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“there is still some way to go before our reforms are in place. This transition period is an opportunity for pharmacy to make its presence felt.”

I profoundly hope that the transition period does not follow distant historical, if not to say Trotskyist, precedent and aspire to a state of permanent revolution. I sincerely hope that the Government can allow the community pharmacists to do what they do best.

At the present time the playing field is not level, but opportunities there are aplenty. One of the five domains in the NHS outcomes framework—I have to say, Mr Speaker, that the Minister is a good and decent and honourable man, and I have had the pleasure of his company and his acquaintance for many years. I cannot believe that he would ever talk about the “five domains of the NHS outcomes framework.” There are those around us who do and it is to them that we must give credit tonight, but let them come out with this peculiar, strangulated syntax. I hope that the Minister will reply in honest, Norfolk talk.

The NHS outcomes framework refers directly to the quality of life for people with long-term conditions, and this is an excellent opportunity for the community pharmacy, in addition to other qualified health care practitioners, to deliver a key aspect of the Government’s new health care system in England. The pharmacist, as is so obvious when one comes to think of it, may often be the first person to spot a development in a patient’s condition. An early identification can be therapeutically priceless. It is often the community pharmacist who notes that someone has not come in for their medication or, when they are delivering to their home, that the person does not open the door, is looking more tired and pale, or occasionally has something more dramatic such as a nosebleed. This early identification is absolutely priceless, and this is where the role of the community pharmacist has changed beyond almost all recognition. I am seriously worried that such best practice, as recommended by Earl Howe, is threatened by the impact of changing priorities as commissioners change.

The funding passed to CCGs and local authorities is already being used to commission services from community pharmacies, so that for every new service there is a very real possibility that an existing one will be ended. Local authorities will, quite rightly, look to address their own priorities. I referred earlier to the additional pharmacy-led services in England and the huge growth in recent years, but 2012 actually saw a decrease of 5%. It is reasonable to assume that the transition period between commissioners in 2013 and 2014 will see that decline continue. It must be recorded that any diversion from existing services will have an immediate effect on patients. If there is one thing we can all agree on, it is how the community pharmacist has earned the trust of patients and the patient community. It has been so remarkable and beneficial that it cannot be threatened. If there is one thing that patients in long-term care plans in particular are terrified of, it is a change in the structure that could affect their medication and the ability of a community pharmacist to provide for their needs.

The General Pharmaceutical Council is the regulator of pharmacists, and as such pharmacists are not required to register with Monitor or even the Care Quality Commission. This lack of a registration number actually inhibits many pharmacists from applying to provide services under the “any qualified provider” scheme. I do