Primary and Community Care

Lord McColl of Dulwich Excerpts

Thursday 5th June 2025 Lords Chamber

[Baroness Merron (Lab)]

This is a good news story, and I certainly share my noble friend’s view of the benefits that he outlined. Community diagnostic centres are now delivering additional tests and checks in 169 sites across the country. They have delivered almost 4.5 million tests, checks and scans since last July, and we have committed to expanding the number of existing CDCs and their opening times. In England, Pharmacy First clinical pathways have been developed closely with various experts, including pharmacists. The funding for the core community pharmacy contractual framework has been increased to over £3 billion, representing the largest uplift in funding of any part of the NHS. We are grateful for the role that pharmacies play.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that, when we discuss in vitro testing, we should also talk about in vivo testing? That involves taking a history and doing a thorough physical examination of the patient on the spot, but it seems to be going out of fashion. I will illustrate that with the story of a member of staff who had consulted me. He had been investigated at the “St. Elsewhere” hospital for six months, but they had missed the fact that he had ruptured his Achilles tendon. I did an in vivo spot diagnosis. I put my index finger down his Achilles tendon—with his permission, of course—and I could feel the gap in his Achilles tendon where it had ruptured. They had not examined him. Is it not time that we did this inexpensive business of taking a history and doing a thorough physical examination?

[Baroness Merron (Lab)]

I am very glad that the noble Lord asked for permission. I take his point. I know that he understands the value of in vitro point-of-care testing, but he makes the good point that what matters is what is clinically appropriate in the circumstance. We would all expect that to happen for the benefit of the patient.