---

Health and Social Care Bill

moved Amendment No. 71: 71: Schedule 12, page 187, line 11, at end insert— ““( ) In section 164(5) of the NHS Act (remuneration for persons providing pharmaceutical services), at the end of paragraph (5) insert ““and shall be contained in regulations in respect of remuneration which relates to all persons who provide pharmaceutical services.”””” The noble Earl said: My Lords, this amendment concerns arrangements for the NHS remuneration of community pharmacy contractors. As a member of the All-Party Parliamentary Group on Pharmacy, I very much believe in the importance and value of pharmacy services in local communities and I am encouraged by the Government’s recent White Paper, Pharmacy in England: Building on Strengths—Delivering the Future, which sets out a range of new services that patients and the wider public will be able to access from community pharmacies. The White Paper is based on a report published by the all-party group last year and reflects many of our recommendations. The House may not be aware that, on average, community pharmacies derive around 90 per cent of their income from the NHS services that they provide. This means that arrangements for remuneration by the NHS are crucial. Community pharmacists need certainty and stability in those arrangements. That stability enables them to plan and invest with confidence. As it stands, the Bill unnecessarily—and perhaps unintentionally—casts doubt over the nationally agreed arrangements for community pharmacy remuneration and therefore jeopardises plans for investment in existing and new pharmacy services. Amendment No. 71 would address that by inserting what I hope the Minister will see as a modest new provision in Section 164 of the National Health Service Act 2006. That Act sets out the arrangements for remunerating community pharmacy contractors. Remuneration is determined by so-called ““determining authorities””—either the Secretary of State, primary care trusts or other persons appointed by the Secretary of State. Pharmacy owners need to know the remuneration that they will receive for those substantive parts of the contractual framework so that they will have the confidence to continue to invest in their businesses. In Grand Committee, the noble Baroness, Lady Thornton, confirmed that, "““the Government remain fully committed to the view that fees and allowances for essential services and advanced services should continue to be determined nationally in negotiation with the Pharmaceutical Services Negotiating Committee and in discussion with the NHS. It is not sensible for pharmacy contractors or PCTs to negotiate such payments on an individual basis””.—[Official Report, 22/5/08; col. GC 629.]" However, she did not accept the amendment tabled by the noble Baroness, Lady Barker. Section 164(3) of the NHS Act 2006 allows the Secretary of State to authorise a PCT to exercise the functions of a determining authority by issuing an instrument of appointment. Section 164(5) allows him to set out in that instrument of appointment the requirements with which a determining authority must comply in making determinations. However, although Section 164(5)(b) allows an instrument of appointment to be contained in regulations, there is no statutory requirement for any particular instrument of appointment to be contained in regulations. The Government, I know, recognise the importance to pharmacies and to PCTs of setting some fees and allowances nationally and have given assurances of their intention to continue to do so. However, this is of such importance that any instrument of appointment that seeks to delegate to PCTs the determination of fees and allowances for the national elements of the pharmacy service should be contained in regulations. Section 164(5)(b) already provides that some instruments of appointment ““may”” be contained in regulations. Amendment No. 71 seeks only that, in relation to these important nationally specified pharmaceutical services, the instrument of appointment must be contained in regulations. This is of great importance to community pharmacists and to the public who rely on pharmacy services. The amendment would simply put in the Bill the intentions expressed by the noble Baroness, Lady Thornton, in Grand Committee. I therefore hope that it will prove acceptable to her today or at least that she will undertake to consider the matter before Third Reading. I beg to move.