HL Deb 19 November 1998 vol 594 cc1365-7

3.14 p.m.

Lord Quirk asked Her Majesty's Government:

Whether they are satisfied that primary care group boards are so structured as to make proper use of the skills and knowledge of pharmacists.

Baroness Hayman

My Lords, primary care groups will need to work with a wide range of professionals in order to take advantage of their skills and expertise for the benefit of patients. The membership and size of a PCG board has to be manageable and workable. We value highly the skills and knowledge of pharmacists. We made it clear in guidance issued in the summer that they are among the professional groups which PCGs will have the power to co-opt on to a board.

Lord Quirk

My Lords, I am grateful to the Minister for that Answer and I note carefully what she has said. Does she not agree that the 12,000 or so pharmacies up and down the country provide our most direct access to healthcare; that they are the first port of call in time of sickness, especially for the poorest in our society; and that in the process they reduce the pressure on GPs' surgeries? Is the Minister aware that graduates of the English schools of pharmacy—from the biggest in Bradford to the oldest in London—are very keen to show that their skills can contribute significantly both operationally and strategically to primary care groups, as they already do with the analogous structures in Wales and in Scotland?

Baroness Hayman

Yes, my Lords. I echo some of the noble Lord's remarks about the contribution that the skills of, particularly, community pharmacies can make to people's health and their importance in terms of providing a very local and accessible service. That is why we made it clear in our guidance in the summer that they should be involved as far as possible. That is because a great deal of the work of primary care groups will depend on good prescribing advice and support from professionals such as pharmacists.

Lord Clement-Jones

My Lords, is the Minister aware that many local pharmacies are considering closing as a result of workload, competition from supermarkets and particularly cash-flow problems? Do the Government plan to revise the payment system for local pharmacies as part of their forthcoming community pharmacy strategy? Will the Minister confirm whether the Crown report on prescribing will be published at the same time as that community pharmacy strategy?

Baroness Hayman

My Lords, the noble Lord is correct that we are currently looking at our community pharmacy strategy. That should build on the contribution that pharmacists can make. We have received a great many suggestions and comments on that. My right honourable friend the Secretary of State had a useful round-table meeting to discuss it. We now need to consider the contributions that have been made and to publish the strategy in due course. I do not think that I can make a commitment that the Crown report will be published at the same time. It might well be in advance of it.

Baroness Masham of Ilton

My Lords, does not the Minister think it rather unbalanced to have between four and seven doctors on such groups but not one pharmacist or dentist? As a member of a former family health services authority, does not the Minister agree that those bodies were far more balanced and democratic?

Baroness Hayman

My Lords, there is a difficulty here in terms of getting the balance right. The skills and expertise of many professional groups will be needed if primary care groups are to function effectively. That is why we have included powers of co-option—to balance against the need also to have a manageable and workable core membership. In specific areas, primary care groups have the ability to set up executive sub-groups, which it might well be appropriate for a co-opted member such as a pharmacist to lead.

Baroness Uddin

My Lords, can my noble friend the Minister tell the House how it is intended to monitor the structure of primary care group boards to ensure that they reflect the equal opportunities commitment that we have made for the health service?

Baroness Hayman

My Lords, the health service is committed to effective implementation of equal opportunities. I believe that it has done a great deal in terms of appointments made to trust boards and health authorities during the time of this Government. The primary care group will be a sub-committee of the health authority and I expect it to monitor equal opportunities among the membership, as it does other areas of its work.

Earl Howe

My Lords, why is it that pharmacists are to be included automatically in primary care group boards in Wales and Scotland but not in England?

Baroness Hayman

My Lords, the noble Earl will be aware from the many debates in this House that it is possible to hold different views about the appropriate structures for different parts of the United Kingdom. That is very much the outcome of the legislation that has been debated in this Session. As far as concerns England, as promised in the White Paper, the Government believe that doctors and nurses should be very much in the driving seat and that other appropriate professionals, be they occupational therapists, physiotherapists, midwives or pharmacists, should be brought in to make their contribution as and when appropriate.