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Mr. David Hinchliffe (Wakefield): It is a pleasure to follow the hon. Member for Romsey (Sandra Gidley), who speaks with great authority on these issues and has recently made an important contribution to the Health Committee inquiry into this matter.
As this is the firstpartialhealth debate since the reshuffle, I should like to take the opportunity to welcome the Minister of State, Department of Health, my hon. Friend the Member for Doncaster, Central (Ms Winterton). It is good to have a Yorkshire voice on the Health team. I also look forward to working closely and warmly with the other new members of the team. I also welcome the Under-Secretary of State for Trade and Industry, my hon. Friend the Member for Bradford, South (Mr. Sutcliffe). I am bereft of my Yorkshire Whip now that he has gone to the Department of Trade and Industry. I shall miss him, although whether he will miss me is a different matter. We have had a very good relationship over the years, and I wish him well in his work.
I pay tribute to the work of my right hon. Friend the Member for Darlington (Mr. Milburn). I deeply respect his decision to be with Ruth and the children; he has many achievements to his name of which he can be very proud.
I find myself in an interesting situation. This is the first occasion that I can recall during my time in Parliament on which I could quite easily vote for either the Opposition motion or the Government's amendment. I am quite happy with both, and I have no difficulty with either position because they both encompass clear concerns, aims and objectives that we can all share.
I find the Tories' positiona significantly increased role for the market in health careinteresting. On an issue such as this, however, when their constituents are expressing concerns about the possible disappearance of local pharmacies, they are actively arguing their case in relation to an OFT report that the Government have yet to consider.
Today, the Health Committee published its report following a brief inquiry, and I shall base my speech on it. I feel strongly that, historically, we have failed to exploit the potential of a number of key elements of the NHS, primary care being a good example. I pay tribute to the Government's attempts to devolve more power to that sector: I think we shall see the benefits in the longer term. Similarly, we have failed for many years to exploit the potential of community pharmacies.
My constituency contains a number of first-class community pharmacies and pharmacists. I am especially privileged to have as a constituent Gill Hawksworth, who last week was elected president of the Royal Pharmaceutical Society of Great Britain. She has badgered me long and hard about the potential for community pharmacies to play a much larger role in the NHS. The time that I spent with her in her Mirfield pharmacy taught me a great deal.
I also thank Irene Gummerson, a pharmacist at the Warrengate pharmacy in my constituency, for allowing me to spend a morning in her pharmacy and to see exactly what is done in pharmacies. I learnt a great deal there as well. I have also spent time at Boots in my constituency, and learnt much about what it does as a major player in community pharmacy. Finally, let me thank Phil Bratley, who has been secretary of the local pharmaceutical committee, for his support and advice.
The current regulatory regime was introduced in 1987, and it is right for us to review it on occasion. The Government deserve praise for their detailed examination of the greater role that could be played by community pharmacies, but the OFT review is rooted in economic and competitive arguments rather than arguments about health, as has already been pointed out today.
The Health Committee inquiry was undertaken because of many Members' anxieties about the possible consequences of the OFT report. On one day we took evidence from a range of key players, including the OFT, the Pharmaceutical Services Negotiating Committee, various providers and, of course, Asda, which would be a major player in the event of deregulation. The evidence made it clear to me that there was broad agreement about the fact that the number of pharmacies would increase initially following deregulation, but that in the longer term many pharmacies in rural and deprived areas would be threatened by a loss of dispensing revenues to new pharmacies, especially in bigger stores.
We reached a number of conclusions. First, we concluded that, as the Secretary of State has said, the control of entry regulations need reform and modernisation. In many parts of the country, including parts of my constituency, people have no access to prescriptions out of normal hours. We established that community pharmacists support modernisation, and they would plainly want to be key players in the process of ensuring a more positive service.
The evidence suggested a strong likelihood of closures in the event of acceptance of the OFT report. That would have a particular impact on poorer communities and especially on elderly and immobile people, some of whom would lose their local services. A calculation in our report, which I have no time to quote, shows the exact percentage of community pharmacies that could be lost.
The Committee also felt that the OFT's projected savings were questionable and did not stand up to detailed analysis. In particular, a reduction in community pharmacies is highly likely to lead to people wanting to access more expensive elements of the national health service, such as GPs and casualty units, to get the service and the prescriptions that they need. We felt that there is a need for an enhanced role for primary care trusts to plan the provision of pharmacy services, to ensure that local pharmacies do provide extra services. Indeed, I believe that the Minister agrees that that is the way forward.
I hope that the Government will take note of the points made in our report and in this debate. The key conclusion that I reach is that market forces are not a proper basis for health care provision. I make that point to the Opposition, but I also make it to the Government.
Mr. Peter Ainsworth (East Surrey): It is a pleasure to follow the distinguished Chairman of the Health Committee, the hon. Member for Wakefield (Mr. Hinchliffe), on the day when the Committee produced an intelligent and thoughtful report on a subject of huge interest to all of our constituents. I received petitions containing some 3,000 names, all of which I forwarded diligently to the Department in the earnest hope that they will be taken seriously and that the concerns expressed will not only be listened to but acted on when the Government take their decision on the OFT report.
Let me come straight to the point made by the hon. Member for Wakefield about the Conservatives' position. It is quite simple: where we see that market forces will benefit patients, help to raise standards and help to lever funds into the health service, we are keen to use them. However, where opening up to market forcesof course, we are talking about a system that was put in place by a Conservative Government in the 1980sreduces access to health care, as in this case, we do not think it such a good idea after all. I have no doubt that my hon. Friend the Member for Epsom and Ewell (Chris Grayling) will have more to say about that issue later.
At a time when we often hear that people are not interested in politics, it is worth noting that an issue such as this can really grab people's attention. People care very much about their local pharmacies, and the strength of the public's response is evidence of that. Indeed, one welcome outcome of the Government's otherwise unwelcome prevarication about the future of community pharmacies is that it has heightened public awareness of the valuable contribution of pharmacies to communities throughout the country. That has enabled this important industry to set out its stall, which it has done extremely well.
The Office of Fair Trading report makes a reasonable case on behalf of the industry, particularly on the issue of access. As we have heard, the OFT says that 90 per cent. of people find access to their local pharmacy easy to achieve. It also states:
Broadly speaking, I support open entry into markets and I am wary of protectionism, but competition is not a virtue in its own right. It may often have virtuous consequences, but its benefits must be weighed against its potential impact on society, individuals, communities and the environment. Competition ceases
With the benefit of hindsight, few would fail to see that, before it was checked by my right hon. Friend the Member for Suffolk, Coastal (Mr. Gummer), the growth of out-of-town shopping centres had a huge and adverse impact on town centres throughout the country, weakening social cohesion and encouraging car dependency. Few people now applaud the way in which the growth of supermarkets has led to the steady decline of corner shops. Social cohesion has already suffered enough dereliction in the name of progress. The Office of Fair Trading proposals would, if implemented, only make matters worse.
The case for throwing the network of community pharmacies to the winds of competition is fundamentally flawed for two principal reasons. First, the OFT proposals would deal directly with only 5 per cent. of the total market, but might have enormous effects on the market as a whole, especially on access to NHS prescriptions. Secondly, pharmacies and pharmacists are a key partperhaps the most undervalued partof the NHS. That is what makes them different from other commercial businesses. My hon. Friend the Member for South Suffolk (Mr. Yeo) touched on that point in his opening remarks.