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2.46 pm
The Minister of State, Department of Health (Mr. Mike O'Brien):
I certainly agree with my hon. Friend the Member for Dartford (Dr. Stoate) that those proposals
need to be given serious consideration. Let me begin by congratulating him on holding this debate, on a subject that is important to him as chairman of both the all-party pharmacy group and the all-party primary care and public health group. Self-care is a cause that he has championed. He has made a strong case that some people turn to their GP when they do not need to, for minor ailments such as coughs and colds, and indigestion, rather than using simple and basic methods of care themselves. That is partly about knowledge and partly about self-confidence, as well as about people being willing to make a judgment about when they really need to see their GP and when they are going just for a bit of reassurance.
Last November, the Proprietary Association of Great Britain and the Royal College of General Practitioners launched their "Declaration of Self Care". They put the total cost of GPs treating minor ailments at around £2 billion, of which £1.5 billion is in GP time. The potential benefits of some element of self-care are considerable, if we can begin to change the attitudes of some patients, some GPs and others. With proper support from health professionals such as pharmacists, people can take the appropriate level of responsibility for their own health. GPs could then focus on treating more complex conditions, which make better use of their expertise and time.
We need to get the balance right. We do not want people with difficult long-term conditions not going to see their GPs. That is not what this debate is about, nor is it about saving money. The NHS budget has increased massively in recent years. It will increase by 5.5 per cent. this year and 5.5 per cent. next year, and we will lock in that further increase for front-line services over the following two years.
Self-care, which comes in many forms, is about people looking after themselves and their families better, where that is the right thing to do. Many people do it, whereas some do not. Self-care can range from taking paracetamol when someone gets a cold, to disinfecting their child's grazed knee when they fall, and from eating healthily and exercising more to stay fit, to getting out for a walk if they are feeling low-or it can mean someone deciding actively to manage their long-term condition with the help of health care professionals.
Society has changed in recent decades. People want more choice. They want to remain independent and stay healthy. They want safe, effective services, tailored to their needs and delivered as near to their homes as possible. A survey in 2005 showed that more than 80 per cent. of people with long-term conditions already play an active part in their own care, that more than 90 per cent. want to do more, and that more than three quarters would feel far more confident about taking care of their own health if they had the right support.
The NHS has also changed. The Government have long been committed to making medicines available over the counter by switching their legal status when it is safe to do so. For example, azithromycin, for people with chlamydia, has moved from being available only on prescription to being available over the counter in pharmacies. Similarly, many nicotine replacement therapies that were previously available only on prescription in pharmacies are now widely available on the high street. We have now made them available without a prescription.
The Government have gone to great lengths to give people more and more accessible information on health.
In the late 1990s, we launched NHS Direct, providing national, 24/7 access to information, advice and support over the phone and on the internet. NHS Direct has a number of online tools to help people to care for themselves at home, such as symptom checkers and a "click to call back" function, whereby patients can request a phone call from NHS Direct. In 2008-09, 52 per cent. of all calls to NHS Direct were completed without the need for further medical attention-for example, from a GP.
In 2007, we introduced the NHS Choices website, which now receives more than 8 million visits a month. It provides convenient, comprehensive and clinically accredited information about treatments and local services on health, health improvement and social care. There, people can find "Your health, your way", a guide to long-term conditions and self-care. It also tells people about the range of self-care support available to them locally, including healthy living advice, information about their condition, training to help people feel more in control, and access to self-help groups and to new technology to help people remain independent and in control. As a consequence, people are increasingly using NHS Choices rather than calling NHS Direct or visiting a GP.
Self-care is about more than just providing information, however. It is also about improving the partnership between professionals and the general public. General practitioners have a crucial role to play in engaging people in their own care and helping them to manage their condition, and many GPs already do this brilliantly. But we need to support new GPs and those who want to improve, and we have worked with the Academy of Medical Royal Colleges to produce an e-learning module called "Supporting Self-Care", which is now part of the Royal College of General Practitioners' e-GP training materials.
Of course, not everyone has access to the internet. Those who are not on the web can visit their local community pharmacy for information and support. Pharmacies already support self-care, providing advice and selling over-the-counter medicines, when appropriate. Since the 2005 community pharmacy contractual framework was introduced, support for self-care has been one of the essential services delivered by all community pharmacies in England.
The aim was to increase access and choice for people, including their carers, who wish to look after themselves or their families, helping them to self-manage minor illnesses, injuries or long-term conditions. Every day, pharmacies advise millions of people on how to treat or manage minor conditions, and on the appropriate use of over-the-counter medicines. When a pharmacy cannot help, it can provide information on health and social care providers or support organisations that can offer that help. The contractual framework represented a major change in the role of community pharmacies, from the place where medicines were dispensed, to somewhere that can offer more clinical services, such as chlamydia screening, health checks and support for people with long-term conditions. Some PCTs have even commissioned pharmacies to provide minor ailment services for those who do not pay prescription charges. By 2008-09, more than 3,200 pharmacies provided this service, an increase of 5 per cent. on the previous year.
If these measures are to make a real impact, however, people must first understand that pharmacists are highly trained clinical professionals in their own right who can help them with their self-care. So this year, we will raise public awareness of the skills, expertise and services offered by pharmacies. We are also funding some PCTs specifically to promote services commissioned through and delivered by community pharmacies.
Pharmacy has an important contribution to make to improving public health and reducing health inequalities. One of the themes in our 2008 White Paper "Pharmacy in England: building on strengths-delivering the future" was to help people to self-care-to improve their health and well-being and to take better care of themselves. Work is progressing on a framework to transform into healthy living pharmacies, focusing on prevention as well as cure. We have also published a number of
educational resources to help pharmacy staff deliver advice to members of the public on subjects including stopping smoking, weight management and physical activity.
The Government therefore recognise the importance of having reliable, convenient advice readily available-whether it be on the phone, on the NHS Choices website, in GP surgeries or in local pharmacies. I think that the proposals set out at the end of my hon. Friend's contribution are an important contribution to the debate on how we should drive this agenda forward. There are enormous benefits to be gained from encouraging people to take more responsibility for their own well-being, where it is right to do so. We will continue to support people to make their own informed choices.
2.56 pm
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