Pharmacies and Integrated Healthcare: England

Steve Double Excerpts

Wednesday 11th January 2017 Westminster Hall

[Steve Double (St Austell and Newquay) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate my hon. Friend the Member for St Albans (Mrs Main) on securing this debate on what I believe is a very important issue.

There is no doubt that our health service is currently under great pressure, as we have heard already. People are living longer and we are able to treat far more conditions than we could in the past, which adds to the demand on our health services. Although more money is always welcome, I am sure that many of us would agree that simply throwing more money at the health service is not the solution. We need to find better, smarter, more efficient and more effective ways of working to provide the healthcare that our growing population so desperately needs.

I have no doubt that pharmacies, particularly community pharmacies, can play an important role in finding better and smarter ways of providing healthcare to the people of this country. Community pharmacies continue to be an undervalued and underutilised section of our health service. As a country, we really need to embrace the role that community pharmacies can play in delivering health services. They have much more to offer than they are currently seen be to offering.

The Government have started to recognise that, with the current pilot scheme, started in 2015, to increase the presence of clinical pharmacists in general practice. That is clearly a step in the right direction, but I propose that we should also look the other way. We should not only look at integrating pharmacies into GPs’ surgeries; we should be looking to integrate GP services into our community pharmacies. It is quite clear that many of the routine services that people typically go to their local GP for could be provided by their local pharmacists in a much more cost-effective way.

[Oliver Colvile]

rose—

[Jake Berry (Rossendale and Darwen) (Con)]

rose—

[Steve Double]

I will give way to my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) first.

[Oliver Colvile]

I thank my hon. Friend for giving way. He makes a very powerful point. I have thought for some while that we should be trying to put GP surgeries into pharmacies, so that when someone goes to their GP and says, “I have got this ailment and I need some help,” he can say, “Don’t come and talk to me; go and talk to the pharmacist, because he or she can manage the thing properly.” To my mind, that seems a very clever way in which we could take some of the pressure off the finances of GPs, as they would not necessarily have their own lease, but could get the likes of Boots or others to provide facilities.

[Steve Double]

I thank my hon. Friend for that intervention and I agree with him. Clearly, part of the answer is getting GPs and pharmacies working much more closely together, and co-locating can often be one way to help with that.

[Jake Berry]

My hon. Friend is making an excellent speech. Does he accept that the demand for prescribing pharmacies can be demonstrated by the recent proliferation of adverts we have seen on television for “pay to see your GP” services, which I was very surprised to see so many of on TV over Christmas? For £20, someone can pay to have a Skype consultation with a GP, who will then email or contact the local pharmacy to issue them with a prescription. An NHS that is free at the point of use should be absolutely fundamental to us in this country, but the fact that people are now paying to see GPs rather than waiting to see them shows that there is huge demand for people to have minor ailments prescribed for by a pharmacist.

[Steve Double]

I thank my hon. Friend for that intervention; he clearly watches far more TV than I do, because I was not aware of that. However, he makes the point well that there has been a huge increase in the demand being placed on our GP services, and people are therefore looking for other ways to meet that demand when it cannot be met in the usual ways.

I applaud and support the Government in their desire to create a truly seven-day-a-week health service. Part of the way to achieve that is by making far better use of our community pharmacies. Many are already open for longer hours than GP surgeries, typically on a Saturday, and my hon. Friend the Member for St Albans made the point that maybe some need to consider opening for longer still. That is something the Government could certainly help with. If we are to achieve a truly seven-day-a-week health service, we need to make more effective use of our pharmacy services.

[Margaret Greenwood]

The hon. Gentleman is making a strong case for the importance of community pharmacies. Pharmacies in my constituency of Wirral West that will be unable to receive money under the planning access scheme have written to me to say they are very concerned that they face closure. Does the hon. Gentleman agree that it would make sense for the Government to pull back from those cuts while they consider the whole issue of integrating services?

[Steve Double]

I thank the hon. Lady for that intervention, and in many ways I share her concerns. While I respect the desire of Department of Health’s to ensure that money is well spent and delivers value for money, there are cases of over-duplication, as we have already heard. Some changes need to be made to the funding models. I agree that we need to do all we can to protect our community pharmacies, particularly in more rural areas such as my constituency in Cornwall, where they play such a vital role for rural communities. I was pleased that the Department was able to do something to help—certainly many pharmacies in my area benefited from the changes to the funding—but I respect the fact that that may not have been the case in her constituency, and I will be urging the Minister to do all we can to ensure that these vital services in our rural areas are protected as much as possible.

With the right support, and indeed the right funding streams, our pharmacies could play a role that would take pressure off the parts of our health service that are clearly under severe pressure, in particular primary care and acute and urgent care. We are all aware of the pressure that our A&E departments are under at the moment. I believe that many times, when people go to A&E—perhaps because they cannot get to see their GP as quickly as they would like or feel they need to—they could actually get what they need from their local pharmacy.

Part of this is about increasing people’s awareness of what our pharmacies can offer. Part of the learning curve that I have been on since becoming an MP has involved going to see our local community pharmacies and getting a better understanding of exactly what services they provide, which I was not aware of before. More could be done to promote the role that pharmacies can play and the services that they can offer by making the public more aware of those services. That in itself would take pressure off our GPs.

[Mrs Main]

I did not make this point in my speech, but my hon. Friend is almost making it for me—it is that our pharmacists are hugely qualified, but too often they are the most under-utilised highly qualified local health professional. It is nonsense that their expertise is not being used routinely, challenged or made available, because people do not seek to use it and are not even necessarily aware that it is there for them to utilise.

[Steve Double]

I thank my hon. Friend for making that point, which I completely agree with. There is much more we could do to increase the general public’s awareness of exactly how highly qualified our pharmacies’ staff are and of the excellent services that pharmacies can provide.

My hon. Friend the Member for Plymouth, Sutton and Devonport talked about the need to integrate IT systems better, which I believe is part of the solution we seek. My understanding is that community pharmacies can access summary care records, but on a read-only basis. Many pharmacists I talk to say that if they had read-write access to that information, so that they could input data about treatments they have given to patients, that would be better. For example, if they could take a patient’s blood pressure and input that reading into the patient’s care record, that would save the patient time as they would not then have to go their GP to have the same reading taken and put into their record. I urge the Government to consider carefully whether read-write access could be granted to pharmacies, because I believe it would save a huge amount of time and reduce what I believe is often duplication of work within our health system.

An interesting fact that I discovered in my discussions on this subject is that the average time that someone waits when they go to see their pharmacist—that is, the time between entering the pharmacy and actually getting to see the pharmacist—is eight minutes. Many people in this country would be absolutely delighted if they could see a health professional within eight minutes of asking to see one. I am sure that many hon. Members here today have in-boxes full of people’s complaints about how long it takes them to see their GP. If people were aware that if they went to see their local pharmacist they would only have to wait eight minutes on average to see a very well qualified health professional who has a good chance of providing them with what they are looking for, I believe they would be delighted. That is another example of how we can promote the work of pharmacists, which would provide a far better service to the people of this country and take pressure off the other parts of our health system.

[Bill Esterson (Sefton Central) (Lab)]

I am grateful to the hon. Gentleman for giving way and I apologise, Mr Bailey, for missing the start of the debate.

The excellent pharmacies in my constituency do much of the fine work that the hon. Gentleman and other speakers have described, but it struck me as I was sitting here listening to him that he is making a very powerful case for investment in our pharmacies, rather than the cuts that the Government have proposed. Does he accept that point? Will he and his hon. Friends take this opportunity to call on the Health Secretary to think again about pharmacies and the important role they play and to see them as an investment, so that they can play their part, particularly in taking pressure off A&E?

[Steve Double]

Although I agree with some of what the hon. Gentleman says, I believe the funding model for pharmacies needs to be looked at because there is a great deal of duplication. The money spent could be better utilised, so the funding model needs to be reviewed. Some of the recent changes are a step in the right direction, but I will always make the case that, particularly in our rural communities, we need to be careful how those changes are applied so that our local pharmacies continue to be viable and able to provide the services that are needed.

[James Cartlidge]

My hon. Friend is making an excellent speech. I understand why Labour Members want to focus on the potential savings that once again the Government are having to make, but I point out that the two pharmacies that I visited in Clare and Hadleigh in my constituency accept the changes, provided they are balanced by their having a more positive role in the healthcare system and doing more for our communities. That is what they want.

[Steve Double]

I agree absolutely. This is not only about money; it is about reviewing the way we provide our healthcare services, embracing a greater role for our pharmacies, and understanding and promoting the role that they can play.

I want to pick up on the point about tourist areas made by my hon. Friend the Member for St Albans. I represent the constituency of St Austell and Newquay in mid-Cornwall, and tourism is the biggest part of our economy. Hundreds of thousands of tourists come every year, which puts a great deal of pressure on our A&E and local GPs, because if people fall ill on holiday, they try to get to see a GP.

I commend the work of one of my local pharmacists, Nick Kaye, in Newquay. The Secretary of State visited a couple of years ago and saw the excellent work that he does working closely with the local GP surgery to provide a frontline service particularly for tourists. By doing so, he takes pressure off the other parts of the health service. We could see more of that if we supported pharmacists and promoted the excellent work that they can do.

We have already touched on my final point. We cannot have a one-size-fits-all approach. The services provided in urban metropolitan areas are very different from those provided in more rural parts of the country. As we have heard, there might be multiple pharmacies in a town, all falling over one another to compete for business—so different from the many rural villages that have one local pharmacy, which is struggling to make ends meet and to provide an ongoing service to the community. Another fact I have learnt is that there is an oversupply of qualified pharmacists in many areas, whereas in Cornwall we have a shortage. We cannot get enough into Cornwall to meet demand, so we cannot have a one-size-fits-all solution. I encourage the Minister to look carefully at the specific needs of different parts of the country, particularly with regard to pharmacies, to make sure that funding streams meet need and that we can sustain the vital role that community pharmacies play in our rural towns and villages.

I am pleased to have been able to contribute to this important debate. As we continue down the path of integrating pharmacies into the health service, we must value and promote the role they play and make sure they are able to provide a service. They are part of the solution that we need to make sure our health service is fit for purpose.

[Mr Adrian Bailey (in the Chair)]

I intend to bring the Front-Bench spokesperson in at 10.30.