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My hon. Friend makes a very good point.
Independent pharmacies in Sutton conduct medicine reviews, which we have heard about, and often deliver to their patients’ homes. They therefore see people in their own environment, rather than in a GP surgery. They get to see what is left in the bathroom cabinet, forgotten about or set aside. Ignoring or forgetting to take prescribed medicines causes such a lot of waste. There is an estimated £300 million a year that could go to other front-line services. By seeing the patient in their own environment, the pharmacist can make an assessment based on the patient’s everyday life, rather than just a snapshot, which might be affected by things such as white coat syndrome.
Consultation room services, such as sexual health, smoking cessation and minor ailment services, have to be a good thing for the NHS and should be encouraged. From what I have seen in pharmacies, there is still too much of a disconnect in the exchange of patient information between GPs and pharmacists. If advice and treatment are to work, they must be done in full knowledge of the patient’s background and medical history.
I understand the concerns that have driven the review and the changes that we are debating. The current funding system encourages pharmacy companies to open numerous low prescription volume sites, especially with the guaranteed fixed payment of £25,000 a year, regardless of size, quality or local demand. Some 40% of pharmacies are in clusters of two or more, with 20% being within 10 minutes’ walk of at least two others. That is reflected in Sutton. There are three in Worcester Park, four in north Cheam and six in and around Sutton High Street.
My concern is that any closures that result from these changes are more likely to come from the independent portion—those pharmacists who go beyond the corporate approach, often offering services at no cost or at a loss, because it is the right thing to do; those who prioritise the service that patients need, rather than shareholder value. Responding to customers on a personal basis allows independent pharmacists to consider savings such as generic substitution. We talk about a seven-day NHS, but pharmacists need to be set free to offer a high street NHS.
The Government’s changes recognise much of what pharmacists’ bodies have been raising. The changes seek to move pharmacists away from being reliant primarily on dispensing income, which is more vulnerable in the long term, towards services. Repeat prescriptions and those who come in via the 111 service will be directed to pharmacies, rather than out-of-hours GPs. For the first time, pharmacies will be paid for the quality of the services they provide, not just the volume. There is much to be welcomed, but I urge the Minister to keep the impact of the changes on independent pharmacies, which are often family run, under constant review.