To ask His Majesty's Government what guidance they have issued to Integrated Care Boards on the allocation of resources towards prevention, primary care, and community services.

To ask His Majesty's Government what guidance they have issued to Integrated Care Boards on the allocation of resources towards prevention, primary care, and community services.

New clause 50 debated and negatived on division (4 to 9). New clause 51 debated and withdrawn. New clause 52 negatived on division (1 to 9). New clause 56 negatived on division (1 to 9). New clause 57, discussed with new clauses 58 and 104, debated and withdrawn. New clause 66 debated and negatived on division (4 to 8). New clause 72 debated and negatived on division (2 to 9). New clause 76 negatived on division (1 to 13). New clause 77 debated and withdrawn. New clause 81, discussed with new clause 82, debated and negatived on division (4 to 9). New clause 82 negatived on division (4 to 9). New clause 83 debated and negatived on division (4 to 10). New clause 84 negatived on division (5 to 9). New clause 85, discussed with new clause 98, debated and negatived on division (5 to 9). New clause 86 debated and negatived on division (4 to 9). New clause 87, discussed with new clause 113, debated and negatived on division (5 to 9). New clause 96, discussed with new clause 97, debated and withdrawn. New clause 97 negatived on division (5 to 9). New clause 98 negatived on division (5 to 9). New clause 99 debated and negatived on division (4 to 9). New clause 101 debated and negatived on division (4 to 9). New clause 104 negatived on division (5 to 9). New clause 105, discussed with new clause 106, debated and negatived on division (4 to 9). New clause 106 negatived on division (4 to 9). New clause 108, discussed with new clause 109, debated and withdrawn. New clause 109 negatived on division (5 to 9). New clause 112, discussed with new clauses 110 and 111, debated and negatived on division (4 to 9). New schedule 1 agreed to. Clauses 68 and 69 agreed to. Clause 70, as amended, agreed to. Amendment 37 to clause 71 negatived on division (4 to 9). Amendment 38 to clause 71 negatived on division (4 to 9). Amendment 39 to clause 71 negatived on division (5 to 9). Clause 71, as amended, agreed to. Clause 72 agreed to. Bill, as amended, to be reported (Bill 131). Written evidence reported to the House.

New clause 50 debated and negatived on division (4 to 9). New clause 51 debated and withdrawn. New clause 52 negatived on division (1 to 9). New clause 56 negatived on division (1 to 9). New clause 57, discussed with new clauses 58 and 104, debated and withdrawn. New clause...

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure commissioners are making use of capacity and expertise in primary care optometry to improve access to care for those (a) at risk of and (b) with glaucoma.

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure commissioners are making use of capacity and expertise in primary care optometry to improve access to care for those (a) at risk of and (b) with glaucoma.

To ask the Secretary of State for Health and Social Care, what assessment his department has made of the adequacy of GP provision in Gillingham and Rainham; and what steps his department is taking to improve access to primary care services for residents in areas of higher deprivation within that...

To ask the Secretary of State for Health and Social Care, what assessment his department has made of the adequacy of GP provision in Gillingham and Rainham; and what steps his department is taking to improve access to primary care services for residents in areas of higher deprivation within that...

Amendment 9 to Clause 43, discussed with new clauses 27, 33 and 34, negatived on division (1 to 7). Clauses 43 to 46 agreed to. Clause 47 under consideration.

Amendment 9 to Clause 43, discussed with new clauses 27, 33 and 34, negatived on division (1 to 7). Clauses 43 to 46 agreed to. Clause 47 under consideration.

To ask His Majesty’s Government what assessment they have made of the impact of increasing numbers of local pharmacy closures on primary healthcare services.

To ask His Majesty’s Government what assessment they have made of the impact of increasing numbers of local pharmacy closures on primary healthcare services.

My Lords, pharmacies are an easily accessible front door to the NHS and we understand the impact that closures may have. We have increased the community pharmacy budget by £340 million—a 10% uplift that builds on the 19% increase, which was at the time the largest uplift in the NHS. That was delivered in 2024-25 and 2025-26 in order to support pharmacies’ essential role. Recent data indicates that closures have slowed, with 19 net closures in 2025-26 compared with 112 in 2024-25.

My Lords, pharmacies are an easily accessible front door to the NHS and we understand the impact that closures may have. We have increased the community pharmacy budget by £340 million—a 10% uplift that builds on the 19% increase, which was at the time the largest uplift in the NHS. That was delivered in 2024-25 and 2025-26 in order to support pharmacies’ essential role. Recent data indicates that closures have slowed, with 19 net closures in 2025-26 compared with 112 in 2024-25.

My Lords, I thank the Minister for her response, but 65% of community pharmacies are now operating at a loss; 45% have been forced to rely on personal savings or remortgaging their own homes just to keep their doors open, mainly to vulnerable people with the highest levels of need. What is the Minister’s response to the fact that individual pharmacists are subsidising essential front-line services out of their own pockets? Given that the closures are hitting deprived communities the hardest, what specific measures is the Secretary of State taking to prevent the creation of pharmacy deserts in areas with the greatest health needs?

My Lords, I thank the Minister for her response, but 65% of community pharmacies are now operating at a loss; 45% have been forced to rely on personal savings or remortgaging their own homes just to keep their doors open, mainly to vulnerable people with the highest levels of need. What is the Minister’s response to the fact that individual pharmacists are subsidising essential front-line services out of their own pockets? Given that the closures are hitting deprived communities the hardest, what specific measures is the Secretary of State taking to prevent the creation of pharmacy deserts in areas with the greatest health needs?

We are taking a number of actions on the point that the noble Baroness rightly raises. I have spoken about the uplift on the back of a major uplift in the two years previously. For underserved areas, the pharmacy access scheme provides financial support to pharmacies in areas where there are fewer of them. About 1,400 benefit from the scheme and they receive an average of £1,130 per month. Also on the question that the noble Baroness raised, local authorities

have health and well-being boards, which assess whether the local provision of pharmacy services meets the needs of the population. Integrated care boards make decisions on pharmacy openings, and they can directly commission a pharmacy if necessary.

We are taking a number of actions on the point that the noble Baroness rightly raises. I have spoken about the uplift on the back of a major uplift in the two years previously. For underserved areas, the pharmacy access scheme provides financial support to pharmacies in areas where there are fewer of them. About 1,400 benefit from the scheme and they receive an average of £1,130 per month. Also on the question that the noble Baroness raised, local authorities

have health and well-being boards, which assess whether the local provision of pharmacy services meets the needs of the population. Integrated care boards make decisions on pharmacy openings, and they can directly commission a pharmacy if necessary.

My Lords, while we all will welcome this year’s very significant increase in funding, which greatly helps the viability of small chemists, we have a real problem in Cumbria, with its small towns, rural communities and limited chemist availability. Could we go further where the result of non-viability is problems in primary healthcare? Could we allow the remaining chemists greater flexibility and discretion in making changes to the strength, quantity and formulation in prescriptions? This could help to relieve the impact on primary healthcare services.

My Lords, while we all will welcome this year’s very significant increase in funding, which greatly helps the viability of small chemists, we have a real problem in Cumbria, with its small towns, rural communities and limited chemist availability. Could we go further where the result of non-viability is problems in primary healthcare? Could we allow the remaining chemists greater flexibility and discretion in making changes to the strength, quantity and formulation in prescriptions? This could help to relieve the impact on primary healthcare services.

My noble friend is quite right to identify the very important role that pharmacies play in the move from hospital to community. That is why we are funding the rollout of, for example, independent prescribing from autumn this year. That will build on the success of Pharmacy First and the pharmacy contraceptive service, and provide much more local, on-the-spot care for common conditions. In rural areas, dispensing doctors can dispense medicines to patients who live more than a mile from a pharmacy. Also, online pharmacies can deliver medicines free of charge.

My noble friend is quite right to identify the very important role that pharmacies play in the move from hospital to community. That is why we are funding the rollout of, for example, independent prescribing from autumn this year. That will build on the success of Pharmacy First and the pharmacy contraceptive service, and provide much more local, on-the-spot care for common conditions. In rural areas, dispensing doctors can dispense medicines to patients who live more than a mile from a pharmacy. Also, online pharmacies can deliver medicines free of charge.

My Lords, I refer to my interest advising the Dispensing Doctors’ Association, and my late father and my brother were dispensing doctors. The Minister will be aware that where there are no community pharmacies, dispensing doctors stand prepared to give vaccinations, such as for meningitis B for students returning to university. Will she make good the commitment by dispensing doctors to dispense meningitis vaccinations to this cohort? It seems to have been overlooked in this case.

My Lords, I refer to my interest advising the Dispensing Doctors’ Association, and my late father and my brother were dispensing doctors. The Minister will be aware that where there are no community pharmacies, dispensing doctors stand prepared to give vaccinations, such as for meningitis B for students returning to university. Will she make good the commitment by dispensing doctors to dispense meningitis vaccinations to this cohort? It seems to have been overlooked in this case.

We are constantly in discussion with Community Pharmacy England and its organisations about how we develop their role. I am very enthusiastic, as many noble Lords are, about the role that they can play. I was looking at statistics between April 2025 and February 2026 about the millions of clinical services, not just vaccinations, that have been delivered. For example, there have been over 4.7 million flu vaccinations. There is scope for discussion on how we can expand the vaccination programme, but the service provided by community pharmacies is to be credited.

We are constantly in discussion with Community Pharmacy England and its organisations about how we develop their role. I am very enthusiastic, as many noble Lords are, about the role that they can play. I was looking at statistics between April 2025 and February 2026 about the millions of clinical services, not just vaccinations, that have been delivered. For example, there have been over 4.7 million flu vaccinations. There is scope for discussion on how we can expand the vaccination programme, but the service provided by community pharmacies is to be credited.

My Lords, has the department undertaken any analysis of the characteristics of pharmacies that are most of risk of closure to understand whether geography, deprivation, the ownership model or dispensing volume are the principal drivers? Does she agree that having this data might help the department to target some of the uplift more effectively and prevent closures? Can she update the House on whether the department carries out that analysis?

My Lords, has the department undertaken any analysis of the characteristics of pharmacies that are most of risk of closure to understand whether geography, deprivation, the ownership model or dispensing volume are the principal drivers? Does she agree that having this data might help the department to target some of the uplift more effectively and prevent closures? Can she update the House on whether the department carries out that analysis?

I know that the noble Lord is aware of this, but pharmacies are private businesses that open and close for a range of reasons. Sometimes pharmacies close and then reopen. That is why I spoke in my Answer about 19 net closures. It is worth noting, as the previous Government did, that access to pharmaceutical services remains good—80% of patients can access a pharmacy within a 20-minute walk. However, local authority health and well-being boards look at local areas and we have a financial scheme to support the development of pharmacies in underserved areas.

I know that the noble Lord is aware of this, but pharmacies are private businesses that open and close for a range of reasons. Sometimes pharmacies close and then reopen. That is why I spoke in my Answer about 19 net closures. It is worth noting, as the previous Government did, that access to pharmaceutical services remains good—80% of patients can access a pharmacy within a 20-minute walk. However, local authority health and well-being boards look at local areas and we have a financial scheme to support the development of pharmacies in underserved areas.

Has any consideration been given to some relaxation of the rules which restrict the ability of GPs to open pharmacies at their practices, to which the Minister has already alluded? Might it be possible to alleviate this problem by relaxing those rules?

Has any consideration been given to some relaxation of the rules which restrict the ability of GPs to open pharmacies at their practices, to which the Minister has already alluded? Might it be possible to alleviate this problem by relaxing those rules?

As I have said, we keep this constantly under review, but it is the case that GPs can provide dispensing services in a number of situations. That particularly helps if people live further away from a community facility than is ideal.

As I have said, we keep this constantly under review, but it is the case that GPs can provide dispensing services in a number of situations. That particularly helps if people live further away from a community facility than is ideal.

My Lords, I thank my noble friend the Minister for her reassuring reply about the closure of local pharmacies. However, research published in 2025 shows that access to local pharmacies has declined almost four times faster in England’s poorest communities. What assessment have the Government made of the impact of this on health inequalities? What steps will they take to integrate pharmacy services within neighbourhood health centres?

My Lords, I thank my noble friend the Minister for her reassuring reply about the closure of local pharmacies. However, research published in 2025 shows that access to local pharmacies has declined almost four times faster in England’s poorest communities. What assessment have the Government made of the impact of this on health inequalities? What steps will they take to integrate pharmacy services within neighbourhood health centres?

That comes into the category of underserved areas, particularly if there are fewer pharmacies. I disagree with my noble friend about the overall picture in terms of pharmacies; we are supporting them to do more work, and a bigger range of work strengthens their position. It is not necessary to live right near a pharmacy, because of provision by online pharmacies. Finally, I repeat that local authorities can also seek to open pharmacies where there are underserved areas.

That comes into the category of underserved areas, particularly if there are fewer pharmacies. I disagree with my noble friend about the overall picture in terms of pharmacies; we are supporting them to do more work, and a bigger range of work strengthens their position. It is not necessary to live right near a pharmacy, because of provision by online pharmacies. Finally, I repeat that local authorities can also seek to open pharmacies where there are underserved areas.

My Lords, community pharmacy has lost thousands of full-time pharmacists in recent years, and many have been recruited directly to other parts of the NHS that can afford to pay more. What more can the Government do to support community pharmacists to minimise this internal displacement and help keep vital local pharmacies open?

My Lords, community pharmacy has lost thousands of full-time pharmacists in recent years, and many have been recruited directly to other parts of the NHS that can afford to pay more. What more can the Government do to support community pharmacists to minimise this internal displacement and help keep vital local pharmacies open?