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Ms Hewitt: Let me make it plain that it is the OFT's job to examine competition, not to advise us on health policy. On the matter of the OFT's investigations into the impact of Government regulations, we do not leave it to the OFT to make the final decision as we now quite rightly do in merger cases. It is for the Government to make the policy decisions on public services, including the national health service.
I know very well—this debate has already reflected it—the deep concern that there is inside and outside the House that simply abolishing the control of entry
regulations might lead to widespread closures of community pharmacies, particularly in rural or deprived areas. That concern is reflected in today's report from the Select Committee on Health. I am grateful to the Committee's members for their speedy inquiry. We will consider their report and conclusions before we take our decisions.
Mr. Nigel Dodds (Belfast, North): The situation in Scotland and Wales was mentioned earlier, but will the Secretary of State welcome the decision made by her colleague the Minister for Work when he was the Under-Secretary of State for Northern Ireland with responsibility for health? He was not a devolved Minister but a direct-rule Minister, and he unequivocally rejected the Office of Fair Trading recommendations for Northern Ireland on 26 March. He cited the detrimental impact that the proposals would have on the infirm, vulnerable and less well off. Would she care to follow her colleague's example?
Ms Hewitt: Health Ministers in each of the devolved Administrations made their decisions, which was absolutely right. We shall take our decision when we have completed the consultation and deliberation that my right hon. Friend the Member for Darlington (Mr. Milburn) and I announced before the end of March.
As I was saying, the OFT's job is to examine competition, not to decide health policy. As my right hon. Friend the Chancellor of the Exchequer argued forcefully in a lecture earlier this year, there are limits to markets, especially health care markets. There are certainly limits to competition among pharmacies, and I agree with the hon. Member for South Suffolk that pharmacies are, on average, dependent for about 80 per cent. of their income on revenue received for dispensing NHS prescriptions, the price of which is fixed by the Government. Labour Members are clear that pharmacists are clinicians and not only shopkeepers.
As my right hon. Friend the Member for Darlington and I said on 26 March, we will come forward before the summer recess with a balanced package of measures. We favour change to open up the market and to improve quality, access and choice for patients—hon. Members of all parties have supported those points—without diminishing the crucial roles that pharmacies play, especially in poorer and rural areas. We have already consulted widely and I am grateful to the thousands of people, including many hon. Members, who have given us their views. We shall consider especially the impact of any change on rural communities in line with our commitment to those communities and also ensure that all policies take account of their specific needs and circumstances. The hon. Member for South Suffolk got rather hot under the collar on that subject and I am sure that his failure to mention the fact that rural post office closures have almost stopped was a mere oversight. Closures are occurring at the lowest rate since 1995 thanks to the measures and financial support that this Government have put in place.
Mr. Yeo: What the right hon. Lady says does not take account of the fact that the direct consequence of the
Government's policy to change the way in which benefits are paid is that two fifths of rural post offices' income has been taken away.
Ms Hewitt: I know that the hon. Gentleman is becoming increasingly impatient with any change at all. He clearly pays no attention to the fact that the present system of giro books is acutely vulnerable to fraud and extremely expensive to administer. However, that is all that we can expect given that we inherited the system from his Government. The measures that we have implemented to ban any avoidable rural post office closure and the financial support that we are providing for rural post offices, linked with our support for shops in our rural villages, are helping to strengthen our rural communities.
I regret the fact that the hon. Gentleman continues to peddle the idea that the only way to get people to use rural or urban post offices is by chaining them there with their benefit books. He should welcome changes that the Post Office's new management is making to ensure that people with a range of bank accounts may do their banking at post offices and gain other services and benefits when they do so.
Roger Casale: I welcome the sensitive and balanced recognition that my right hon. Friend is giving to the need for sensible regulation. I have consulted Paresh Modasia, who is a leading community pharmacist in my constituency, and he and other community pharmacists are keen to work with the grain and the Government. They recognise the need for change, not least keeping pharmacies open later in the evening and developing their role in the new NHS. Will she confirm again that her Department is keen to work with representatives from community pharmacies to develop dialogue so that we can find out how to achieve the best outcome for everyone?
Ms Hewitt: My hon. Friend is right. There is a full dialogue and partnership between the Department of Health and community pharmacists, building on the proposals in "Pharmacy for the Future" that are being developed in discussions on the new contract. All of that will inform the policy decision that we make on the particular issues raised by the Office of Fair Trading report.
John Mann: The success in implementing the Government's updated drugs strategy requires community pharmacists to provide greatly increased supervised consumption of methadone and other substitute drugs. Will my right hon. Friend comment on the importance of the community pharmacy in the success of that strategy?
Ms Hewitt: My hon. Friend is right. Part of the way in which we will deal with the menace of growing illegal drug use is by mobilising community pharmacists to supervise much more effectively the treatment of drug addicts within the community. That is one of the many issues that we are taking into account as we consider how to move forward.
Mr. John Horam (Orpington): Does the right hon. Lady recognise the vital point made by my hon. Friend
the Member for South Suffolk (Mr. Yeo) that two things are going on simultaneously for which she is responsible—the closure of sub-post offices and the possible closure of pharmacies? Those two together, both in suburban areas like my constituency and in rural areas, pose a threat to small local shopping parades and villages. The worry is that there will be less accessibility to services overall.
Ms Hewitt: I understand those concerns, but the hon. Gentleman ignores what I just said and the steps that we have taken to protect and reopen post offices and shops in many of our rural communities. He assumes that changes will lead to the closure of community pharmacies. We will ensure that that is not the case. That is why we made it clear in our statement on 26 March that we will produce a balanced package to achieve the goals, which I hope he shares, of better quality access and choice for patients and a stronger, not a lesser, role for community pharmacists.
Mr. Peter Ainsworth: Will the right hon. Lady give way?
Ms Hewitt: No, I intend to bring my remarks to a close.
The proposals that we will produce before the summer recess will also be the subject of full consultation and debate within the House.
As our Government continue to improve the NHS, we will ensure that pharmacists are recognised as full contributors to primary care services, as the first port of call for patients and consumers in discussing everyday health problems, and as important partners in reducing health inequalities and in dealing with some of the most serious health problems that our communities face. The Government are increasing investment in the NHS by a third over the next three years. For all the crocodile tears that the hon. Member for South Suffolk shed, we know that the Conservatives would cut investment in health services by 20 per cent. What would that do for community pharmacies, hospitals, doctors and nurses?
We will make the investment that our health service needs and promote the reforms that it needs. We will make that investment and those reforms in the interests of patients and communities. In doing so, we will strengthen the vital role of our community pharmacists. I commend the amendment to the House.
5.44 pm
Sandra Gidley (Romsey): Unlike the hon. Member for Stroud (Mr. Drew), I welcome the opportunity to debate community pharmacies. The subject is of great interest to many of my constituents and fellow professionals. Perhaps I should explain that I am fairly unique among hon. Members in that I was a community pharmacist.
Clearly pharmacies are a health issue and should not come under the remit of the Department of Trade and Industry. Although I welcome the thrust of the Conservatives' argument, the hon. Member for South Suffolk (Mr. Yeo) over-egged the pudding.
It was with utter disbelief that I listened to his "emperor's new clothes" speech, showing the Conservatives' new, cosy, caring attitude. Personally, I found that hard to take, but he did the health service a big favour by highlighting how the drugs budget could be reduced. Instead of prescribing emetics, a doctor could just give a patient some over-the-top passages from the hon. Gentleman's speech demonstrating the Conservatives' caring nature, and the desired result would be achieved.
There is a lot of consensus on this issue on both sides of the House. Many Members have presented petitions either in the Chamber or to the Department of Trade and Industry, and today the Select Committee on Health, on which I serve, has produced a report on the issue, on which it was easy to secure all-party consensus. Our earlier debate concentrated on the Cabinet reshuffle, one aspect of which, sadly, has not attracted any attention. Five of the six Ministers in the Department of Health have been replaced, and I wish the new Minister with the brief for pharmacies well. I looked up the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman) to investigate the history of his interest in health, and found that he had a doctorate in isotopic abundances in soil development—[Interruption.] The Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton) points out that she has responsibility for pharmacies. I urge her to tell the information unit at the Department of Health, which clearly thought that somebody else did. There is confusion in the Department about who has responsibility for the matter.
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