§ Mr. Kenneth Clarke
I am glad to say that we are making very good progress. The new arrangements we intend to introduce will safeguard and improve the NHS pharmaceutical service while ensuring NHS funds are used to best effect. We are now consulting the representatives of the pharmaceutical profession on the content of the regulations and guidance which will be needed to implement our agreement. Family Practitioner Committees (FPCs) will decide on applications for both new openings and moves of existing pharmacies solely by reference to the NHS needs of local people. The governing principle will be to ensure each local population has reasonable access to the full range of NHS pharmaceutical services but that no locality has an expensive and unnecessary surplus of dispensaries. We have no Government target for NHS pharmacy numbers, nationally or locally. The needs of the public and patients will determine the number of new pharmacies gaining NHS contracts.
In outline the regulations would require each FPC to establish a pharmacy practices sub-Committee (PPSC) to 528W exercise its powers to control entry. Each PPSC would consist of three pharmacists and three non-pharmacists plus a lay chairman. The pharmacist members would be appointed from a list drawn up by each FPC's local pharmaceutical committee and there would be the normal rules governing declaration of interest. There would always be a majority of non-pharmacists taking part in any determination of an application. Minor changes of location such as a move to better premises or a move which reflects changes in patients needs would normally be approved by a quicker procedure. Other more significant changes would be considered in detail by the PPSC.
After any oral hearing or site visit it considered necessary, the PPSC would decide whether the proposed change in NHS patient services was necessary or desirable. In other words whether the NHS pharmaceutical service to the public would be improved to a worthwhile extent if the application were approved. Where there was more than one application far any particular location, applications would be considered in the order in which they were lodged.
We would recommend firmly that PPSCs should not adopt norms or rules constraining local judgments, but PPSCs would have available to them FPC strategies for primary care services plus a very wide range of other information. This would cover both NHS service patterns and such local data as for example, census data and population projections. Community health councils, local medical and pharmaceutical committees and other pharmaceutical contractors in the locality would also be offered a chance to comment, within 30 days of notice of the application being sent out. There would be provision for applicants and anyone who commented to the PPSC to appeal against its decision. Such appeals would be heard by locally convened appeals panels.
Their composition would parallel that of the PPSCs, but the members for any particular appeal would be drawn from lists prepared by FPCs who had not been involved in that application. The appeal panel's decision would be binding on the FPC concerned. There would be no further appeal. The existing rules governing the opening of pharmacies in rural areas would remain in operation. Applicants in rural areas successful under the new scheme would be referred as at present to the Rural Dispensing Committee and would require its consent also. Unless successful applicants provided NHS pharmaceutical services as specified in their application within a defined period, their permission to do so would lapse.
Contractors who, before this new scheme was announced, had entered into binding financial commitments will be protected by short-term transitional arrangements. I intend this new scheme, which offers considerable benefits to patients and the NHS to come into operation at as early a date as possible. The consultation 529W should be completed in two or three weeks. The regulations will then be laid and the guidance document will be placed in the Library.