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Health: Medicines

Volume 706: debated on Tuesday 16 December 2008


Asked By

To ask Her Majesty’s Government whether they intend to withdraw facilities for the dispensing of medicines from those dispensing general medical practices situated within one mile of a community pharmacist.

My Lords, in asking this Question, I declare an interest. I am registered with a dispensing practice in Belford, Northumberland, where the senior partner is one of my former students.

My Lords, the Government have been listening carefully to all the representations that have been made on this issue, including the option mentioned by the noble Lord in his Question, one of several that have been under consideration. My honourable friend the Minister will be making an announcement on this specific matter before the Recess.

My Lords, I thank the Minister for that reply. Is she aware that the British Medical Association has conducted a major survey that has resulted in it coming out strongly in favour of the status quo, the first option in the White Paper? In the rural practice to which I have referred, a similar survey of the practice’s patients has again come out strongly in favour of the status quo, not least because the practice dispensary is open at times when the local pharmacist is closed, and if the dispensing facilities in the practice were closed, that would inevitably result in the practice having to withdraw vital services that are crucial to the local community.

My Lords, we fully appreciate that dispensing doctors play a key role in ensuring continued access to pharmaceutical services and providing patient care to those who need it most, particularly in rural areas where GPs can and do play a vital role. We are also aware that dispensing doctors’ profits are an important issue in the continued investment in those rural practices.

My Lords, what is the Government’s timetable for reform of pharmacies, and will it address the real shortage of pharmacies in some areas? I am sure my noble friend will appreciate that accessibility to pharmacies is terribly important for an ageing population.

My Lords, my noble friend is right. The issue of dispensing doctors is only part of the White Paper on reform of pharmacies. We want pharmacies to complement and support GPs in promoting health, and we want them to expand their role in preventing sickness and providing a service for their local communities. Indeed, the consultation that ended on 20 November, to which we have had tens of thousands of responses, is going to focus on the extended role of pharmacies in the areas where they are needed.

My Lords, when the Government make up their mind about this matter, will they please bear in mind the inconvenience, particularly to pensioners who attend the doctor’s surgery regularly and are able to pick up their medicines simply and straight away, of having to go home and perhaps get a car out, thus ruining their footprint, as it were? The convenience and the health of the pensioner are very much tied up with this question. Does the Minister agree?

My Lords, the noble Baroness is correct, and I include my own mother in that. The dispensing doctor that she attends is very important for her, for all those reasons.

The point about the pharmacy White Paper, which was welcomed by the pharmaceutical services in general, is to examine the controls for the entry system to look at issues of distance and ensure that those entry requirements are appropriate to the areas in which you want either to expand or look at the cover of pharmacies, including dispensing doctors.

My Lords, I rise, trembling, to disagree with the noble Lord, Lord Walton. Does the Minister agree that pharmacists frequently provide a check on the prescriptions that are made out by general practitioners? They certainly were in my day, and a valuable check at that. At a time when prescriptions and drug therapy are getting more and more complicated, and in any case GPs have usually got ample supplies of samples from the representatives of the drug companies, does she not think that this is a rather antiquated way of practising and that dispensing doctors should no longer have a place in the NHS?

My Lords, we do not agree with that. There needs to be patient choice here, which is why we have no plans to stop GPs being able to dispense when that is appropriate. As I have said, the pharmacy White Paper is about making pharmaceutical services in general better, more available and part of preventing illness. Pharmacists can and should be involved, and we want them to be equipped to do that. This is not an either/or situation in our view.

My Lords, I am sure that the Minister is aware that medication-related errors account for 40 per cent of patient safety errors reported. That being so, does she agree that those who dispense medicine should be fully trained, not only in prescribing but in dispensing medicine?

My Lords, the noble Lord is absolutely right. Indeed, one thing that the noble Baroness said that was right was that pharmacists are part of providing a check on the accuracy of dispensing medicine.

My Lords, will the statement that the Minister promised cover the control of entry regulations for dispensing doctors?

My Lords, my understanding is that the announcement that will be made will be specifically and only about dispensing doctors. The statement about the generality of pharmacists will come in the new year, when we have dealt with the tens of thousands of other parts of the consultation which are to do with the whole of dispensing.

My Lords, does the Minister agree with me that many severely disabled people living in rural areas have extreme difficulties in getting to surgeries or even pharmacies? I agree with her that choice is the best thing.

My Lords, the noble Baroness is absolutely correct. As noble Lords know, both pharmacists and dispensing doctors do home deliveries.