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Opposition Day Debate on Cuts to Community Pharmacies

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Yesterday I had the pleasure of closing the Shadow Health team’s Opposition Day debate on Government cuts to community pharmacy funding, which will see many pharmacies close. As many of you are aware, this is a subject that is very dear to my heart. I worked with my husband, who is a pharmacist in community pharmacy, for 24 years. I must make it clear that I no longer have any financial interest in community pharmacy and haven’t had since 2010 but I do have a clear understanding of the contribution that community pharmacies make to patients, communities and to the wider NHS.  The Government’s pharmacy access scheme, which it argues will help pharmacies at risk of closure, disproportionately helps pharmacies in rural areas and does little for urban areas like Burnley. All of the 24 pharmacies in Burnley will not be protected from the planned funding cuts and 6 face the real risk of closure. In my speech I argued against the planned cuts. You can watch it here at: https://www.dropbox.com/s/o8czu30wc4k068m/HoC%202%20Nov%202016%20Cooper.mp4?dl=0  

In my speech I said said the following:

It is my pleasure to respond to this interesting debate. I was not feeling very well today so on my way here I called at my community pharmacy, and I am feeling much better now. This is a very important subject. I wish first to pay tribute to my hon. Friend Michael Dugher for his sterling work in standing up for community pharmacy, and to the chair of the all-party parliamentary group on pharmacy, my right hon. Friend Kevin Barron for ensuring that the contribution of pharmacy is always recognised.

I have to say that this subject is very dear to my heart. I worked with my husband, who is a pharmacist in community pharmacy, for 24 years. I must make it clear that I no longer own a community pharmacy, but I do have a clear understanding of the contribution that community pharmacies make to patients, communities and the wider NHS. Many members have spoken powerfully today about the pharmacies in their constituencies and how much they mean to the people they serve. We have heard from my hon. Friends the Members for Hyndburn (Graham Jones), for Bolton South East (Yasmin Qureshi), for Bristol South (Karin Smyth), for Stoke-on-Trent Central (Tristram Hunt), for Oldham West and Royton (Jim McMahon), for St Helens North (Conor McGinn), for Wirral West (Margaret Greenwood), for Sedgefield (Phil Wilson), for Bradford West (Naz Shah) and for City of Durham (Dr Blackman-Woods).

Make no mistake, community pharmacy is for many the gateway to the NHS, providing far more than prescriptions and paracetamol. As my hon. Friend Luciana Berger pointed out, it is a lifeline for many people. The Minister spoke last week about the need to move to a focus on quality and not just on the volume of scripts dispensed. He also spoke of the desirability of community pharmacies becoming an integrated part of the primary care team. I say to him that that has been happening for years. The fact that he does not know this is in itself proof that he needs to take his plans back to the drawing board.

The typical community pharmacy, whether it serves a rural or an urban population, provides a wide range of services to support the sick, the elderly and the disabled, together with a host of initiatives to promote health and wellbeing in the community. Community pharmacies have close working relationships with other members of the primary care teams, including GPs. Of all those health professionals, the community pharmacist, who employs a no-appointment-necessary approach, is the most accessible and often provides the only continuity of care in a health service that is struggling to recruit and retain staff.

On the subject of NHS staff, the promise of more than 1,000 additional pharmacists in GPs’ surgeries is a red herring. It is a separate issue and will do nothing to mitigate the loss of local community pharmacies. The Minister spoke last week of the need for pharmacists to move to a more clinical approach to healthcare. Again I say to him that that has been happening for years. All community pharmacies have consulting areas where patients can speak privately. They also provide a perfect space for the provision of a variety of important services. There is an ever-expanding list of services, which a number of Members have described in their speeches. My hon. Friend Maria Eagle mentioned the fact that pharmacists often go above and beyond the call of duty, sometimes delivering prescriptions at 8.30 in the evening. I well recognise that situation. The list is limited only by the Government’s unwillingness to engage and the clinical commissioning groups’ lack of funding to commission services.

Let me make it clear that community pharmacies, far from being a costly drain on NHS resources, actually save the NHS money through a variety of schemes, some of which have been mentioned today. The minor ailments service is already available in some areas, and I welcome the Minister’s suggestion that it will have a full roll-out. Medication use reviews carried out in the pharmacy often identify medicines that are routinely ordered but are no longer taken, and wasteful stockpiling of such items can therefore be avoided. In addition to the specific services, every prescription item dispensed presents the opportunity for a productive health intervention. Given that the average community pharmacy dispenses thousands of prescriptions each month, the potential impact is enormous and the professional advice of the pharmacist is undoubtedly invaluable in the promotion of health and wellbeing. Norman Lamb rightly identified the prevention work that pharmacists do, and mentioned the fact that the promotion of health and wellbeing can reduce demand on the NHS overall.

Despite statements to the contrary, community pharmacies have been making substantial efficiency savings in recent years. The vice-chair of the all-party group, Oliver Colvile, mentioned a 40% increase in funding over the past 10 years, but he omitted to mention that prescription numbers have increased by 50% during the same period and that pharmacy funding has been static for the past two years.

Under the Government’s current plans, pharmacies would have to implement a year’s worth of cuts in four months with only six weeks’ notice. As someone with considerable experience of community pharmacy, I know that the plans will force the closure of many pharmacies and a service reduction in others. I do not know how many will close and neither does the Minister. Alistair Burt suggested that the number could be as high as 3,000, and I can assure the Minister it will not be the large pharmacy chains that close but the small independents, the owners of many of which have put their heart and soul into providing an excellent service to the community.

Those that do not close will reduce services. An NPA survey of 250 pharmacies found that 76% are likely to reduce services from April 2017 if the cuts go ahead. The assessment of the financial impact of the closures is flawed and provides no evidence to support the Department of Health’s claim that access to services will not be compromised. It is clear that community pharmacies satisfy an ever-growing demand for services. When they close, that demand will not just disappear. Where will all the patients go? Some will pack out their GP surgery and others will head straight to A&E. The NHS is already in the throes of a staffing and funding crisis. Forcing community pharmacies to cut back services and close down is short-sighted in the extreme and could be catastrophic in the long term.

The Minister has frowned on the growth of pharmacy clusters, but he really needs to understand that clusters have grown, often in the most deprived areas, in response to considerable demand. My hon. Friend the Member for Bradford West outlined examples of such areas of deprivation. Is the Minister really suggesting that forcing the closure of such pharmacies is the most effective way to reduce demand for healthcare in deprived communities? The Minister has got this wrong. The proposals on the table are short-sighted and will do more harm than good. They will have a negative impact on patient care and will force extra demand on already stretched GP surgeries and hospitals. The proposals will not save money. They will not reduce the number of patients with long-term conditions or the number of medicines they require.

It is right to review the situation. I agree with the Government Members who said that it is right to examine the funding issues, but instead of forcing through damaging changes to a service that the Government clearly do not understand, I ask the Minister to listen to pharmacists and sit down with them to discuss how pharmacies can help to ease the burden on the wider NHS in a planned and cost-effective way. I ask the Minister to listen to his Conservative colleagues who spoke against these simplistic cuts, which have not been properly planned. I ask him to recognise that the access scheme will do little to protect the long-term future of urban or rural community pharmacies.

The Government have shown time and again an unwillingness to listen to professionals. I urge the Minister to listen to community pharmacists, to the pleas of Members and to people across the country, and to rethink the funding cut. I ask him to sit down with pharmacists and their representatives and work with them to develop and extend services that will take the burden off GPs and off the NHS. I ask that he do so now before he makes a decision that will devastate a whole sector and bring even more pressure to bear on our overstretched health service.

 

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