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2.47 pm
The Parliamentary Under-Secretary of State for Health (Ann Keen): I congratulate the hon. Member for Lewes (Norman Baker) on securing the debate. I know that this matter is causing great concern to him, to other Members and to his constituents, and he has put his case exceptionally well. He mentioned my former position in the health service. As a district nurse, I greatly valued the pharmacy and delivery services.
Let me briefly outline the law on this matter before dealing with the position in Newick. First, the current regulations governing NHS pharmaceutical services have been in place since April 2005, and replace NHS regulatory systems that had existed in one form or another since 1948. Indeed, I understand that regulations relating to the provision of dispensing services in rural areas can be traced back as far as 1936, or possibly even earlier. The 2005 regulations implement a series of measures that were agreed between pharmacy and medical representative bodies in 2001. It is important to bear in mind that the regulations that gave rise to the PCT decision about which the hon. Gentleman is concerned are based on that accord between doctors’ and pharmacists’ representatives.
Secondly, it is a long-established general precept, endorsed by all Governments since the NHS came into being, that doctors prescribe medicines and pharmacists dispense them. In that way, patients receive the benefit of both professions’ expert advice, intervention and care.
I use the term “general precept” carefully. I am sure we can all agree that both medical and pharmaceutical services have developed greatly since 1948. Our White Paper “Pharmacy in England: building on strengths—delivering the future”, which we launched in April, set out the ways in which we want pharmaceutical services to grow in the future. But it can be that a community pharmacy is simply not a viable proposition in every part of the country, especially in very rural areas. Patients need to receive their NHS-prescribed medicines promptly and efficiently, which is where the services of dispensing doctors can play a vital role. In that way, patients can pick up their medicines from the surgery’s dispensary without having a possibly lengthy journey to their nearest preferred pharmacy.
In the vast majority of cases, if a patient wishes to receive dispensing doctor services, they need to live in a designated “controlled” locality, by which I mean that the area in which they live is rural in character and more than 1.6 km as the crow flies from their nearest pharmacy. The minimum distance of 1.6 km—about one mile, as we used to say—between the patient’s address and pharmacy is set out in regulations, and the PCT has no discretion in this matter. I understand that the residents of South Chailey live further than that from the pharmacy in Newick.
Norman Baker: Let us be clear that the residents live further than that from the pharmacy in Newick, but, obviously, not further from the proposed dispensing point, which is the one to which they are objecting.
Ann Keen:
A patient can apply to their local PCT for their local medical practice to provide dispensing services where the patient has such a need. The practice seeks
approval from the PCT, which is known as outline consent. Where a PCT receives such an application, it invites views from interested parties locally, including medical and pharmacy contractors and their representative bodies, and the local patient and public involvement forum, as was. Such bodies have now been replaced by the local involvement network. The PCT can also seek views from other interested public, consumer and community groups, but whether it does so is for it to decide. The minimum notice period within which representations need to be made to the PCT is 45 days, after which it reaches a decision on the application.
Any such decision can be appealed to an independent body—the NHS Litigation Authority—by those who are statutorily entitled to make an appeal. In this instance, an appeal can be made by interested local contractors who made representations to the PCT. The right of appeal does not extend to the general public. I want to emphasise that the NHS Litigation Authority is independent; it is independent of the PCT, local contractors and local interests.
Let me turn now to the situation in Newick. I am advised by my officials that the local GP practice applied to provide dispensing pharmaceutical services at its branch surgery in South Chailey. Details of the application were circulated to interested parties locally, but I understand that that did not include the local patient and public involvement forum. I feel for the hon. Gentleman, because he was not consulted, and sympathise with the points he raised. The decision is ultimately made by the PCT, but I accept that the provision of new dispensing facilities is a change that the PCT should consider in relation to its obligations to consult. I understand that this was a genuine mistake on the part of East Sussex Downs and Weald PCT, which, in the circumstances, is to be regretted. However, that is what happened, and apologies should be made.
The hon. Gentleman will be pleased to hear that I have received assurance that the PCT has amended its process to ensure that the local involvement network and the local parish council will, in future, be notified about such applications as a matter of course. I understand that the PCT subsequently approved the application, and that details of the approval were notified to interested parties on 30 April.
I understand that details of that approval have caused widespread local concern about the future effect on the existing pharmacy in Newick; indeed, Baroness Cumberlege raised the issue recently in the other place and she has tabled a question about it this week. Her championing of such issues is well known in the health service.
I understand that an appeal against the PCT decision was last week lodged with the appeal unit of the NHS Litigation Authority. The appeal unit has yet to decide whether to hold an oral hearing, as the hon. Gentleman is seeking today. It would be inappropriate for me to comment on the actual details of this case, but I would like to outline the usual procedure that is followed.
The first stage in all appeals is for the appeal unit to invite written views from those entitled to make representations. I understand that it will do so as soon as possible. The appeal unit will then decide whether to hold an oral hearing. If it does, it will convene an expert appeal panel. This will afford the opportunity to those contractors who have made representations to put their case across at the hearing.
I would stress here that the decision whether to hold an oral hearing, and who to invite to present evidence, will be entirely one for the appeal unit. This is not a matter in which Ministers can or should intervene. However, I fully understand the hon. Gentleman’s concerns in seeking an oral hearing.
I am assured by the NHS Litigation Authority that as soon as a decision has been reached on whether to hold an oral hearing, the authority will let the hon. Gentleman know. But I can tell the House that pending the appeal, the application to provide dispensing services in South Chailey is on hold. In the light of that, I hope that the House will agree that it would be wholly inappropriate for me to give an opinion on this matter. In due course, the authority will hear and weigh carefully all the evidence it needs to come to its own independent conclusion. That is the right way for these things to be determined.
I heard very clearly from the hon. Gentleman how highly regarded is the current provision of pharmaceutical
services in Newick. I hope that we can all recognise and agree that we want every pharmacy and dispensing practice to provide excellent services, which can make an enormous contribution and real difference to our local communities.
Our White Paper makes it clear that we want to see pharmacy services as a whole move forward, whether in urban or rural areas, and irrespective of who provides them, to a position in which excellence receives its just rewards. Our pharmacy service has much to offer over the next few years, and the expectations of patients, consumers and the communities that it serves will change greatly. The pharmacy service will be at the heart of that community, providing excellence in service quality and delivery.
Adjourned accordingly at three minutes to Three o’clock.
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