Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I beg to move amendment 133, in clause 28, page 30, line 12, after ‘period’, insert

‘and in consultation with the professional and regulatory bodies for pharmacists.’.

Robert Key (Salisbury, Conservative)

With this, it will be convenient to discuss amendment 134, in clause 31, page 31, line 36, after ‘period’, insert

‘and in consultation with the professional and regulatory bodies for pharmacists in Wales’.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I am sorry that nobody else is getting up to speak at the moment; I feel that I have talked enough already. [Laughter.] Do not all agree.

Happily, we have now reached clause 28, which is on the second page of the second list of grouped amendments and not on today’s list of grouped amendments. Amendments 133 and 134 would place a duty on PCTs to consult the regulatory and professional bodies for pharmacists in England, in relation to clause 28, and in Wales, in relation to clause 31. They seek to probe the Government about where the power to suspend pay should lie.

Earl Howe raised the issue of a PCT’s powers of intervention in matters concerning pharmacists’ professional conduct in the other place. However, he did so with regard to another clause in the Bill. I want to address some of the issues that he commented on with respect to clause 28, as I question whether it is appropriate for a  PCT to suspend the pay of a pharmaceutical service. The power to suspend pay could be detrimental to patient care if it is not strictly controlled. If the payment of pharmaceutical services is suspended, those services could deteriorate rapidly and that could severely hamper services to patients. As the National Pharmacy Association put it:

“Pharmacies’ day-to-day financial outlay cannot usually be deferred, so withholding payment would have an immediate and dramatic effect on cash flow and the consequent ability to provide core services.”

We must ensure that the measure is used as a last resort and that the power to suspend pay is not exploited in inappropriate circumstances. What assurances can the Minister give that the use of this power will not have a detrimental effect on local services?

Another reason that I tabled my amendment is that PCTs may not understand the nuances of the pharmaceutical sector and therefore may not be in a position to make a judgment as to whether they have breached the arrangements for service delivery. However, I believe that the principle behind clause 28 is right. I merely wish to query whether the decision to suspend pay should be a collaborative one rather than one that is made solely by the PCT.

Perhaps the Minister can specify in his response the measures that he will put in place to prevent PCTs from abusing the power to suspend pay. If a PCT has commissioned a pharmaceutical service, it is perversely in its interest to suspend pay while still reaping the benefits of that service. In extreme circumstances, the system could be abused to bring about cost savings. An arbiter in the form of a pharmaceutical regulatory body could prevent such a situation from arising and ensure that the case of the accused pharmaceutical service is sufficiently represented.

To quote Earl Howe:

“The natural question that arises is who regulates pharmacists. Is it PCTs or is it the Royal Pharmaceutical Society of Great Britain? If it is in effect both, which body takes precedence?”

In her answer to Earl Howe, the Minister, Baroness Thornton, stated:

“The GPhC will be the new regulator for pharmacists, pharmacy technicians and pharmacy premises, taking over the role currently performed by the Royal Pharmaceutical Society of Great Britain”.

She assured Earl Howe that the Government will

“strive to demarcate in the regulations”

of clause 24

“the respective responsibilities of the new regulator and the responsibilities of primary care trusts.”—[Official Report, House of Lords, 11 March 2009; Vol. 708, c. GC481-482.]

However, her reply does not answer my question on the suspension of pay in clause 31. Should the council, with its new responsibilities, be given a role in deliberating whether the actions of a pharmaceutical service warrant the actions outlined in clause 31? I would be grateful for the Minister’s reply on that point.

Robert Key (Salisbury, Conservative)

The question is that the amendment be made. I call Mr. Stephen O’Brien.

Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

Too many O’Briens, Mr. Key.

First, I should like to make it clear that we see the use of the powers as a matter of last resort, not of first resort. They will be part of a progressive series of steps to ensure that contractors achieve acceptable quality standards, and PCT decisions will be appealable. The same provisions are proposed in clause 31 for Welsh Ministers.

The amendments would place a duty on PCTs in England and on local health boards in Wales to consult professional and regulatory pharmacist bodies before deciding whether to withhold NHS contractual payments that are due to a person when there are continuing concerns about poor or inadequate performance. I am not convinced as to why that is necessary. As a general rule, we strive to keep NHS contractual matters and professional regulatory matters distinct. The amendments would confuse and integrate the two.

I reassure the hon. Member for Eddisbury that there is no intention to penalise individual pharmacists for poor performance. In that respect, the aim is to look at the practitioner as the person as set out in the pharmaceutical list. The list is published by the PCT of persons who are authorised to provide pharmaceutical services by the PCT. In other words, it is essentially a list of contractors. They may be sole traders, partners or companies and it is not a list of individuals.

The aim is to ensure that when absolutely necessary, we are able to intervene to deal with something when it gets to such a poor state that the quality of provision being made available to local people deteriorates unacceptably. If we accepted the amendment, it might leave professional and regulatory bodies rather baffled as to what they would be expected to do if a PCT consulted them. That is not the remit of those bodies, nor would they be equipped to take on such a role. They are not really in a position to take a view on a PCT’s responsibilities. For that reason, Welsh Ministers and I cannot accept the amendments, and I ask the hon. Gentleman to withdraw.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

Obviously, I listened to the Minister and he said early in his reply that the powers were last resort powers, which is important. He also made the point that there was a degree to which the regulatory bodies would be baffled. Whether or not that is the case, I made it clear that my amendments were probing and that I did not intend to press them to a Division. The Minister’s response went a long way towards clarifying the question of the demarcation of responsibilities for regulation, and I beg to ask leave to withdraw the amendment.