigma often also experience discrimination, which has a profound negative effect on their lives. That is unacceptable, so I welcome the debate as a forum to raise awareness of ME and talking about it. The hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) mentioned that MND is being talked about, and he is absolutely right. He is a very good communicator, and I think this will probably be one of his next Facebook Live sessions.
(6 years, 7 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Perhaps we should start with what we agree on, which seems to me fundamental for all of us in Parliament: the NHS is more precious than perhaps any institution except our monarchy and democracy. We all agree that it is and should remain a public institution available to everyone, no matter what they earn, and free at the point of delivery. We absolutely agree on those tenets of the NHS and the health services that our constituents benefit from. However, there are also things that we disagree on.
I suggest that the debate has frankly more to do with imminent local elections in London and elsewhere than with the health of the national health service. It is at least the fourth time in my short eight years in Parliament that the left, or some of the left, have tried to weaponise the NHS. When I hear Labour MPs talking as the hon. Member for Colne Valley (Thelma Walker) did about the “dismantling” of the NHS, I say to them that if the Conservatives had ever intended to privatise the NHS it would have been done by now, for the Conservatives have been the party of government for much longer than Labour since 1948. Secondly, privatisation of the NHS has never been in a Conservative manifesto. I defy any Opposition Member to find a single Conservative Member of Parliament who would want it, although it is normally possible to find one MP to sign up to most things. There is a challenge to Labour MPs, and particularly to those new ones who have known only the right hon. Member for Islington North (Jeremy Corbyn) as their leader. If anyone really believes that real privatisation is anything more than a fantasy threat, I ask them please to go and find a single Member of Parliament from the Conservative party Back Benches who would support it.
I have huge respect for the hon. Gentleman and have come to admire him over the years, but clearly he has not visited a hospital lately and seen privatised portering services, privatised catering services, privatised nurses being provided by privatised banks, privatised doctors being provided by privatised agencies, and patients being delivered by privatised hospital car services. I suggest he should pop down to Ealing Hospital while it is still standing. I will show him the true horror of privatisation. It is prevalent, endemic and everywhere.
That is an interesting point, but the hon. Gentleman may not be aware that I volunteer in my local hospital, and have done for the past eight years. I have not only seen porters in action; I have worked alongside them—and ditto for a variety of wards. The situation he paints about what goes on in Ealing is completely different from what happens at the Gloucestershire Royal Hospital in my constituency, where those services are carried out by employees of the NHS—and will continue to be, whether they are in a subsidiary company or not—effectively and well. I pay tribute to all four of the NHS trusts in my constituency, one of which, Gloucestershire Care Services, received a good rating, alongside the already highly rated 2gether mental health trust. I shall put that issue to one side, but the hon. Gentleman is a distinguished Member of the House and knows better than to scaremonger about privatisation. Real privatisation is what happens in America, as he knows. It does not exist here in the United Kingdom.
The narrative today is, I am afraid, about scaremongering, with the favourite Labour bogeyman, privatisation, to the fore. There is one sentence from the petition that in a sense gives it away:
“Companies should not be profiteering from NHS contracts”.
The logic of that is that every single provider of equipment or services to the NHS, from pencils to EpiPens to imaging machinery to software, should do so at a loss. They should not. It is crucial that businesses make profits, invest and innovate for the future, reduce paperwork, increase scientific solutions to all sorts of difficult health issues and improve the life chances of our constituents. The opposite logic, of businesses making no money at all and going bankrupt, and the state trying to do everything, has been tested to death—literally—in both Russia and China. If Opposition Members, as socialists, want to understand why China has been so successful, I commend to them joining my all-party parliamentary China group, to visit China and understand what socialism with Chinese characteristics looks like and means.
As I said, there are concerns. I have concerns: some of my constituents have difficulties. The overall quantum of healthcare funding—I will return to this at the end of my remarks—is putting pressure particularly on rural areas that I represent. We need to tackle a number of different issues. With regard to the future of healthcare funding, my perspective is similar to that of my hon. Friend the Member for Gloucester (Richard Graham): we should be working on a cross-party basis to deliver the solutions.
In terms of private or public, the public are absolutely behind the point that they have no preference. A greater number of people express no preference, in terms of a private sector or public sector provider, as to who provides their healthcare. Yes, of course the public are massively in favour—89% are in favour—of a taxpayer-funded healthcare system, but on the question whether the care should be delivered by private or public providers, it is a very different picture.
The hon. Gentleman has been extremely generous in giving way. I am reluctant to wander too far down memory lane, but when the NHS and I were born at the same time, in July 1948—[Laughter.] Two great institutions, both in need of considerable support! The NHS was born out of compromise. I spent 10 years working in the Middlesex Hospital. We had a private patients wing. The entire GP facility within the NHS has been private. GPs have always been self-employed. There has been compromise. The issue is not the fact that there is a compromise and private practice within the NHS, but the fact that there is a creeping expansion of privatisation, which my constituents and, I would suggest, those of every right hon. and hon. Member here feel is corrosive to the heart of the NHS. Yes, there is privatisation within the NHS, but we have to stop it. We must not expand it. We must return to core principles.
It is only corrosive if it is not in the patient’s interest. There are clear commissioning rules that it must be in the patient’s interest for this commissioning to take place. The key is what is right for the patient. I do not doubt that the hon. Gentleman may be right that some of the commissioning is wrong, but whether it is private or public should not be the overriding principle; it should be what is right for the patient.
I respect the hon. Gentleman, but the point made by my hon. Friend the Member for Leeds North West (Alex Sobel) was about the added value brought by people who work in the NHS. When I was a porter for 10 years at the Middlesex Hospital, we finished at 10 o’clock on Saturday night and started again at 6 o’clock on Sunday morning. We worked a rotating three shift system.
The Middlesex Hospital is now a hole in the ground, but when I last went to see former colleagues from the ancillary staffs council, I was told about the agency workers who turn up to do a day’s shift. They have no emotional connection with the hospital, or any feeling for it, so they simply cannot make the same commitment. Surely the hon. Gentleman, who is far from being a fool—he is actually a humane man—recognises that some people bring an immense amount of added value by working for the NHS rather than for an agency that works for the NHS.
I agree with the hon. Gentleman. I am not arguing for privatisation. I am arguing that privatising some services improves patient care, which is surely what we are all interested in.
(6 years, 9 months ago)
Commons ChamberAs I have said, we will continue to look at that, but, as my hon. Friend knows, the Department has a really strong track record of tackling infection. Incidents of MRSA are down 54% on 2010. We have published a revised code of practice on hand hygiene and we are working with partners across health and social care to ensure that this remains a focus.
There has been some excellent work on extending hand gel usage throughout the NHS, and the decline in MRSA is, I think, indicative of that. However, there is a glaring prejudice, certainly in my part of the world, amongst people who think that these gels contain alcohol, and will not use them for that reason. Is it possible to instigate some form of signalling or marking to prove and to state that there is no alcohol within these hand gels, because we do not want to see people prevented from using them?
The hon. Gentleman makes an excellent point, and it is certainly something that we can look at more closely.
(6 years, 9 months ago)
Commons ChamberThat would be great. Even the most technophobe of us should be able to manage doing that if it takes only two minutes, and maybe there could be one of those clever apps to make it even easier for all the young people to do this.
I have no knowledge of apps, but I do have my donor card here, held proudly in my hand, which I got by telephoning. When I introduced my Bill on this subject many years ago, I was accused, as were the supporters—including Dr Evan Harris, who brought in the Bill with me—of being Aztecs. Does my hon. Friend agree that the tide is now flowing in our favour and this is a piece of legislation whose need has been proven, but whose time is now?
Yes, very good, and I must apologise for not commending my hon. Friend for his Bill when I listed the people who had done work on this over the years. That makes us realise how many people have been pushing for this, and if my hon. Friend the Member for Coventry North West is successful today, his great achievement will be following in many other Members’ footsteps.
Whether it is clever people with their apps or people carrying the old-fashioned donor card, we in the Opposition and nearly all of us, or perhaps all of us unanimously, across the House this morning are in favour of a change to the organ donation law, to ensure that everybody whose life could be saved by organ transplant can have the gift of life. I therefore urge the Minister today to take the necessary steps to increase the number of people on the organ donor register, and I am sure this Bill will be a great asset in helping her to achieve that goal.
(7 years, 11 months ago)
Commons ChamberThat leads to an individual patient waiting 35 hours on a trolley to be seen, as happened this weekend. I know that a number of Members have made this point, but it bears repeating: it is disgraceful that staff are blamed when this is going wrong, given that the responsibility clearly lies with politicians—with the Government. I was upset to see that today’s front page of The Times blames the senior civil servant at the heart of the NHS, as this is really down to poor Government planning.
On the subject of poor planning, I am sure that my hon. Friend will, like the rest of the House, have heard James O’Brien speaking on LBC yesterday describing his experience of having conjunctivitis over the Christmas holiday and having to go to a community pharmacist because he could not get a doctor’s appointment and did not want to go to A&E. Is this not the maddest time ever to be considering closing thousands of community pharmacies? Is this not the time when we should be supporting them, not closing them?
I do not know whether a Brexit-fever madness took over, but there was a moment when cutting community pharmacies seemed like the right thing to do. Clearly, it was the wrong thing to do at such a crucial time, particularly given the impact of the illnesses to which we all fall prey during the winter months.
In my earlier intervention, I asked the Secretary of State about the flu epidemic. He assured me on the number of vaccinations, and I am pleased that more people have been vaccinated against seasonal flu. However, let me return to the point I was making. I understand that there has been quite an increase in the number of young people getting the flu, so we are not talking about people in the herd group who would have been advised to be inoculated against it. When people, tragically, get the flu they suffer, and doctors do not have time to isolate those individual cases. That creates a real risk, given how busy staff are, that that flu could become an epidemic. Having given us assurances today, I hope the Secretary of State will take that point up further with chief executives of acute trusts.
I want to give colleagues an idea of what is happening on social care. In 2010, I was a council leader and we had a social care budget for children—this is nothing to do with schools, just children—of £102 million. The same local authority now, in a busy London area, has for 2017-18 got a budget of £46 million. If someone is really telling me that the needs are half as much as they were in 2010 or that somehow families need less help and support, which is what children’s social care provides, I would be very surprised. A cut from £102 million to £46 million in 2017-18 is deeply worrying for the children who are in desperate need of social care.
Adult social care is equally worrying. The Secretary of State told us on Monday that we should not worry because £600 million is going into social care. I would not worry, except that I happen to know that, between 2010 and 2015, £4.8 billion was taken out. Anyone who has even key stage 2 maths will know that that does not add up. If £4.8 billion is taken out over a five-year Parliament, putting in £600 million 18 months later is not going to help.
I feel sorry for councils. If they increase tax, that is quite unpopular, but if they do not the Government blame them for not wanting to sort out the social care crisis. Even where the precept does bring the local authority quite a lot of money, the amounts raised do not help in the longer term because they just go towards a short-term fix—we are not actually fixing the problem that we need to be looking at: we need more homes in which older people can live comfortably, have fewer falls and accidents, be warmer so that they are not suffering from fuel poverty, and stay out of A&Es.
It is all about long-term planning, but we have built hardly any new homes, even for older folk. If we did so we could start a chain and enable their families to move into their old homes, thereby solving another problem. We have reached a crisis in which older folk end up in A&E and, on occasion, have to wait on a trolley for 35 hours, which I still cannot quite believe. I am sure that the newspapers are telling the truth, but 35 hours is an awfully long time to be on a trolley and not be seen.
Last year, my right hon. Friend the Member for Tottenham and I had a debate on mental health in this very Chamber, which was followed by a meeting of Members of Parliament from the local sub-region. We were very worried about people suffering from mental health problems, for whom there is currently a perfect storm. First, there have been benefits cuts. We are now in our seventh year of austerity, and there is no doubt that people with mental health problems have been right at the bottom of the pile. Secondly, we have seen cuts to supported housing and all the programmes that helped people suffering with mental health problems to keep their tenancies. That is all being cut, so people have no one to support them, which is part of the reason they fall ill. Thirdly, we have seen cuts to the number of nurses. There are fewer mental health nurses in the system than there were two years ago and, of course, fewer beds.
A constituent came to see me at my surgery in November to say that he had fallen ill with a mental health problem. He was very surprised because he had never suffered in such a way before and was amazed by the poor care he received, in part because no one was available to diagnose him properly. He spent more than 24 hours in a padded cell, with no explanation and no indication of what sort of service he could expect. There were so few beds that he was sent about 20 miles away to be cared for at another hospital, leading to a great deal of stress and worry for his family.
The whole health system is in crisis and needs our urgent attention. Despite all the demands, political and otherwise, that the Brexit process is going to create, I hope we will not forget not only the most vulnerable—those with mental health problems or in social care and so on—but our basic, universal NHS for all.
Many of my constituents are extremely fortunate to be served by Luton and Dunstable hospital—the hospital that was name-checked twice by the Secretary of State in his statement on Monday. One thing it does extremely well is its excellent streaming process in A&E, with good alternatives when A&E provision is not appropriate. That has helped the hospital to provide very high standards. I am also fortunate that my constituents’ social care is provided by Central Bedfordshire Council, which has been extremely innovative in building extra care court provision for older people. I visited those provisions, which are hugely popular and in central locations. They are much cheaper than residential care and provide a much better living environment for older people. That is exactly the sort of thing that we need a lot more of across the country. Those are two examples of really good individual practice within the NHS and social care. We need to be much better at spreading that good practice across the whole country.
It is worth putting on the record that since this time last year, we have more than 1,600 more doctors and 3,100 more hospital nurses. Since 2010, we have over 11,000 more doctors and 11,000 more nurses. The proportion of patients harmed by the NHS fell by more than a third between 2012 and 2015, and cases of infection are 50% lower than they were one year ago, which is a tremendous achievement. Health spending in England is actually 1% higher than the OECD average and the UK is spending more on long-term care as a percentage of GDP than Germany, Canada and the USA. The King’s Fund has said that STPs are the “best hope” for the future of the NHS in England, and Chris Hopson, the head of NHS Providers, has said that the system as a whole is doing “slightly better” than this time last year.
All that is dependent on having a strong economy, and I would argue that the Conservative party has demonstrated its competence in running the economy. Of course, I am not complacent, and I recognise that there is, in a sense, an arms race between the extra provision I am proud the Government have put in and the increasing demands on the NHS.
One issue that continually disappoints me is that we do not have enough of a focus on quality in these debates—they are always about funding. However, I draw attention again to the “Getting it Right First Time” initiative brought in by the Government just before Christmas, which is projected to save £1.5 billion that could be redirected back towards frontline patient care across 18 specialties. That will result in fewer infections and fewer revision operations, and we are using the data to shine a spotlight on variability, which is absolutely key for our constituents.
On mental health and the very welcome statement by the Prime Minister on Monday, I was delighted to hear the emphasis on first aid for mental health—something that will take place in our schools. However, as important, if not more important, is the issue of keeping fit for mental health. What do we all need to do to maintain good mental health? The Mental Health Foundation says we need to talk about our feelings, eat well, keep in touch with family and friends, take a break, accept who we are, keep active, drink sensibly, ask for help, do something we are good at and care for others. I do not think those 10 pointers from the Mental Health Foundation are as well known as they should be, so I am pleased to have put them on the record. It is crucial that we all look after our mental health, and that will help to reduce the stigma in this area.
Another issue I am passionate about is doing something about obesity, because although we have a national health service, we do not do enough to keep our fellow citizens healthy. I would like to see more emphasis placed on the excellent work of Dr Susan Jebb, an academic at the University of Oxford. She published an article in The Lancet just before Christmas showing that where GPs offered obese patients a referral to 12 weekly one-hour sessions, there was a significant reduction in the patients’ obesity.
I am sure the hon. Gentleman, like me, is a regular reader of the Daily Mail, and he will have noticed the proposal in yesterday’s paper that people who are obese, heavy smokers or even, God forbid, both should be denied medical treatment until they lose weight or stop the filthy habit of smoking. Would he like to recommend to those on his Front Bench the adoption of that policy?
What I am focusing on is what we can do to keep ourselves healthy and to reduce the demands on the NHS by behaving responsibly, and that is what I want to put the emphasis on.
That is important because a quarter of adults are obese, as are 14% of children between the ages of two and 15, and 18% of children in lower income households. Those figures should shame us all, and that is why I intervened on the hon. Member for Central Ayrshire (Dr Whitford) and mentioned the daily mile, which was brought in by St Ninian’s Primary School in Stirling. We need to see more of that and, frankly, a strengthened obesity policy.
My daily newspaper at the moment is the China Daily—it happens to be delivered free to my office. I was intrigued to see that students at universities in China actually have to take a physical fitness test lasting 50 minutes at the beginning of each new semester or they will not be given a graduation certificate. I am not necessarily suggesting that we introduce that here, but we should look around the world to see what other countries are doing to promote the health of their populations—to keep them fit and healthy—and to reduce the pressure on health services.
At the other end of the age spectrum, we need to do a lot more to keep older people fit and healthy, as many of the issues with social care would be greatly lessened if older people were able to stay healthier into later life. I am proud to be associated with the Buzzards 50+ organisation in my constituency, which helps older people to take regular exercise at our local leisure centres. In Andorra, which I mentioned earlier, that is normal for the whole population. Older people in their 70s and 80s will regularly take part in water aerobics classes and go to the gym. When a BBC correspondent went there a few years ago, women in their 70s taking part in these exercises said, “There’s no point in spending your retirement shut up at home. What’s more important than keeping yourself fit? If you don’t keep your body moving, you won’t keep your mind in shape.” Frankly, we need a lot more of that type of activity in our own country to lessen the pressures on our social care system.
(8 years, 1 month ago)
Commons ChamberThe hon. Lady makes an incredibly important point. People who go into a community pharmacy today will see a special treatment room where they can get phlebotomy, advice on blood pressure and all sorts of other things. Is it not perverse, cruel and utterly irrational to say to a group of professionals, who have done all this work to change the way they deliver their services, “Now we are finished with you. Out you go. You’ve done your bit. We are going to put you out and close down your pharmacy”?
I agree with the Government about looking for more services, but this is not the way to work with the profession, given that they want those in it to do more work and to work differently. Sadly, during my time in the House, we have repeatedly seen the Government not sitting down with a profession and saying, “Why not look for where savings can be made?”, but simply making a cut.
(8 years, 2 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The figures to which the hon. Lady refers were announced in the consultation in December 2015. The only change since those figures were announced in that consultation in 2015 is that, because of the delay in looking at this again, the in-year saving this year is likely to be lower.
Those of us who wish the Minister well would probably best describe his performance at the Dispatch Box this afternoon as “courageous”. I feel that he has been sold a hospital pass on this one. He is responsible for a policy that lurches from the inchoate to the indefensible; that talks on the one hand about recruiting thousands of pharmacists and on the other about closing thousands of pharmacies. I am sorry, but we cannot keep loading, even on to the willing shoulders of the community pharmacies, more and more responsibility while we are draining away the financial lifeblood. Would the Minister care to become the most popular Minister on the high streets of our nation by saying that he is going to have another look at this nonsense?
I am always keen to be popular, but I am also keen to do the right thing. Nobody is talking about thousands of pharmacies closing and I do not believe that will happen, but we have talked about hiring 2,000 more pharmacies in the GP sector. That is true, but that is not incoherent; that is the right thing to do.
I just say this to the House: we all need to distinguish at times between the pharmacy profession, which we need and will nurture and help to grow and that can produce all these added values, and those people who own the pharmacy shops, 65% of which are public companies and private equity. The House should just reflect on that.
(8 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
As ever, it is a pleasure to serve beneath your firm but benevolent eye, Mr Streeter. I congratulate the hon. Member for St Ives (Derek Thomas) on bringing this important, relevant and timely matter before us. It is similar to an Adjournment debate I secured in the previous Parliament, to which the right hon. Member for North Norfolk (Norman Lamb) responded, and to a question I put to the Minister the week before last on this very subject. In both cases, the response I received was one of warm words but few concrete proposals and little reassurance for the community pharmacies.
Like everyone else in this Chamber, I happen to believe that the Minister is a good and decent man, but I fear I can see the handcuffs of the Treasury holding him tight. I feel that he is beneath the terrifying thrall of the Treasury. The proposals are nothing to do with improving patient service. They are nothing other than a pathetic attempt to balance the books on the backs of one of the most productive, hard-working, positive and excellent groups of people in our society: the modern community pharmacist. Every day, they perform a miracle on the high street. They have changed from the old-fashioned world of the dispensing retail chemist to the modern world of preventive medicine. In fact, in many ways pharmacies are multi-speciality community providers. It will not have escaped your notice, Mr Streeter, that we have here Members representing the highlands and islands, the Isles of Scilly, the Isle of Wight, Southend-on-Sea, and Members from Armagh to Ealing. This issue is one that the whole nation is concerned about.
I am sure it was an oversight by my hon. Friend that he did not include Knowsley in that long list. I hope that the high street pharmacies are not depending on miracles. I rather hope that they are dependent on science.
Not for the first time in my life, I have been corrected by my right hon. Friend. When I referred to a miracle on the high street, I was referring to the contrast between the traditional chemist that we have known in the past and the modern community pharmacist. To go into the modern community pharmacy is to see a treatment room or an interview room, to get a blood pressure test or travel advice or to get advice on smoking cessation, healthy eating or obesity. Those are all things that we would never have thought of before with a pharmacy. To my mind, that is miraculous, mostly because it has been organic and has not come about by Government diktat. As a great believer in state centralism, I find that quite shocking, but that is all the more reason for this area to be nurtured, supported and not threatened.
The point that greatly concerns me is that the proposals go against the grain of all current thinking—not just the Carter review and the “Five Year Forward View”, which is the NHS document that talks about an enhanced role for the community pharmacist—and against every single professional body. That is not just Pharmacy Voice and the royal colleges. Everyone seems to feel that the proposals are a retrogressive step that will not only make the situation worse, but that cannot be justified because the knock-on costs to overcrowded GPs, A&E departments and urgent care centres will ultimately end up costing us so much more.
This issue concerns me greatly. One cannot imagine a more different constituency from that of the hon. Member for St Ives than mine in west London. I represent a tightly knit urban community. People are close together and tightly packed, as opposed to the great rural beauty of the Isles of Scilly. We are, however, what is known as an under-doctored area, which is typical of the big cities. The typical GP in my constituency is a single-handed elderly practitioner, often operating out of a terraced house. That is changing, but as it is changing there is a period in which a great many of my constituents—many of them are transient constituents who are moving in and moving out, and cannot register with a GP nor wait two or three weeks to see a GP, and they queue up at the A&E department or the urgent care centre and cannot be treated—are asking, “Where can we go?” The answer is that they can go to a source of good, sound advice that is both responsive and preventive. They can go to a person who is qualified and skilled. In many cases in my part of the world, we have community pharmacies with two or three pharmacists who are experts in their area. We can even do minor injuries. There is no reason why we should not expand the community pharmacies.
There is much talk of the seven-day NHS, and the model exists before our eyes. The NHS can be a seven-day service in the community pharmacies and, I profoundly hope, everywhere else. The opening hours of the community pharmacies—they are sometimes found in hospitals and supermarkets—are a great model that we should be working to support. I know that the Minister’s heart is in the right place. I know that he wants to stand up and say, “I will resist the Treasury diktat and support the community pharmacists for the sake not just of all our constituents, but of future generations, too.” Community pharmacists deserve that, and they are certainly entitled to it.
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?
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?
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.