Health Bill

Let me begin by clearly stating the Government’s position. We believe that the general rule should be one responsible pharmacist for one pharmacy. This will allow the pharmacist to exercise fully his or her important responsibility to secure the safe and effective running of the pharmacy. We see a pharmacist having responsibility for more than one pharmacy at the same time as the exception, not the rule. We recognise the concerns expressed by a number of noble Lords about the possibility of stretching a pharmacist’s ability to meet his responsibilities if he is in charge of more than one pharmacy at a time. We know that there are also concerns that allowing a pharmacist to be responsible for more than one pharmacy might result in him or her being present in each of these pharmacies for relatively brief periods during the working day. However, new Section 72A(2) will allow us to look at all the circumstances where it might be appropriate to consider allowing a pharmacist to have responsibility for more than one pharmacy at a time. We believe that there is a need to consider each set of circumstances on its merits and that the requirement to maintain patient safety must be central to any such consideration. Therefore, we brought forward a government amendment in the other place to tighten further the regulation-making power in new Section 72A(2). For a pharmacist to be responsible for more than one pharmacy at the same time, there will now be a requirement to meet specified circumstances and to comply with certain conditions set out in the regulations. Certainly the circumstances mentioned by the noble Baroness, Lady Barker, would need to be taken into account in this kind of consideration. These provisions underpin the general principle that a pharmacist responsible for more than one pharmacy at the same time will be the exception rather than the rule. The overall intention of the regulations will be to ensure that the responsible pharmacist fully exercises his or her duty to maintain patient safety in each of the pharmacies for which they are responsible, including supervision of dispensing activities. It is our intention that these regulations should be tightly drawn. In due course we will consult all interested parties on the circumstances that support consideration of an exception to the general rule of one pharmacy, one responsible pharmacist, and the conditions to be met before a pharmacist can assume responsibility for more than one pharmacy at a time. However, we believe that circumstances may well arise that require some flexibility in considering the general rule. I mentioned the technology developed in Australia that allows the pharmacist to provide advice and dispense certain medicines through his control of a vending machine sited at another location. We do not want to end up with a situation where the responsible pharmacist would have to stand by the vending machine while it was operating and being controlled by a pharmacist from elsewhere. Amendment No. 76, by completely preventing any exceptions to the one responsible pharmacist/one pharmacy rule, would effectively stop modern developments in pharmacy practice that could improve the public’s access to pharmaceutical services. Our intention is that the regulations will continue to protect public safety and ensure the proper exercise of the responsible pharmacist’s duty to secure the safe and effective running of each pharmacy for which he or she may be responsible at any one time. The regulations will also need to allow sufficient flexibility to reflect existing and future developments in the provision of pharmaceutical services. This approach allows us to set out the conditions to be met in greater detail in regulation, and for these to be reviewed in the light of future changes. With regard to Amendment No. 77, I do not think it necessary or appropriate to place these specific requirements in the Bill. By their very nature, such circumstances are the exception, not the usual situation of one responsible pharmacist for one pharmacy. We are very clear that that is the norm. I foresee difficulties in defining terms such as ““exceptional”” and ““emergency”” and in the way that these will confine consideration of the circumstances where a pharmacist might be allowed to assume responsibility for more than one pharmacy. As I have said, we think that a judgment should be made on whether such circumstances comply with a detailed regulatory framework that safeguards patients, rather than on whether these circumstances meet what is defined as exceptional or as an emergency. An emergency in itself may not be sufficient justification to make an exception to the one responsible pharmacist/one pharmacy rule. Exceptions should be made only where patient safety can be maintained. It is worth recalling that these changes to the Medicines Act 1968 and the NHS legislation concern the preparation, sale and supply of medicines. Other services, such as health promotion campaigns, signposting and advice on stopping smoking, are not governed by the Medicines Act. Both the noble Baronesses, Lady Barker and Lady Murphy, prayed in aid of their concerns these other services that might be available in particular communities. In recognition of the wider range of services available under NHS contractual arrangements for community pharmacy services and the pharmacists’ involvement in those services, I acknowledge that some respondents to the consultation suggested that there might be a requirement on the pharmacist to be available in the pharmacy for a minimum number of hours per day or week. We can certainly discuss that in taking forward these changes regarding the sale and supply of medicines, which is the primary aspect of this part of the Bill. The noble Earl, Lord Howe, mentioned that pharmacists do not want this provision, but the pharmaceutical societies and the profession have generally welcomed it. When the exception of the pharmacist-controlled vending machine was explained, pharmacists accepted the sense of having the ability to make exceptions while recognising that the general rule will be one responsible pharmacist/one pharmacy. Let me reassure the Committee that we can consult on limiting the number of premises and cover in the regulations, so we are not being rigid about this. However, we believe that this provision needs to be in the Bill so that we can introduce tightly controlled regulations after a full and extensive consultation with the various interests. That is our reason for not wishing to accept the amendments. I hope that I have gone some way towards reassuring noble Lords.