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Health Bill

My Lords, I recognise the lingering doubts expressed in Committee that have prompted a return to this amendment. I reiterate the firm statement I made in Committee: the general rule should be one responsible pharmacist/one pharmacy. That is our position. However, the noble Earl, Lord Howe, has shown how circumstances can change. People can come up with new ways of operating that are consistent with patient safety but provide better service to them. None of us wants to get in the way of those changes where they can be made to operate. The noble Earl’s point about not going faster than the profession wants to go is sensible, and one with which we find it difficult to disagree. The Government are quite clear on this matter. We think it is important to allow the pharmacist in charge to meet fully his or her statutory responsibility for the safe and effective running of the pharmacy. I do not think that there is any disagreement between us on that. As I have stated before, we expect the vast majority of pharmacies to each have a responsible pharmacist. I also welcome this opportunity to make clear once more that any exception to this general rule will need to meet specified conditions and circumstances set out in regulations for it to be considered on its merits and our intention is that these regulations are tightly drawn. 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. We cannot be sure that a requirement to make an exception to the general rule of one responsible pharmacist, one pharmacy will not arise in the future. I am sorry that the noble Baroness did not like my examples. I recognise that there will not be a Glastonbury festival this year, so perhaps the rock festival example may not be one on which I wish to place a lot of weight. However, I come back to my vending machine, even if it is an Australian vending machine. It is quite possible that vending machines will be used in this country in this way. Already, as I said, we can accept that for a pharmacist to be responsible solely for pharmacy premises where a vending machine is located would not necessarily be a sensible way of using a pharmacist’s extensive clinical training. If the noble Baroness’s amendment were accepted, a vending machine would literally have to have a pharmacist standing by it all the time. That does not seem to us a sensible way to proceed, particularly when people of all shades of opinion recognise that much more use can be made of pharmacists’ skills in areas other than the preparation, sale and supply of medicines, important though that is as their core business. Other services were included in the pharmacists’ contract negotiations, such as health promotion campaigns, signposting and advice on stopping smoking. Those services are not governed by the Medicines Act. We believe that pharmacists can provide those services and pharmacists believe that they can provide those services for the benefit of patients. That is why it is important to future proof this legislation so that when new ways of working, technological or otherwise, come along, we do not put unnecessary legislative barriers in their way, but use the regulations provided for in the Bill to ensure that patient safety is safeguarded. Rather than make no provision we believe that it is necessary to allow us the opportunity to consider such circumstances as and when they arise. To return to the vending machine example, if the noble Baroness’s amendment were accepted we would limit the pharmacist’s capability to do other things and the opportunities for improving the public’s access to certain medicines. I hope that I have made it clear that these regulations will safeguard public safety in looking at any exception to the general rule, while allowing us to take account of future changes so that we do not hamstring existing and future developments in the provision of pharmaceutical services and ways of improving the public’s access to medicines. It is important to be clear that there is no long list of exceptions to this rule. Almost by definition this provision allows us to make exceptions. If we had a long list of these exceptions, I would provide them. However, we do not have such a list. That does not seem to me to alter the case that we have some known exceptions, which makes it sensible to make this future-proofing provision in legislation. With those assurances, I hope that the noble Baroness will feel able to withdraw her amendment.