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Philip Hunt on the increased risks to the viability of thousands of community pharmacies

With the NHS now preparing for what promises to be one of the most pressurised winters ever, it seems perverse that community pharmacists – well placed as they are to take some of the load off other busy health professionals – face a cut in funding.

These pharmacies are the most accessible of all healthcare services, with many extending their hours and services. Last year, saw an average 137 visitors each day, 281 medical reviews, the dispensation of around 87,000 prescribed products, and the distribution of nearly a million flu vaccines.

According to a Price Waterhouse Coopers (PwC) analysis commissioned by the Pharmaceutical Services Negotiating Committee (PSNC), in 2015, community pharmacies contributed £3bn in value to the NHS and public sector in England. This included £1.1bn for the NHS; £600m in benefits to patients and £242m avoided in treatment costs.

Budget cuts and changes to how funding is distributed are putting all of this at risk, and threatening an increased burden on GPs and A&E departments. 

The majority of community pharmacies’ funding comes from the NHS, and pays for premises staff and all other operating costs. Funding reductions however, have seen a 7.5% drop in financial support since 2015-6.

These are not the only changes to funding, as a number of dispensing fees will be combined into one – with established fees being phased out. Pharmacies in isolated areas will receive funding from an access scheme and high performers will receive an extra £75 million in quality payments as a way of promoting greater cooperation with other parts of the NHS. In addition, a pharmacy integration fund will provide an extra £42 million. All of this is welcome but it will not ameliorate the impending crisis, as the overall package risks the viability of many pharmacies.

The government is well aware of the scale of the potential closures. In a meeting last year with the All Party Pharmacy Group, the then Health Minister Alistair Burt said multiple pharmacies are more likely to adapt to the new system than the smaller independents. In fact, he forecast between 1,000 and 3,000 would close. So much for Tory support for the SME sector!

Currently in many parts of the country, such as busy high streets, there is a choice of community pharmacy. For a government supposedly in favour of competition, it’s surprising that a stated aim of its approach is to reduce that choice. But it’s also a real worry that our more deprived areas are the most vulnerable to such closures 

Pharmacies have also been hit with unpredictable high wholesale bills. With a squeeze on NHS funding alongside this, many have been left in in difficulty trying to find a source of credit to pay thebills. The PSNC are warning that banks may withdraw credit if income covenants are not met.

There is palpable fear within the sector about the impact of overstretched services in the past few months and a dire situation this coming winter. If predictions are correct, Britain will be hit by a flu epidemic that began in Australia. Community pharmacies will be on the frontline of this.

In the Lords today, I will drawing attention to these problems. For the sake of the millions of peopledependent on nearby and well stocked community pharmacies, ministers must stop the madness.

Lord Philip Hunt of Kings Heath is Shadow Health Minister in the House of Lords. He tweets @LordPhilofBrum

Published 19th October 2017

 

Me and the pharma

Philip Hunt on the increased risks to the viability of thousands of community pharmacies

LeslieGriffiths.jpgLeslie Griffiths on the need to encourage the success story that is Channel Four

I start my tenure within the Shadow DCMS team with a debate on the future of Channel Four – a future that should be a matter of concern for all of us.

Since being set up in 1982, Channel Four has become part of a brilliantly conceived system of free-to-air provision which allows for as broad a diversity of programming as can be devised or imagined. That’s why it always seemed difficult to understand why ministers set their hearts on selling it off. And when the Lords Communication Committee turned their expertise to this subject they showed a similar disbelief.

Just two years ago, Channel Four was granted a new ten-year license and it is bewildering, so soon into that new mandate, to seek what would virtually amount to a dismantling.

Perhaps a failure to meet objectives was the reason for the government’s desired privatisation? Not according to the Committee, which found that most of the objectives were being addressed responsibly. They also found that the business was viable, with considerable sums spent on commissioning new programmes.

Mercifully, wiser heads in the government saw the error of its ways and earlier this year dropped their interest in privatisation. But the government’s main piece of advice – something that has a feel of a command about it – has become the need for Channel Four to work much harder at serving the UK’s nations and regions. 

Now, nobody can be against that – a bit like breathing I’d say. But the barely disguised suggestion is that the relocation of a significant part of Channel Four’s core business, if not all of it, should up sticks and move out of London to another part of the country.

Culture Secretary Karen Bradley announced both the u-turn on privatisation and the pivot toward regionalisation from the heart of Salford’s Media City. Indeed, she offered Greater Manchester as an example of what was being done for the industry by those prepared to move out of the capital. We should however, be careful about facile comparisons.

I just happened to be working with the BBC in a peripheral way when, during the 1990s, some departments were being decanted from London to Manchester. The existence of an already vibrant BBC activity there, together with the eventual presence of ITV, allowed these relocated departments the possibility of achieving critical mass as the bold new venture was developed. No similar place is beckoning the Channel Four operation.

Like the government’s approach to devolution it takes more than warm words and catchphrases to bring about change. Everything would have to begin several steps back from what happened back then.

Nor should we forget that the BBC did most of its work in house in those, producing its own programmes. Channel Four doesn’t work that way, commissioning from outside bodies. Its entrepreneurial success in creating vast networks of programme makers in the regions and nations, well beyond the capital, cries out to be listened to.

That said, it would be interesting to look more closely at where the terrestrial broadcasters as a whole currently commission their programmes, to make sure that independent producers in all of our nations and regions get the chance to tell their stories and broadcast their ideas about the world, from their perspective. This is not just a Channel Four issue – other public service broadcasters such as BBC and ITV should also be asked to defend commissioning policies. A key feature of our terrestrial TV system is that it is a complex inter-related ecology where the channels compete on quality and diversity so that audiences receive the best service possible.

A new Chief Executive Officer, Alex Mahon will take up post at Channel Four in November – the first woman CEO of a national broadcasting company. She is very aware of the nature of this discussion and fully committed to producing bold and substantial plans for increasing Channel Four’s contribution to the nations and regions. All of this suggests we should make haste slowly and help it become an even more successful company than it already is.

Lord Leslie Griffiths of Burry Port is a member of Labour’s frontbench team in the House of Lords

Published 17th October 2017

Commission statement

Leslie Griffiths on the need to encourage the success story that is Channel Four

MaggieJones2014.JPGMaggie Jones on feeding the nation post-Brexit

There are some responsibilities of government where even the most incompetent cannot afford to fail. Providing enough food at an affordable price, along with pure water and clean air, come pretty near the top of the list. Which is why the House of Lords Brexit reports on agriculture and animal welfare make such stark reading.

Without overstating matters, a healthy UK farming sector is fundamental to our economy, environment, individual prosperity and consumer confidence in food safety.

Yet this is the sector most reliant on existing EU rules for its operation and the one facing the greatest upheaval when we leave. So, not surprisingly, farmers and food manufacturers are increasingly nervous at the lack of progress in the talks and ministerial emphasis on a ‘no deal’ option.

A future tariff-free trade deal which replicates the benefits of the Single Market is vital. In the interim, the government needs to get serious about a transition based on current terms. We are completely reliant on trade with the rest of the EU, as evidenced by 80% of our agricultural exports and 70% of food imports.

The UK is only 61% self-sufficient in food and the figure is falling. At the weekend, one Cabinet Minister, Chris Grayling suggested that British farmers can simply grow more in the event of no deal. While it would be great to produce more of our own food, there are no quick fixes and if we end up in such a scenario it’s close to impossible to imagine how we would begin to feed the nation.

At the same time, concern is growing amongst producers and manufacturers about access to seasonal and full time migrant labour – without which UK food production would drop further. Ministers deny there’s a problem but ample evidence exists of our reliance on overseas workers. The British Poultry Council estimate 60% of its workers are from elsewhere in the EU, as are 56% of the workers on dairy farms. These are jobs that UK citizens cannot – or will not – do. So a sector specific migration policy is crucial.

There are also, understandably, concerns about animal welfare standards and food safety. Without robust new rules to replace those of the EU we are in danger of being flooded by cheap imported adulterated food - including chlorinated chicken, which undercut the quality products which both farmers and consumers value. There is as yet no agreement amongst ministers that our high standards will be protected, and a real fear that new import deals will take priority in the race to find new markets.

Much of UK farming would not be sustainable without a degree of subsidy. There is a widespread agreement that the Common Agricultural Policy needs reform with a future focus on payments for those in real need, those protecting the environment and those contributing to food security. But we are a long way for agreeing a new payment scheme and concerns are increasing about the battle with other powerful lobby groups over a declining pot of money. A pot which has already been promised several times over.

The current Environment Secretary, Michael Gove has played great emphasis on the future of UK farming being based on science and agri-technology. But all of this knowledge and expertise is being developed in the Europe-wide institutions in which we collaborate and reciprocate. Unless we reach agreements on participation we will be forced to replicate this research in separate UK institutions. This is simply not cost effective and our knowledge base risks falling behind.

Sustainable production is so fundamental to our future well-being that the government can’t afford to get this wrong. The farming and food sector needs certainty and reassurance. Planning and investment is already being delayed and will have longer term consequences. Ultimately, Mr Gove needs to demonstrate that he has a seat at the top table when crucial trade and investment decisions are made to ensure that future food security is recognised as a priority.

Baroness Maggie Jones of Whitchurch is Shadow Defra Minister in the House of Lords. She tweets @WhitchurchGirl

Published 16th October 2017

Food for thought

Maggie Jones on feeding the nation post-Brexit

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