Steve Brine is the MP for Winchester. He was the Pharmacy Minister 2017 – 2019.
Jacob Rees-Mogg recently joined the growing line of cabinet ministers to heap praise on pharmacies for their vital work during the coronavirus pandemic. He called pharmacists “a model of public service”.
Before him, the Health Secretary and even the Prime Minister have repeatedly thanked pharmacy teams and promised support.
The gratitude is genuine and well deserved.
Since coronavirus hit our shores, nearly 70 per cent of the population has visited a local pharmacy for treatment or advice. Throughout the crisis, pharmacies have stayed open when other parts of the health service retreated behind closed doors. In doing that, they have put themselves at risk and incurred huge extra operational costs.
As a former Minister for Pharmacy, I can’t imagine how the country would have coped over the last few months without their support. I agree with Jacob that they have been a bedrock in communities across the land.
So there is plenty of goodwill, but it’s high time to translate this into meaningful support to change the precarious situation on the ground, because pharmacies are struggling to keep vital services going.
To put it quaintly, fine words butter no parsnips. To put it bluntly, pharmacies need a response from government and NHS England in the form of hard cash, urgently. The issue at hand is the £370 million advance payment which was made available to address Pharmacy cash flow pressures caused by the pandemic. I fail to see why this could not be turned into a ‘Covid grant’. Unfortunately, the critical matter of resources is apparently floating about somewhere between the Treasury, NHS England and DHSC. Unless one of these seizes the initiative, they will jointly be held responsible for wearing down a service relied upon by millions of vulnerable people.
My wish is for NHS England’s Chief Executive, Simon Stevens, to step up here and do something wonderful. Infamously, he once told a parliamentary committee that the job of pharmacies is to “dole out pills” but I know that isn’t where he stands and he absolutely recognises that primary care would have fallen over during the pandemic without pharmacies to absorb much of the pressure.
As well as supplying vital medicines to millions of people, pharmacists provide urgent care, give expert medicines advice to people with long term conditions, advise on common illnesses, and take pressure off GPs and hospitals.
A pharmacy has never been just about tablets; they’re highly trained healthcare professionals in their own right.
Ministers decide. Officials advise. But to get NHSE to act it may need a push from the big guns in Downing Street. Rishi Sunak grew up ‘above the shop’ as the son of a pharmacist, and his intervention would make a world of difference.
According to research by Ernst & Young, commissioned by the National Pharmacy Association, many pharmacies could vanish due to chronic underfunding. EY says that almost three-quarters of family-owned pharmacies in England are at risk of closure if a serious funding shortfall is not addressed. More than a third are already operating at a loss.
Funding has already been dropping in real terms and will continue to do so for another four years under current arrangements. Meanwhile, pharmacies in England have racked up a £375m debt as a result of unavoidable COVID related costs. It’s my view that NHS England should write this off, so that pharmacies can keep their doors open to the public and be motivated for the next phase of the pandemic response, the vaccination programme where they could really move the dial.
But this isn’t just about COVID bail-outs, the opportunity now is to resolve the structural problems – the market failures – that exist in community pharmacy and also to build NHS services back better.
By developing local pharmacies into neighbourhood health and wellbeing centres, and allowing pharmacists to put their clinical skills to full use, more capacity can be released into an NHS system under severe strain. Local pharmacies should become people’s front door to health (a phrase used recently by Matt Hancock) – dramatically improving access to healthcare, face to face and close to home.
As a Minister, I bored my officials to death by banging on that community pharmacy is not just a key part of the primary care team, but in fact offers pre-primary care too; stopping people from getting ill in the first place, not just treating them when they are unwell. It’s why PCNs (Primary Care Networks) are such an opportunity for the sector.
In my view, pharmacies should be supported to lead the way in a great national effort to re-build the health of the population, which has suffered so much due to COVID and the necessary responses to it. From blood pressure to weight management and mental health, pharmacies could play a key role in the build back better agenda. This could be especially important in deprived areas, in which community pharmacies have a reach that other parts of the health service lack.
So let’s get behind this critical part of the NHS family, which has done so much over the last year to prove its worth and save lives.