Social Care (Liverpool)

Debate between Baroness Berger and David Mowat

Tuesday 7th March 2017 Westminster Hall

[David Mowat]

I thought that I had said that I agree with the hon. Lady that it would be wrong to punish those that are doing better. She mentioned that Knowsley is one of the stronger councils in that regard; St Helens is even stronger. It would be completely wrong if that were the basis of the allocation. Frankly, that is not my understanding.

I want to talk a little about what the Government plan to do on social care. Part of that involves recognising the pressures that exist. One thing that we get into quickly in social care discussions is a debate about adult social care and frail people—people on the borderline between being ill and being old. If they are ill, they are in hospital under the NHS, and if they are not, they are old, and care is either means-tested or provided by the council. That is a difficult area.

One third of the pressure on councils such as Liverpool arises not from older people but from people with severe learning difficulties, autism and disabilities more generally. Over the past decade, thankfully, the health inequality from which that cohort suffers has decreased considerably, and the life expectancy of people in those categories has increased. The cost to local authorities is clearly severe. In addition, the Government are determined to press ahead with a programme called Transforming Care, which came out of the Winterbourne View case. Too many people with severe learning difficulties were in institutions and long-term hospitals, with all that goes with that. We are moving them into communities with the help of local authorities. There is a plan to move some 3,000 people out of institutions—places hopefully much better than Winterbourne View—and into care. All of that creates pressures of the sort that we have been hearing about in this debate, but that does not mean that it is not the right thing to do.

[Luciana Berger]

Does the Minister acknowledge that those 3,000-plus people should have been moved a lot sooner? According to various reviews, we should not be in the present situation, with too many people still in that type of accommodation who should not be there.

[David Mowat]

That is a fair challenge. We have a plan, and we are implementing it in that process. Winterbourne View was about seven years ago now. I have met a number of parents of the children affected and there has been a lot of pressure from them to go as far and as fast as we can. I make the point that every one of those facilities is a project of its own in terms of finding other accommodation and putting in place care—sometimes round-the-clock care. To answer the hon. Lady’s question directly, I would like us to go faster, but I think that we are doing as well as could be expected given the starting point. However, it is a fair challenge.

Community Pharmacies

Debate between Baroness Berger and David Mowat

Wednesday 2nd November 2016 Commons Chamber

[David Mowat]

When one takes into account the £112 million that we are spending on getting more pharmacists into GP practices, the right hon. Gentleman’s point is incorrect.

[Luciana Berger]

Will the Minister give way?

[David Mowat]

I will give way to the hon. Lady in a moment.

Finally, I want to talk about the work that we are doing to ensure that everyone in the country has access to a community pharmacy. We have developed a scheme with two components. First, all pharmacies that are more than 1 mile from another pharmacy will be eligible for additional funding, which will almost entirely mitigate the impact of the changes. That component is specifically designed to protect areas where current provision is quite spread out. In total, it will apply to around 1,400 locations—roughly half urban and half rural. Pharmacies that are in the highest 25% by prescription volume, and therefore most profitable, will not be eligible for the scheme. Secondly, there is a near-miss scheme under which pharmacies that are located up to 0.8 miles from each other and in the 20% most deprived areas in the country can apply to be reviewed by NHS England as a special case. The final safeguard is that NHS England has a continuing duty to ensure the adequate provision of services. Its role is to commission a new pharmacy in any area where it believes access is inadequate. That duty will continue.

[Luciana Berger]

I thank the Minister for very kindly giving way. Will he correct the record on something? Pharmacies are not all private enterprises. Many co-operatives across our country provide community pharmacies, often in rural and isolated areas. For the purposes of this debate, will he clarify his understanding of the distinction between a community pharmacy and a GP pharmacy? That has not been clear in his remarks so far.

[David Mowat]

The distinction is that a community pharmacy is part of a privately owned business that dispenses and is paid in that way. The ones that we are hiring into GP practices will leverage GP time and do medicine reviews, and I expect them to enable the pharmacy network in an area to work more cohesively. It is a welcome and, frankly, overdue step forward.

Community Pharmacies

Debate between Baroness Berger and David Mowat

Monday 17th October 2016 Commons Chamber

[David Mowat]

Yes, I will confirm that. I am not in a position to announce today precisely how the access scheme will work, but I agree with my hon. Friend that a central part of it will be to make sure that everybody has a baseline distance to travel to get to a pharmacy and that everybody in the country will be able to access pharmacies within a reasonable time.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

NHS England’s five-year forward view stresses how important prevention is. Community pharmacies, which are anchored in the communities they serve, are vital in keeping people out of their GP surgeries and out of accident and emergency. The Minister talks about distance. What will the distance be? If I reflect on my own constituency, where the millionth signature of the petition was signed, my constituents really value each and every one of our community pharmacies. How many will he be cutting and how far does he expect people to travel to access one?

[David Mowat]

The hon. Lady mentions the five year forward view. If she reads the “General Practice Forward View”, she will see that central to it is the recruitment of 2,000 pharmacists into GP practices across the country by 2020. That is how we will embrace the pharmacy profession and link it much more closely to GPs. I am not in a position, because we have not yet announced it, to discuss in detail today the final form of the access scheme and how it will work. Let us be very clear, however, that we do not expect people to have appreciably more of a journey to any pharmacy. We are talking about tens of metres, if any. The fact is that we will protect the pharmacies that need to be protected, so that everybody in the country has access within a reasonable time.