| Previous Section | Index | Home Page |
Ms Hewitt: My hon. Friend is absolutely right. He makes the very important point that the public and pharmacists are telling us that much more could be done to use pharmacists' skills and expertise to deliver better health care to patients. Only the Conservative party says that nothing should change—typical of Conservative Members. The programme for pharmacies sets out exactly how we will continue to improve pharmacy services. We need to ensure that they can meet patients' changing needs, ensuring that people can get the medicines and pharmaceutical advice that they need easily and, wherever possible, in the way and at the time and place that they choose.
We have heard very little about patient and consumer choice from the Opposition. That is why my right hon. Friend the Secretary of State for Health is taking steps to ensure that patients can obtain more medicines over the counter from pharmacies. We want patients to be able to get their medicines out of hours, when that is what they need. We want more patients to be able to receive delivery of their medicine at home. We want
pharmacists to be responsible for far more repeat prescriptions, as that will make life simpler for patients and doctors.
Mr. Mark Francois (Rayleigh): It has already been mentioned several times in the debate today that pharmacists play a very important role, not least in releasing pressure on already hard-pressed general practitioners. My constituency has the fourth highest ratio of patients to GPs in the entire country. Does the Secretary of State appreciate that this is an extremely important point? Has that got through to the Department of Trade and Industry, as well as to the Department of Health, where it was appreciated to begin with?
Ms Hewitt: Yes, of course we are aware of that important point and, through the Department of Health's programme for pharmacies, we will also ensure that pharmacists give patients much greater support and advice on using medicines. We need to reduce the amount of illness caused by medicines not being used correctly, and we certainly need to cut the amount of medicines that are simply wasted because patients do not begin or, more commonly, do not complete their courses. All of that will mean better care for our patients and a greater role, not a lesser one, for community pharmacists.
Mr. Gale : Does not the right hon. Lady understand that the Opposition agree with much of what she is saying? The problem is that what she is saying is not compatible with shipping out pharmacies to out-of-town supermarkets and putting community pharmacies out of business, thereby denying access to local outlets that will provide precisely the back-up, advice and service to the vulnerable, the elderly and young mothers with children that she seems to be talking about.
Ms Hewitt: I think that the hon. Gentleman is tilting at windmills. I hope that by the time I have finished my speech, I will have persuaded him to vote for our amendment. He should not be hostile to the development of pharmaceutical services in supermarkets, all of which are approved by primary care trusts when that is appropriate. I recently visited friends in a village in Suffolk where there have been no shops of any kind for many years. The local supermarket has recently opened an excellent pharmacy service complete with a treatment room and qualified pharmacist within the supermarket. For the people living in that village and others around it, that would be the nearest community pharmacy. He should therefore drop his prejudices and look at the situation on the ground.
Mr. Peter Ainsworth: Will the right hon. Lady give way?
Ms Hewitt: Let me make a little more progress.
Against that background of our programme for pharmacies and our commitment to pharmacists, we are considering the report from the Office of Fair Trading. I welcome that report, which is a useful contribution to public debate and understanding. The hon. Gentleman referred to the history of the control of entry regulations
which, of course, date back to 1987. What he did not know, however, or forgot to mention, is that the situation in 1987 was very different: in those days, payments to pharmacists were being made on a cost-plus basis, with higher payment being made to the smaller pharmacies for each prescription dispensed than to larger ones. The result, not surprisingly, was to encourage more and more pharmacies to open up that were almost entirely dependent on NHS funding and prescriptions. That is why NHS costs kept rising, which is why the Treasury, in 1987, rightly insisted on changes being made. The control of entry regulations gave local health authorities the responsibility of deciding whether new pharmacies were needed, and in doing so dealt with the problem of the perverse incentive, which was driving up costs unnecessarily.Since then, the cost-plus remuneration system has given way to a reformed payment and reimbursement system. As I indicated a few moments ago, the Department of Health is now negotiating a new pharmacy contract, which will come into effect next year, and will provide new opportunities, particularly for the primary care trusts, to introduce services such as minor ailment clinics, repeat dispensing, supplementary prescribing, home delivery services and some others on which we have touched.
John Mann (Bassetlaw): Does my right hon. Friend agree that the situation in my constituency, which has prevailed for 20 years, is absurd? On a Sunday evening, if someone requires a repeat prescription ventalin inhaler the only way to get it is by going to accident and emergency or calling out a GP. Does she think that that needs attention in the review?
Ms Hewitt: My hon. Friend makes an important point. The issue of out-of-hours dispensing is one of those being considered in the Department of Health, with pharmacists, to ensure that as part of the new pharmacy contract and the new arrangements with PCTs, we deliver better services to consumers and patients who often need those services 24/7, 365 days a year, and not simply at times when pharmacies are usually open.
Mr. Todd: Does my right hon. Friend agree that it would be worth while for the contract negotiations also to focus on some of the rather perverse incentives in the current contract, including the fact that any gain that is made by more efficient purchasing is effectively clawed back by the Government in a subsequent year? That is an intensely frustrating and unpredictable process for many pharmacists.
Ms Hewitt: That is an extremely important point, and I am sure that the Minister of State, Department of Health will take note of it. She may wish to comment on it when she winds up.
The role of the OFT is to promote competition and consumer choice. Just as none of us in the House should have any doubt about the importance of community pharmacies, so none of us should be in any doubt about the importance of competition and consumer choice to our wider economic success. When the Conservative
party was in power, it talked about competition, but it has taken this Labour Government to modernise a competition regime that was increasingly inadequate and left us trailing behind other economies. With Labour's Competition Act 1998 and Enterprise Act 2002, we can be proud of giving our country a competition regime that is now among the best in the world.Greater competition has already brought benefits to all of us who buy over-the-counter medicines. When, in 2001, the OFT used the new powers that we had given it under the 1998 Act to challenge the old system of retail price maintenance, prices of leading branded over-the-counter medicines fell by up by 50 per cent.—in some cases within a couple of hours of the OFT announcing the opening of its inquiry. That was good news for patients and consumers. I would have hoped that Conservative Members would welcome it. Above all, it was good news for low-income families and low-income elderly people.
I have no doubt about the contribution that the OFT can make to our deliberations on how we improve consumer choice. I welcome the fact that, as a result of our reforms, it can look specifically at the impact of the Government regulations that may be holding back consumer choice and competition.
Mr. Andrew Lansley (South Cambridgeshire) rose—
Ms Hewitt: I will give way to the hon. Gentleman, because I am sure that he will want to welcome those reforms.
Mr. Lansley: The Secretary of State anticipates my question, and I am grateful to her for that. She is responsible for the oversight of the OFT's work, and I am sure that she will agree that it is desirable that it conducts, as it intends to, at least two investigations each year—and certainly next year—into the impact of Government regulations on markets. She understands, as I do, how competition policy works. Competition has to be constrained when public services are involved and competition policy bites only to the extent that undertakings do not provide services of general economic interest—public services, in the European Union jargon. Therefore, why did not the Secretary of State or her colleague in the Department of Health make sure that, when the OFT examined this market, it did not confine itself to the examination of the market impact of the control of entry regulations, but considered the public service obligations that had to be met by community pharmacies? Why did it not construct its report in that wider context?
| Next Section
| Index | Home Page |