asked Her Majesty’s Government:

Whether they are considering making the oral contraceptive pill directly available from community pharmacists.

My Lords, we recognise that pharmacies could play an increased role in the provision of contraception and other sexual-health services because of their accessibility and convenient opening hours. We will work with primary care trusts over the next year to pilot the supply of contraception, including the contraceptive pill, through NHS arrangements. We will also work with the pharmacy profession to ensure robust standard-setting and appropriate training so that pharmacists are competent to provide this service.

My Lords, I thank the Minister for that reply, which is the best that I could possibly have hoped for, and I am delighted that the Government are to embark on pilots. Do the Government recognise that the current data on abortions, which show that a third of women undergoing termination of pregnancy have had a previous abortion, do indeed represent a contraceptive failure in the country? Will the Government couple moves in the pilot programme with increased education programmes particularly aimed at girls of a sexually active age to ensure that they are aware of ways to access both contraception to protect against pregnancy and condoms to protect against sexually transmitted diseases?

My Lords, the noble Baroness made the point that there is strong evidence of an association between the provision of the full range of methods of contraception and a reduction in teenage pregnancies and abortion rates. I have no doubt that improvements in sexual health and the provision of choice in acquiring oral contraceptives will significantly reduce unintended pregnancies.

My Lords, I welcome the easier access to contraceptive services that local pharmacists might provide. However, does the Minister realise that over the past decade primary care trusts have been saving money by closing family planning clinics all over the country and making it much more difficult for women to have a choice of contraception? How is he going to ensure that the full range of contraceptive methods, particularly long-acting reversible contraception, will be available?

My Lords, the Government recognise that community contraceptive services provide a valuable service. We also recognise that PCT funding for local provision is a local arrangement. However, we have set certain targets. Our key target is that 100 per cent of patients shall be offered an appointment to be seen in one of those clinics within 48 hours, if the need arises. From a primary care setting, in a QOF questionnaire we are looking at making the provision of long-acting contraceptive devices easier from a patient perspective.

My Lords, I am sure the Minister is aware that sexual activity occurs well before the legal age of consent. Will community pharmacists be required to ask the age of a person applying for the facility? If so, how will they be able to establish that someone is of an age to be entitled to apply? This has always been an issue. In the past, there have been separate youth services. What will the arrangement be under this system?

My Lords, the noble Baroness raises an important point not only about the age classification but about the safety of the application of an oral contraceptive. The recognition of age will be a matter for the professional judgment of the pharmacist. At the moment, there is no age limit from a pharmacy perspective, but we envisage that it will be compatible with supplying the morning-after pill, which is 16. It will be for the professional judgment of the pharmacist, and identification of some sort will probably be used to confirm the age of the individual.

My Lords, the noble Baroness, Lady Finlay of Llandaff, mentioned the importance of sex education, but only for girls. Does the Minister not think that it is just as important to make boys aware of their responsibilities in this matter?

My Lords, the noble Baroness makes an important point with which, as a man, I sympathise. I have no doubt that male education is as important as female education.

My Lords, the Department of Health has a public service agreement target to reduce the under-18 conception rate by 50 per cent by 2010. The rate came down by some 11.8 per cent between 1998 and 2004, but how do the Government intend to accelerate that rate so that the department meets its 2010 target?

My Lords, as the noble Earl, Lord Howe, said, between 1998 and 2005, the under-18 conception rate fell by 11.4 per cent to its lowest level for 20 years. The under-16 rate fell by 12.1 per cent over the same period. Guidance on accelerating the delivery of the teenage pregnancy strategy highlights that the provision of young-people-focused contraception and sexual-health services trusted by teenagers and well known professionals working with them has the biggest impact on conception rate reduction in high-performing areas.

My Lords, might I point out to the Minister, with respect, that the sexual-health clinics were given the 48-hour appointment target? Those clinics are overwhelmed by a need to treat sexually transmitted diseases in young people. Not only have their targets not been met in many areas, but they are not able to offer the full range of contraception and counselling that both young and middle-aged people actually need. The community clinics provided those services so well. When are we to get those services back?

My Lords, the Government are leading a major review and, as some of your Lordships may be aware, that next-stage review is my responsibility within the department. One area that we are looking at carefully is the well-being agenda, and one major issue that clinicians across the country are looking at is the provision of contraceptives and sexual health.

Returning to the original point raised by the noble Baroness, Lady Finlay, on the provision of and access to contraception through pharmacists; I feel strongly that that is probably the easiest route for the patient.