Community Pharmacies

Liz McInnes Excerpts

Wednesday 2nd October 2019 Westminster Hall

[Liz McInnes (Heywood and Middleton) (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 this important and pertinent debate and for giving me an opportunity to raise an issue of great concern to residents of Heywood and Middleton.

We know that community pharmacies have struggled with the funding cuts that the Government have introduced since October 2016. As my hon. Friend pointed out, figures compiled in March by the Pharmaceutical Services Negotiating Committee show that 233 community pharmacies in England have had to close since those cuts were introduced. Evidence from local pharmaceutical committees across England supports the picture of community pharmacies struggling financially. Independents are being hit the hardest and have been forced to cut hours or staff as a result.

A consequence of that was highlighted to me last week by my constituent Karen, who told me that her local independent community pharmacy was to start charging £5 for the home delivery of medicines. As my hon. Friend said, the same measure has already been adopted by the four multiples: LloydsPharmacy, Rowlands, Well and—the latest to join—Boots, which recently announced that it would charge a one-off fee of £5 or a 12-month subscription fee of £55 for delivery of prescriptions ordered in branch.

The actions of those multiples seem to be having a knock-on effect on our local independent community pharmacies as they struggle to cope with year-on-year funding cuts. With the cost of a prescription now at £9, the additional charge bumps up the total cost to a hefty £14 for those who pay for their prescriptions and makes an absolute mockery of free prescriptions for those who qualify. If someone is on free prescriptions but cannot get to their local pharmacy because of illness or disability, the delivery charge means that their prescription is no longer free.

As a result of these decisions, some of the most vulnerable people in our communities will suffer, including many who rely on the delivery service to access much-needed and essential medication. Sadly, many people in our communities suffer from chronic loneliness and simply do not have the social contacts to ask someone to collect their medicine for them. I would be interested to hear the views of the hon. Member for Eastleigh (Mims Davies), the Minister for loneliness, on this draconian measure; I will write to her after this debate, when I hope I will have received some response from the Minister who is present.

I urge the Minister to look carefully and seriously at this really important issue, which appears to be a growing problem. The Association of Independent Multiple Pharmacies says that continuing challenges to pharmacy funding are not helping the situation, with the five-year funding cap not covering

“inflation, volume increases and national minimum wage increases.”

The five-year period will be increasingly painful for many pharmacy businesses already under heavy financial pressure. It is only to be expected that many pharmacies will reassess all their existing costs, including the costs of services that they currently deliver for free. The financial model is simply unsustainable for the next five years. I ask the Minister to think about the impact that the changes will have on vulnerable, lonely and housebound people, and to consider approaching the Chancellor to request funding for this vital service and bring an end to this tax on the sick.

--- Later in debate ---

[Jo Churchill]

As I said, there is no one size that fits all. As the hon. Lady articulated in her speech, the difficulty is that we are not looking at a system where businesses are run on the same scale model. At any one point, there are single pharmacists. She stated that the pharmacy she visited was part of a seven-strong business. Then there are the multiples. We need to look at what is the best scheme. However, I would argue that independents have a much higher footfall from their local population, because they are more trusted than many of the multiple pharmacies due to the continuity that comes from their having been in their communities for longer. There are opportunities there for independents.

We know we will need to design new ways of working to make a success of this, and we will need patients to be confident in how they use the services. The enhanced role for community pharmacy will support patients in getting access to help where required and in using the NHS in the best possible way. When people are suffering from minor conditions such as earaches or sore throats and need health advice, we want them to think “Pharmacy First”.

We want to build on that, with other parts of the NHS proactively signposting to local pharmacists. We want everyone to recognise the high-level skills held by pharmacists and to get people to understand that we need them as a first-line service to go to. That will grow trust in the system and spread the load. We will, of course, need to reform the way we work to free up pharmacists’ time so that they are able to deliver these new services.

[Liz McInnes]

I am sorry to interrupt, but the Minister has not referred to delivery times yet, and we have only two and a half minutes to go. Will she mention what she is going to do about those?

[Jo Churchill]

I thank the hon. Lady, but I would like to push through and to come on to the supply of medicines, which the hon. Member for Halifax spent much of her speech discussing.

We must recognise that we need to work in partnership and that this is not only about treating ill health. One of the first services to come online under the new arrangements will be the community pharmacist consultation service, which will start on 29 October. It will establish the first ever national triage system, which will look at community pharmacies referring patients into pharmacy directly from NHS 111 for minor illnesses, wellbeing support and self-care advice, as well as urgent problems. It is important that everybody involved makes this work a success, because we want this to be a two-way process. Over the next five years, we want to include referrals from GPs, urgent treatment centres and NHS Online, but we want to do that based on evidence, sensibly and in collaboration with those in the sector. Registration opened only last month, and more than 2,000 pharmacies have been signed up.

Additionally, by 2020, being a level 1 healthy living pharmacy is expected to be an essential requirement, so that pharmacies can give advice. Integration across primary care is hugely important; the new contractual framework is about not moving minor illness, but about using the whole system better. Community pharmacies are a vital part of the picture if we want to think “Pharmacy First”.

Coming on to the question of medicine supply and shortages, I appreciate the issues that the hon. Member for Halifax mentioned, but, as recognised in last week’s National Audit Office report, we have done an enormous amount in collaboration with pharmaceutical and medical device companies. There are always ongoing shortages, but the Department works all the time to ensure that they are mitigated and that a proper supply of medicine can be got to people. With the issues of Brexit, we know that that is doubly important, and that is what the Department has been doubling down on.