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Mrs. Angela Browning (Tiverton and Honiton): Does my hon. Friend agree that today's Opposition day debate is timely, because the Secretary of State can hear who the stakeholders are and what a sense of community really means in real constituencies? The Labour party espouses the virtues of stakeholders, community, partnership and consultation, so the Secretary of State has an ideal opportunity to hear at first hand from those of us who have presented petitions and made representations exactly what the people want and value.
Mr. Yeo: My hon. Friend makes a telling point.
Hansard cannot reflect the balance of attendance in the House, so now is the right moment to draw attention to the fact that, for the time being, the Conservative party has roughly 40 per cent. of the representation that the Government have in the House, but there are four or five times as many Conservative Members as Labour Members attending this debate, which is so important to every constituency represented in Parliament. [Interruption.] Furthermore, every intervention on the Conservative side has been from hon. Members speaking up for the interests of their constituents, but interventions on the Government side—somewhat few and far between—have consisted largely of cheap debating points.
Sir Paul Beresford (Mole Valley): Does my hon. Friend agree that the debate provides an opportunity
for the Government to identify some of their blind spots? Rural issues are certainly one of their blind spots. Many villages have pharmacies, post offices, pubs and so forth, but the village pharmacies are being threatened.
Mr. Yeo: My hon. Friend is right. I recall visiting his constituency to take part in a conference, which I believe was entitled "Listening to Britain". He may recall that one of the main issues was the anxiety felt by many rural communities about the representation of community pharmacies in their areas. However, it was rightly mentioned earlier that the debate is not about rural communities alone. It certainly goes to the heart of the concerns of many rural communities, but it is equally a matter of concern in many urban areas.
Mr. Roger Gale (North Thanet): The point that my hon. Friend makes has been brought home to me this week, following the receipt of petitions with 2,500 signatures from Payden's and Baxter's and Ferris—not just from Margate in my constituency, but from Garlinge and Birchington, which are urban villages with the community pharmacies right at their core. Is not the Office of Fair Trading report simply about retailing, and nothing whatever to do with the health of people who use the health service?
Mr. Yeo: My hon. Friend is right. The trap into which so many people—including, I fear, the authors of the Office of Fair Trading report—have fallen is in failing to understand the difference between the general retail industry and the role played by pharmacies.
Richard Ottaway (Croydon, South): Is my hon. Friend aware that the Government White Paper entitled "Pharmacy in the Future" says in the foreword:
- "As one of the primary health professions in the NHS, pharmacy has a vital part to play in delivering the plan. Pharmacists are an integral part of most people's experience of NHS care, whether in the community or in hospitals."?
I could find nothing in the OFT report that suggested that deregulating the sector further would improve access to community pharmacies for that part of the population that uses those pharmacies regularly. Indeed, the fear is that the opposite would be the case. If community pharmacies migrate away from high streets and disappear inside supermarkets, the likelihood is that access will become harder, not easier. As Philip Graham, the owner of two independent community pharmacies in my constituency, in Long Melford and Lavenham, wrote to me in April:
- "The customers who use and need pharmacy services are not those naturally targeted by the grocers, or who are traditional users of those outlets."
Mr. Keith Simpson: My hon. Friend will appreciate that, as the pharmacist in the market town of Reepham in my constituency pointed out, many rural and urban pharmacies are part of a strong support system for our general practices. They are already under enormous strain. If community pharmacies are removed, it will have a knock-on effect on GPs. My constituency already suffers from a grave shortage of GPs thanks to the Government's policies, which the Secretary of State for Scotland—I am sorry, I mean the Secretary of State for Health—will be able to address.
Mr. Yeo: My hon. Friend anticipates a point that I intended to make. He is right about the complementary role that community pharmacies play in the delivery of primary health care. In defence of the new Secretary of State for Health, let me say that he is one of the diminishing number of Cabinet Ministers who has only one job to do. He is not a part-timer. Nor is he moonlighting—something of which the hon. Member for Bolsover (Mr. Skinner) often accuses Conservative Members. Let us hope that with the attention that the Secretary of State for Health is able to give the job he will address the shortage of doctors in my hon. Friend's constituency.
Community pharmacies do not compete in the way that supermarkets do—on the basis of price. Indeed, in the case of prescription medicines, which account for the vast bulk of medicines sold in pharmacies, there is no price competition from the point of view of the consumer. What is traditionally the strongest single argument in favour of a more deregulated market—the downward pressure on consumer prices that a deregulated market can exert—simply does not apply to community pharmacies. Even the price of the over-the-counter medicines, which account for about a fifth of the medicines sold by community pharmacies, is likely—in the opinion of the OFT—to fall by only between 1 per cent. and 2 per cent. That is a marginal gain to set against the real disadvantages that Conservative Members have set out.
Surprisingly, the OFT report does not convincingly explain how the present regulations constitute such an insuperable barrier to entry into the market by supermarkets. On the contrary, the report confirms that since 1990—during which time the existing restrictions have been in force—no fewer than 450 new supermarket pharmacies have opened. They now constitute about 4 per cent. of the total network.
One argument that the OFT deploys in favour of more supermarket pharmacies is that they would have longer opening hours. Clearly, there is evidence to support that. Does the Secretary of State for Health want to say something? I should be happy to give way. Does he wish to intervene? No, he has nothing to say. I am glad that he is listening.
There is evidence to support the claim about longer opening hours, but the report presents no evidence that they are a priority for users of community pharmacies.
The clear priority for them, especially for the people who are most vulnerable, is that the quality of service currently offered by community pharmacies should be maintained. There is great anxiety about the possible consequences of accepting the OFT recommendation.The British Medical Association has stated that
- "what little gain it may provide to the consumer in terms of cheaper medicines is insufficient to offset what may be lost. The most vulnerable and the least affluent members of society—the elderly, infirm and housebound—will lose the most if community pharmacies are forced to close."
- "Accessibility to pharmacies would decline as provision moves out of town to supermarkets; and the closure of pharmacies would have a detrimental effect on the viability and vitality of town centres . . . there is no evidence that this will deliver significant or sustained price reductions across the range of"
- "medicines . . . The Government strategy for enhancing the role of the pharmacist and relieving pressure on the NHS will be disrupted, due to staff shortages, earnings dilution and market instability."
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