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Baroness Miller of Hendon: I rise to support the noble Lord, Lord Graham of Edmonton, in what he so ably said about the advantages of competition and the loss to the consumer of our independent pharmacists. Perhaps I may mention one matter which the noble Lord did not. Medicines should not be thought of in the same way as the products which consumers ordinarily buy. They should not be bought in bulk, stored, discounted and sold as loss leaders. Medicines are very important items. From my previous experience as a chairman of an FHSA, I believe that the best way to purchase medicines, whether over the counter or with a prescription, is by visiting a pharmacist.

Perhaps I may add another point for the benefit of the Minister. I very much hope that he will take this on board. When I was chairman of the Barnet FHSA, in line with the previous government's philosophy-- I believe that it is also the philosophy of the present Government--we regarded as paramount the concept of bringing health care out into the community. We began an experiment in Barnet, known as "high street health". The idea was to enhance the benefits which independent pharmacists can bring to consumers by giving them extra training and by encouraging consumers who were suffering from, say, a cold or a sore throat to visit their pharmacist rather than blocking up their GP's surgery. That happened in the past when people used to visit their local chemist rather than rush immediately to the GP. That system in Barnet worked so well that it was used as a model by FHSAs across the country. In the areas where that system was adopted independent pharmacists became people of real value, not only to consumers but also to GPs. I stress that pharmacists in Barnet and elsewhere where the scheme was adopted worked in harmony with, and with the support of, their local GPs.

I grieve for the fact that if the Bill's provisions remain unamended we shall lose so many independent pharmacists that the benefits of competition, as we now know it, will be lost in this important area. I urge the Minister to look carefully at his noble friend's amendment.

Lord Morris of Castle Morris: I support the amendment proposed by my noble friend Lord Graham. The Minister and most of your Lordships may not be particularly well acquainted with the little country town of Llandysul, which nestles in a very agreeable part of west Wales. Your Lordships would not be out of kilter with many other citizens of both Wales and England in

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not being able to recognise Llandysul because it is a very small place and is not easily found either on a map or on the ground.

I mention Llandysul because last week I received a very closely argued, very detailed and very carefully researched plea from the pharmacist--the only one--in Llandysul pointing out in great detail the dangers which attended upon his particular business, which has been there for many years, if something like this amendment is not accepted by this Committee. In that area it is not easy for people to exercise any sort of choice. The area will support the work of only one pharmacist. May I therefore ask my noble friend the Minister when he goes home tonight to spare a moment or so to look on a map for the town of Llandysul and, before he goes to bed, to consider the very real problems which affect people in that area? I hope that the result will be that my noble friend's amendment will be accepted.

4.45 p.m.

Baroness O'Cathain: I rise to speak against the amendment moved by the noble Lord, Lord Graham. In doing so, I should mention that I know Llandysul very well, but I am not sure whether it is the same Llandysul because I did not recognise it from what the noble Lord said. Llandysul certainly has a pharmacy, but the people I know in Llandysul have as their objective catching the free bus down to the local Tesco where they can buy their pharmaceutical products. I can discuss this matter with the noble Lord, Lord Morris, because I happen to know Llandysul.

I heard from both the noble Lord, Lord Graham, and from my noble friend Lady Miller about the benefits of competition. Of course, it is lovely to have five pharmacists in one street in a small town, but the real benefit of competition is the fact that prices can come down. I have in my hand a list of comparative prices for the ordinary medicines that we all buy. You do not need to go to your local GP to get a prescription if you want aspirin or Nurofen--at least, I believe that that is the case.

A 24-pack of soluble aspirin costs 39 pence in a supermarket while a 24-pack of Disprin--exactly the same product--costs £1.50 in a pharmacy. There is a big difference between 39 pence and £1.50. In a pharmacy 24 Nurofen tablets cost £4.69 while in a supermarket they cost £1.99.

I should declare an interest. Most Members of this Committee realise that I am a non-executive director of Tesco--

Lord Graham of Edmonton: Keep taking the tablets!

Baroness O'Cathain: I am sorry; I had been intending to declare that interest when we reached my amendments. I have it properly registered, according to the noble Lord, Lord Graham, in Section 3 of the Register of Interests. I have done that all along, but I repeat it for the benefit of the newer Members of your Lordships' House who may not know. Those who were here during our arguments on Sunday trading know perfectly well where I stand on this.

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We must recognise that all governments in this country have wanted to battle non-stop for low inflation. The mark-ups on some ordinary products are significant. Although such high mark-ups support the local pharmacies--I do not disagree with that strong point--it is the self-same people who use those local pharmacies who are the least able to pay those extremely high mark-ups on highly priced goods. I am afraid that by restricting supply and maintaining the retail price mechanism on such products we are not doing what the Bill sets out to do, which is to lower the cost of living for a lot of people.

Baroness Ludford: I am extremely sympathetic about the concerns which have motivated the amendment because I can appreciate the conflict between achieving lower prices through competition and the maintenance of essential local services, particularly (although not exclusively) in rural areas. In the very metropolitan area from which I come, the London Borough of Islington--the Minister is not unfamiliar with it--our local pharmacies are relied on particularly by those who are not mobile. As I said, although I am sympathetic to the motivation behind the amendment, I can see difficulties with the maintenance of the retail price mechanism on this basis.

Can the Minister assure us that he and his department will look carefully at other ways in which small shops can be helped either through the planning mechanism or the uniform business rate? The powers of local authorities are extremely limited in this regard. Even in urban areas we face ongoing problems in trying to maintain essential local shops. Can the Minister give us such an assurance, even if he cannot accept the amendment?

Baroness Oppenheim-Barnes: I rise to speak briefly and apologise to the noble Lord, Lord Graham, for not being present when he moved the amendment. My noble friend Lady O'Cathain has provoked me--

Baroness O'Cathain: Good!

Baroness Oppenheim-Barnes: Obviously, I respect my noble friend's knowledge of these matters given that she is a non-executive director on the board of Tesco, but I was a non-executive director on the board of Boots for 11 years and I must express this caution to my noble friend. She says that exactly the same aspirins are sold in different places. Many cut-price drugs have been manufactured in the third world where quality control is nowhere near as good as that which is applied to more reputable brands. Whereas in some cases the mark-ups may be exceedingly high--probably too high--I believe that to go for cheapness is not the greatest economy.

Lord Fraser of Carmyllie: I rise to support the amendment moved by the noble Lord, Lord Graham. I very much look forward to hearing the response of the Minister. If I have one disappointment about the Government Front Bench it is that for a debate as potentially important as this on the first day of the Committee stage there is no Minister from the

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Department of Health. There is here a risk of conflict between clear Government policies. As I understand it, the health policy of the Government continues the policy of the previous government; namely, that general practitioners are to be at the forefront of the National Health Service but every effort should be made and every encouragement given to ensure that they do not have an unnecessary workload. Accordingly, the approach promoted by my noble friend Lady Miller when she, among others, had responsibility for the National Health Service was that community pharmacies should be a valuable point at which people with a range of minor ailments could get the requisite advice. Therefore, instead of taking up the time of their GPs and wasting their own time sitting for hours in waiting rooms, they would be able to go along to a pharmacy and see whether their ailments could be quickly dealt with by over-the-counter drugs. Alternatively, if the chemist felt that there was a worry about the individual's health he would be properly referred to his GP. That seems to me to be a good policy. If it remains the policy that we on this side pursued when in government we warmly support it and will give every encouragement to its achievement.

A specific question was asked about this issue at Second Reading. The noble Baroness, Lady Jay, indicated then that the Department of Health was neutral on the point. Frankly, I found that astonishing. In moving this amendment the noble Lord referred to research which indicated that approximately 37 per cent. of those who currently went to pharmacies would go to Asda, Safeway and so on.

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