argyrotsipi/train-dataset huggingface dataset:
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I do realise that, and I mentioned the fact that the King’s Fund is looking into medicine reviews As I have said before in the Chamber, the model that is adopted for pharmacies in Scotland has a lot to commend it, even though we might not adopt it in its entirety. I hope that we will get a chance to discuss that later.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): Before I give way, I should like to quote the chief pharmacist himself. Dr Keith Ridge has confirmed that the review "will support community pharmacy to develop new clinical pharmacy services, working practices and online support to meet the public’s expectations for a modern NHS." Two weeks ago, I announced two initiatives that will proceed in advance of the King’s Fund report. From 1 December, phone calls made to NHS 111 for urgent repeat prescriptions will be directed not to an out-of-hours GP service as at present but to a community pharmacy. This will amount to some 200,000 calls a year, resulting in further revenue streams, for the consultations and for supplying the medicine. NHS England has also committed to encouraging national coverage of a locally commissioned NHS minor ailments service. Some areas, including West Yorkshire, already do this, and we will roll it out to the whole country by April 2018. Both those initiatives will relieve pressure on surgeries and emergency care centres. Both will result in additional incremental revenue for pharmacies, but they are very much only the start.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): In terms of these proposals, we have to be blind to the ownership of pharmacies. The fact is that the average pharmacy sells for something like £750,000. I do not accept that the proposals will cause closures in those segments, if that was the thrust of the right hon. Gentleman’s question.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I want to continue The third area I wish to address is value for money, and I make no apology for doing this. According to recent OECD analysis, the UK now spends above the OECD average on healthcare, but however much money we spend, every penny needs to be spent as efficiently as possible. If that does not happen, waiting lists can become too long, treatments can be denied to patients and drugs might not be available. We also know that efficiency savings are required of every part of the NHS, and community pharmacy must play a role in contributing to the £22 billion of savings that we need to find. I do not apologise for that.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Andrew William Murrison (Conservative, Centre-right): I certainly support the amendment on the Order Paper today, but does the Minister agree that, in relation to efficiencies, the issue of category M clawback is an important one? I tried to extract an answer to that question from the hon. Member for Leicester South (Jonathan Ashworth) earlier. Also, I ask the Minister to think again about the ownership-blind point that he just made. There is not an equal playing field at the moment, and there is a real risk that small independent pharmacies will continue to be done in.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Claire Louise Perry (Conservative, Centre-right): If anybody can square this circle, it is the Minister, given his extensive experience in this area. I genuinely believe that we have to sort out this issue. I am not happy to subsidise large private companies through the system—some of the chains have already been mentioned—so it is right to look at where the clusters occur. The Minister is well aware of the Kennet pharmacy in my constituency, and we all have really value-added pharmacies that are doing very valuable work. How can we help him, over the review period, to identify and support the services that those pharmacies provide? They must not be allowed to close as a result of this policy.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Sarah James (Wollaston) (Conservative, Centre-right): Further to that point, the Minister knows that our pharmacists are a highly skilled and professional resource that has long been underused in the NHS. He has mentioned the ongoing Murray review, and a sustainability and transformation plan process is also going on around the country. My concern is that the closures will come about in a random way, rather than through a planned process based on identifying skills in particular areas. Will he consider delaying them until we have all the reports in place and we can consider the matter on an area-by-area basis?
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): The access scheme is the device that will ensure that pharmacies are not closed in a random way. I want to address the point about closures head on. It is my belief that there will be a minimal number of closures. The impact analysis talks about 100 and it models 100. The average pharmacy has a margin of 15%, and the amount of efficiency savings that we are asking pharmacies to make over two years is 7%. In addition, the average pharmacy is trading for £750,000 when it closes or merges, even after we announced these efficiency savings a year ago. That value is being retained.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Victoria Lorne Peta Borwick (Conservative, Centre-right): Can reassurance be given that local pharmacies are the frontline of primary care? Will the Minister extend the work and responsibility of those local pharmacies, particularly in deprived areas, and reassure us that that is the focus of this debate?
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I spoke to 500 pharmacists this morning and gave them that precise reassurance. The changes that we are making to transform the sector into a service-based, not dispensing-based, economy will do just that. That is where pharmacies need to go and it is where they want to go. Frankly, it has taken too long.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I need to make some progress. I will give way in a moment At present, the average pharmacy receives NHS income of £220,000 a year, which is based on throughput of £1 million from the NHS. That translates into a value of the order of £750,000 for each pharmacy. When pharmacies merge or are sold, that is what they are traded for and the changes will not make a significant difference Returning to an earlier point, 40% of all pharmacies are located within a 10-minute walk of at least two others. Instances exist of a dozen or more pharmacies located within half a mile of each other. As I noted earlier, each one will most likely be receiving £25,000 a year just for being there.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I was brought up on the outskirts of Leicester, so I am delighted to tell the hon. Gentleman that I have indeed been there. Giving all these clusters £25,000 of national health service money is not the best way to spend precious resources In addition, the extra services that pharmacies will choose to provide, such as winter flu jabs and public health services, are commissioned separately and will be unaffected by the reset. For example, 600,000 flu jabs have been given in community pharmacies this year—more than all of last winter.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I will continue to make some progress and then give way towards the end of my remarks I do not want to downplay the impact of the change on the private businesses that own and operate the network. The pharmacy sector is a mixed economy with 70% of the market made up of multiples and chains and 30% owned by independents. It is hard to accurately predict the impact of the changes on those individual business models. What I can say, however, is that the savings we are making will be entirely recycled back into the NHS. Every penny of the efficiency savings that we are asking of community pharmacies will be spent on better patient care, better drugs and better GP access.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I will give way to the hon. Lady in a moment Finally, I want to talk about the work that we are doing to ensure that everyone in the country has access to a community pharmacy. We have developed a scheme with two components. First, all pharmacies that are more than 1 mile from another pharmacy will be eligible for additional funding, which will almost entirely mitigate the impact of the changes. That component is specifically designed to protect areas where current provision is quite spread out. In total, it will apply to around 1,400 locations—roughly half urban and half rural. Pharmacies that are in the highest 25% by prescription volume, and therefore most profitable, will not be eligible for the scheme. Secondly, there is a near-miss scheme under which pharmacies that are located up to 0.8 miles from each other and in the 20% most deprived areas in the country can apply to be reviewed by NHS England as a special case. The final safeguard is that NHS England has a continuing duty to ensure the adequate provision of services. Its role is to commission a new pharmacy in any area where it believes access is inadequate. That duty will continue.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): The distinction is that a community pharmacy is part of a privately owned business that dispenses and is paid in that way. The ones that we are hiring into GP practices will leverage GP time and do medicine reviews, and I expect them to enable the pharmacy network in an area to work more cohesively. It is a welcome and, frankly, overdue step forward.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
David Mowat (Conservative, Centre-right): I need to continue Taken as a whole, I am confident that the three measures I have talked about for protecting access will ensure that everyone has access to a community pharmacy in much the same way as they do at present. The future for pharmacy is bright. The change we are implementing of a 7.4% efficiency requirement over two years is proportionate and will continue to orientate the profession towards services and—for the first time—quality and away from a remuneration model based on dispensing I will finish by again quoting the chief pharmacist, who said: "The public can be reassured that while efficiencies are being asked of community pharmacy just as they are of other parts of the NHS, there is still sufficient funding to ensure there are accessible and convenient local NHS pharmacy services across England. The NHS is committed to a positive future for pharmacists and community pharmacy." Every penny that we save as a result of the efficiency reviews will be spent within the NHS on better care, better drugs and on quicker treatment. I urge Members to support the amendment later today.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Maria Colette Caulfield (Conservative, Centre-right): I am interested in the experience in Scotland, although we do not have the same system in England. What does the hon. Lady think about moving pharmacists into GP surgeries? I think that it is a mistake. I would much prefer the approach that is being taken in Scotland, where pharmacies are expanding by having consulting rooms of their own.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Oliver James Dowden (Conservative, Centre-right): As we have already heard in the debate, many of us have seen the considerable value that local community pharmacies provide in our constituencies. I have seen that myself with the Manor pharmacy in Elstree, which is run by Graham Philips, to whom my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) paid tribute. I would urge the Minister to meet him; he really is a pool of expertise on this issue. The same is true of those at the Crown pharmacy at Borehamwood and Shenley What we see time and time again in these places is that the commitment to the customers goes way beyond what we would see from a normal retailer. There is a genuine understanding of the needs, health and wellbeing of the people who use such pharmacies. The services range from dementia-friendly services, picking up the early stages of the disease; healthy living advice, including assistance with drugs and weight management; and smoking cessation services.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Stephen Daniel Double (Conservative, Centre-right): Would my hon. Friend add to his list Nick Kaye in my constituency? He is carrying out some excellent work to collaborate with local GPs and to find innovative ways to deal with patients. Does my hon. Friend agree that pharmacies are particularly important in tourist areas, as the frontline that can deal with tourists who have health problems, and take pressure off the other health services?
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Oliver James Dowden (Conservative, Centre-right): My hon. Friend is absolutely right that pharmacies play a crucial role in relieving the frontline of NHS services. However, that does not mean that reforms are not necessary. Of course we need to incentivise the kind of advantageous behaviour we have talked about; but we also need to recognise some of the problems with the provision of pharmaceutical services We know the basic problem; it has been referred to by other Members. The pharmacy budget has increased by 40% over the last decade. Even taking into account all the changes that the Government are proposing, funding for community pharmacies will still be 30% higher than when this Government first came to office in 2010. Equally, we have the problem of excessive clustering—a situation where there are many pharmacies within a short distance of one another Those who argue that there is no need for reform really need to explain where the money will come from. If we are not recycling these services to the frontline, we need to look for other savings, or we need to look at lower levels of service in the frontline of the NHS, whether that is services for diabetes or for cancer. There is no magic money tree. We have to take these difficult decisions in order to provide for the frontline, so I completely agree with the overall thrust of Government policy We can take an intelligent approach towards this issue. As we have heard, there is a big difference between various types of pharmacies. At one end of the scale, there are the very large pharmacies that are often in large retail outlets such as supermarkets and sit at the very back of the store. They are there, in essence, to encourage customers to go through the rest of the store to purchase other goods. They could easily take a larger cut than is being proposed, because they are just operating as loss leaders for those stores to get customers in the door in the first place.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Maria Colette Caulfield (Conservative, Centre-right): My hon. Friend is making an excellent point. I was slightly disappointed that the shadow Minister did not really understand the principle of vertically integrated pharmacies. Some big national companies are making a lot of money out of pharmacy at the moment.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Oliver James Dowden (Conservative, Centre-right): That is precisely the point that I am coming to. As we proceed with these reforms, hon. Members need to recognise that we will need further savings in this area. I am not attacking large retailers because of their size; it is because of the lack of such wider provisions. We need to look at ways of securing further savings from them which we can plough back into the community pharmacies that are providing the services on which all our constituents rely. I completely accept that pharmacies that are purely dispensing services are very inefficient as such. They are highly labour-intensive; it is just a very expensive way of delivering drugs. We need to identify ways in which we can bifurcate the two different types of providers I pay tribute to what the Minister has announced so far. He clearly demonstrates an understanding of the situation, as we have seen in relation to the protection of key local pharmacies through the community access scheme. For example, in my constituency, the services in places such as Elstree and Shenley, where we have small, rural communities, often with an elderly population, will be protected. Equally, the quality payment scheme recognises some of these wider community benefits However, I urge the Minister to do more in that area. Let me make two brief suggestions. First, we need more detailed recording of the sorts of services that are provided by pharmacies which take pressure off the NHS. As I understand it, there is no systematic way in which these additional benefits are recorded, and we are all working on the basis of estimates. We could have a system whereby the community pharmacies systematically recorded the benefit that they provided, and then they could be better rewarded for those benefits. At the same time, there would be a means by which we could penalise, or find further cuts from, the pharmacies that did not provide those additional services Secondly, the hon. Member for Central Ayrshire (Dr Whitford) rightly commented on the common ailments scheme that operates in Scotland. The Minister indicated that the Government are moving down that route. I urge the Government to go further on this. There is absolutely no reason why patients suffering from things such as common cold and flu symptoms or head lice could not be referred directly from their GPs to pharmacies, thereby saving money for GPs and providing additional income for those pharmacies I support the overall direction of reform, but as the Government proceed with these reforms, they could do with engaging more in looking at ways of supporting what is best in community pharmacies while providing further savings from the services that do not provide them.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Nigel John Mills (Conservative, Centre-right): I declare an interest, as my wife works as a community pharmacist just outside my constituency. It is probably fair to say that from my discussions with her and with my local pharmacists, I know the valuable work they do and the pressures on them, as well as the changes that they would like so that they can give a better service The Public Accounts Committee has had nine or 10 inquiries in the past year or so looking at the pressure on NHS finances and the various deficits in the system. It is therefore quite hard to stand up and say that the Government are completely wrong to try to find some efficiency savings from the pharmacy budget, or that we should just ignore the £3 billion or so paid to pharmacies each year without trying to find some savings. If we are going to hit the efficiency target across the NHS of £22 billion during this Parliament, while having all the services we want, we will have to accept such savings in every area, although it is not going to be easy wherever they fall. I can therefore see the logic of why the Government need to look at the pharmacy budget I also accept the logic that although the system we have ended up with, in which we give each pharmacy a fixed establishment payment, may well have been suitable when we had a very controlled regime, under which a licence had to be got to open a new pharmacy, it probably did not fit well with the old 100-hour regime, under which there was a vast expansion in the number of pharmacies across the country. It is right to look at that system. It may also be right to look at the 100-hour pharmacies to see exactly what the rules for them should be I welcome the pharmacy access scheme, which is a very welcome improvement on what was originally suggested for this round of cuts. Two pharmacies in my constituency will benefit from it. I met both pharmacists when the cuts were first announced. Those pharmacies provide the only health provision in the villages they serve, so it is vital for them to be saved.
Community Pharmacies — House of Commons, 2016-11-02
Topic: Health
Paul Stuart Scully (Conservative, Centre-right): During the past year, I have visited a number of local, independently run community pharmacies across Sutton. They add much to our local healthcare provision, and they have the potential to add so much more, as we have heard. We therefore need to tread carefully when looking at changes to funding and configuration. When I spent time in those pharmacies, I saw a steady stream of customers. The pharmacist knew most of them by name, as well as their background and wider circumstances. Such a special relationship takes time to build, but it can be so valuable in assessing health needs and pre-empting any problems. We need to look at how we can develop community pharmacies further as a neighbourhood health and wellbeing hub, so that they become the go-to destination for support and advice and act as a gateway for other healthcare services As a number of hon. Members have done, I have been to A&E and seen people who have not had an accident or do not appear to be an emergency, so it is right to look at how we push people towards GP services. However, there seems to be less discussion in public about encouraging people to look to their pharmacist, rather than to their GP, for healthy lifestyle advice, minor ailments care and routine support. The all-party parliamentary group on pharmacy heard some great evidence from the LloydsPharmacy group about its diabetes foot service and inhaler check service, which enable people to get the most out of their treatment and can make their medication far more effective. Those kinds of extra services make community pharmacies incredibly valuable.