Showing every spoken contribution, including 5,578 under 12 words. Hide short remarks
It is perfectly reasonable to rule things out. The Minister has had plenty of time to talk to No. 10 since his interview on Sky. I am sure the Labour party would rule out many things at this stage—I am sure it would rule out leaving the European convention on human rights, getting rid of net-zero targets and bringing back the death penalty—so why is it so hard for the Minister and the Government to rule out rejoining the EU?
Over the summer, the Prime Minister announced that mayors will keep a proportion of income tax receipts. Why will mayors like Conservative Mayor Ben Houchen not be allowed to use that money to cut taxes or offer rebates to local residents and businesses?
I thank the right hon. Lady for her answer, but she did not answer my question. My question was about the income tax receipts that Ben Houchen will be allowed to retain. Over the summer, she said that he would not be allowed to use that to give rebates to local individuals and businesses. At the moment, councils already have the power to levy council tax discounts and business rate discounts. Why can mayors not do the same with income tax receipts?
Despite long and historic disagreements between successive UK Governments and Israel, it has remained a steadfast ally in counter-terrorist efforts to keep our people safe in this country. We are now embarked, it seems, on a full diplomatic dispute with Israel and tit-for-tat expulsions of diplomats. What advice was the Foreign Office giving Ministers on this matter, and what advice were the security services giving about our national security interest before this decision was taken?
I welcome the Secretary of State to her place and thank her for her statement. The Government’s reorganisation of the NHS will see the abolition of Healthwatch England and all the other local watchdogs, including Healthwatch Somerset. At a time when NHS services in Somerset are in great need of improvement, how confident is the Secretary of State that she will be aware of patients’ views without Healthwatch Somerset?
I welcome the Secretary of State to her new role, and I agree that we need to reform education for children with SEND. Somerset council is failing children across the county. While neighbouring North Somerset council manages to assess 85% of children for their education, health and care plans within 20 weeks, Somerset council assesses fewer than 2% within that time limit. How confident is she that the incompetent Liberal Democrats who run Somerset council will be capable of improving outcomes for our children?
Jaguar Land Rover is Britain’s largest car manufacturer, so it is deeply concerning for workers and the whole supply chain, including Agratas in my constituency, to learn of 4,000 job losses there. JLR is at a competitive disadvantage, given the excessive energy costs in Britain. Does the Minister agree that the key to protecting Britain’s manufacturing is to provide lower electricity costs to all businesses in Britain?
Order. I regret to interrupt the Minister, but Members should not use the word “you” to refer to each other. They should speak through the Chair, who is here to adjudicate, so that the debate does not become too fractious.
I will call Alex Mayer to move the motion and then the Minister to respond. I remind other Members that they may make a speech only with the prior permission of the Member in charge of the debate and the Minister. As is the convention for for 30-minute debates, there will not be an opportunity for the Member in charge to wind up.
The hon. Member for Shrewsbury has been given permission to speak by the hon. Member for Dunstable and Leighton Buzzard and the Minister, but I will be calling the Minister to speak at 20 minutes past 11.
I beg to move, That this House has considered Government funding for local pharmacies. It is an honour to serve under your chairmanship, Mr Betts. I am pleased to have secured this debate, and I thank colleagues from both sides of the House for joining me to discuss this vital pillar of our primary care network. Community pharmacies are the frontline of healthcare in our constituencies. In Leicester East, they are not just commercial premises but places that serve the very heart of our community. It is estimated that 1.6 million people access pharmacy services in neighbourhoods every day, ranging from elderly residents accessing swift advice to busy families picking up emergency prescriptions and vulnerable constituents using the opportunity to receive healthcare close to home without needing a GP appointment. Despite that, in Leicester East and across the country this crucial sector is reaching a tipping point. Independent economic analysis of community pharmacy finances for the NHS revealed that community pharmacy is facing a funding gap of around £2.5 billion. As a consequence, England lost roughly 1,000 pharmacies between 2016 and 2026, which is an 8% decline. In Leicester East, we have seen our local provision drop from 32 pharmacies down to 29, which is a net loss of 9% of our local community network. Behind the numbers is a harsh reality for a vast number of people. We have to consider not only the impact of small business closures on our local high streets, but the everyday consequences for residents who rely on pharmacies for their care. A loss of three pharmacies may sound like a minor shift, but the real implication is deeply concerning. Fewer pharmacies means longer journeys for frail patients, longer queues at the counters that remain open and increased pressure on nearby GP surgeries that are forced to pick up the slack. We have seen a 19.5% increase in online pharmacies since 2021, and although it is positive that medication and assessments can be accessed in that way, it must be a priority for the Government to protect in-person high street chemists. The closures are obviously not due to a lack of demand. People across my constituency recognise the importance of local pharmacies and use their services constantly. The reason for the closures lies in the structural financial strains that make running an independent pharmacy untenable. My team and I have had several conversations with the owners and staff of pharmacies across Leicester East, and I recognise and thank them for all their hard work on the frontline of our healthcare provision. They have raised several alarming issues; I hope that, by outlining them today, we can collectively commit to positive and constructive changes to support these independent businesses. The current reimbursement model for medicines is the first aspect of the system that fails independent providers. As it stands, pharmacies are expected to buy <span id="369WH" class="column-number" data-column-number="369WH"></span>medicines up front. They can then wait anywhere from two to three months for the NHS to reimburse those costs. To make matters more severe, the NHS reimbursement calculation works on the assumption that pharmacies receive massive bulk-buy discounts from suppliers. Large national chains may possess the purchasing power to make that assumption work, but such bulk discounts simply do not exist for a small, independent community pharmacy in Leicester East. Small pharmacies routinely pay more to acquire necessary drugs than the NHS repays them. Although concessionary pricing mechanisms exist to adjust for market spikes, the delay in the adjustments means that independent contractors are constantly left bridging the shortfall. That disparity forces wholesalers to look overseas for cheaper stock, creating supply chain bottlenecks and leaving local pharmacists to face the frustration of patients when vital medicines are backordered for weeks. The Independent Pharmacies Association recently conducted research that shows that an average pharmacy dispensing 10,000 items a month still faces a shortfall of circa £56,000 compared with what is needed to keep in pace with inflation. Pharmacies cannot be expected to continue to foot this bill. The Government must do more to ensure that pharmacies are properly reimbursed, to prevent further pressure and demand on other areas of our NHS. On top of the margin pressures, pharmacy owners in my constituency are caught in a constant struggle between rising operating costs and completely fixed incomes. Over recent years, overheads have increased right across the board. The recent decisions to raise employer national insurance contributions and the minimum wage and to escalate business rate liabilities have significantly increased the financial burden on pharmacies up and down the country. Furthermore, unlike other small high street businesses, community pharmacies receive no business rates reliefs on their premises—a major oversight for essential healthcare providers operating right at the heart of our local economies. When running costs go up for a normal high street business, such as a local shop, café or dry cleaners, it can adjust its prices to cover higher wage bills and energy costs. Independent communities pharmacies cannot do that. Their primary income is fixed directly by the Government tariff. When employment taxes increase or utility bills rise, independent business owners cannot pass those costs on. They must absorb the loss directly until their reserves run dry. I welcome that our new Prime Minister has introduced business rates relief for the leisure and hospitality sector, but does the Minister agree that we must also introduce further assistance for the pharmacy sector? GP and dental premises benefit from the NHS reimbursement of business rates, while community pharmacies, which also provide vital frontline services, do not. Introducing a form of relief to end the disparity for local pharmacies would make a substantial difference. In addition to the fixed margins, the current funding framework expects community pharmacies to deliver essential services at a financial loss. For example, home delivery services for housebound or vulnerable residents became vital during the pandemic, and remain a crucial <span id="370WH" class="column-number" data-column-number="370WH"></span>lifeline for many elderly constituents across Leicester East, but local pharmacies receive no core NHS funding to run delivery vehicles or pay driver wages. They fund the operations entirely by themselves, committing their own profit to ensure that vulnerable patients receive their medication on time. In addition, pharmacy owners have described how, although the Government support preventive clinical services, the rules and restrictions imposed are unnecessarily constraining. It is positive that vaccinations and immunisation are being moved into pharmacies, but the Independent Pharmacies Association suggests that shifting more flu vaccinations into pharmacies could free up around 4.5 million GP appointments each year. As we approach winter and flu season, the Government should seriously consider the benefits of reallocating services, and ensure that proper funding is in place to back up the increased expectations. Blood pressure screening is another service that is being redirected to pharmacies. It is a simple, cost-effective way to catch cardiovascular issues early and prevent avoidable hospital admissions, yet under the current NHS caps reimbursement is limited to just one check per patient every five years. No small business can survive indefinitely when its costs are rising, its prices are frozen by the Government and it is expected to deliver services for free. This financial pressure feeds directly into an acute workforce crisis. The pharmacy pressures survey published by Community Pharmacy England revealed stark results: 60% of pharmacy teams reported active staffing shortages, and 54% of owners said they were struggling to recruit permanent staff. Crucially, more than 80% reported longer patient wait times and more than half acknowledged that shortages were reducing their ability to offer direct advice. We are also seeing a troubling rise in temporary closures, when a pharmacy must shut its doors for hours or days at a time simply because it cannot secure a qualified pharmacist. The freedom of information data collected by Healthwatch across various integrated care boards revealed that, in a single year, there were nearly 14,000 temporary closures across England, resulting in over 46,000 lost hours of care. Without strategic planning for staffing, the long-term future of our community pharmacies remains deeply uncertain. The Company Chemists’ Association estimates that England could face a shortfall of 16,000 community pharmacists by 2036. While it is positive that thousands of pharmacists have been recruited into the GP practices via the additional roles reimbursement scheme, we must be careful not to strip our high street pharmacies of the very talent they need to remain open. As the long-awaited NHS long-term workforce plan continues to undergo revisions, it is vital that the Government give sufficient priority to the baseline staffing needs of community pharmacy. We know that expanded training targets and the roll-out of independent prescribing qualification upon registration present a real opportunity to expand clinical care on our high streets. Similarly, recent regulatory challenges to allow pharmacy technicians to supply specified medicines and deliver services under the Pharmacy First scheme have the potential to free up valuable pharmacist time. But none of these reforms will succeed if the underlying pharmacy network is allowed to shrink due to unfunded operational mandates.<span id="371WH" class="column-number" data-column-number="371WH"></span> I want to be entirely fair to the Government and to Ministers and acknowledge that we have seen some positive movement in this policy area. Progress is being made, but we must ensure that the pace of our action matches the urgency of the situation before us. The community pharmacy contractual framework—CPCF—settlement for 2026-27 secured almost £3.7 billion for the sector, which is a £340 million increase on the previous year. That builds on the two-year agreement that saw funding rise in previous settlements. Pharmacy trade bodies have expressed concern, however, that the funding uplift will not be sufficient to support the introduction of independent prescribing. We must ensure that the new expectations placed on pharmacies to share services are matched by funding commitments. We have also seen practical relief in the write-off of historic pandemic-era medicine margin debt, and in adjustments to the single activity fee. Furthermore, the roll-out of the Pharmacy First scheme has demonstrated the real appetite for community-level care. Across England, more than 10,900 pharmacies are participating, delivering millions of consultations for common conditions like earache, shingles and minor infections. That is a demonstration of real and effective triage that takes pressure off A&E departments and GP surgeries. However, we must listen to what sector stakeholders are telling us. Community Pharmacy England welcomed the recent funding adjustments as a step away from real-term cuts, but was explicit that this was a “first step” towards stability and not the final destination. The National Pharmacy Association made the same point: structural underfunding means that current settlements will struggle to match the “true cost” of service delivery. The Health and Social Care Committee was blunt in its analysis, describing the current CPCF funding model as “not fit for purpose” and “overly complex”. A major flaw in the scheme is that pharmacies only get paid for many clinical services if local GPs or hospitals actively refer patients to them. In practice, that leaves independent business owners completely dependent on someone else’s admin system, meaning many pharmacies are fully staffed and ready to treat people but receive zero referrals simply because a local surgery is not using the system properly. The current policy framework is simply not delivering for our high streets, and we need an operational model fit for the next decade. If we want pharmacies to continue delivering on the frontline, expanding Pharmacy First, delivering preventive health checks and taking pressure off our local GP surgeries, we must fix the underlying economic model that keeps their doors open. As a Conservative, I believe in supporting small business owners, encouraging enterprise and removing unnecessary administrative barriers. High street pharmacies are independent businesses delivering frontline public care efficiently, but when Government policy sets fixed tariffs while escalating business rates liabilities and employment taxes, it creates a system that actively undermines independent providers. I ask the Minister to address four specific, practical areas today. The first is reimbursement reform. We must review the drug reimbursement formula and concessionary pricing mechanisms, so that payment calculations reflect the actual market acquisition prices paid by the independent <span id="372WH" class="column-number" data-column-number="372WH"></span>pharmacies, rather than relying on assumed bulk discount rates that small independent businesses simply cannot access. The second area is contractual and operational certainty. We need to update the CPCF to ensure that core funding is predictable, transparent and fair, rather than heavily dependent on variable, patchy referral targets managed by NHS bodies over which pharmacy owners have no control. The third area is business overhead and rates relief. I urge the Minister to work with colleagues in the Treasury to address the cumulative tax and cost burden facing small health providers. That includes reviewing business rates liabilities and the impact of the employer national insurance contribution increases on independent high street providers. The final area is workforce and capacity support. NHS workforce planning must balance the expansion of primary care roles with the baseline staffing requirements of high street community pharmacies. As policies such as independent prescribing expand, Ministers must ensure that independent pharmacies are provided with the direct resource and funding needed to put clinical roles into practice safely. Community pharmacies are one of the most cost-effective, high-impact assets that our healthcare system possesses. They keep people well, they prevent avoidable emergency admissions, and they give local high streets across Leicester East and the country vital commercial and civic life. The current approach needs real correction to ensure that independent business owners and patients are properly supported. I look forward to hearing the Minister’s response, and I urge the Government to give our local pharmacies the financial certainty and stability that they desperately need and deserve.
Thank you for your chairmanship of the debate, Mr Betts. I express my sincere thanks to colleagues from across the House who have contributed <span id="392WH" class="column-number" data-column-number="392WH"></span>today. It is a reflection of how valued our local pharmacies are in communities throughout the country, and it highlights the importance of our commitment to improving Government support for these invaluable frontline small businesses. I thank my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak) for his contribution. He is a long-standing advocate for pharmacies and has witnessed at first hand the value that high street pharmacies bring to our communities and their potential to improve primary care provision. I thank him for his commitment to serving the community, which started at a very young age, as we heard. I am also grateful to the hon. Member for North Somerset (Sadik Al-Hassan) for bringing his experience to the debate and raising the important issue of integration across primary care. I thank him and the hon. Member for Newbury (Mr Dillon) for all their hard work on the APPG. I also thank my hon. Friend the Member for South West Hertfordshire (Mr Mohindra) for his continued efforts and campaigning for community pharmacies. The breadth and range of the contributions reflect how deeply this issue resonates in every constituency in the country. I am grateful to the Minister for her detailed response and for taking the time to address the concerns raised. These initial measures, welcome as they are, must be the starting point for further structural reform. Our local high street pharmacies are independent businesses delivering essential public care right on the frontline, but, as we have heard throughout the debate, they cannot continue to absorb squeezed margins, rising wage bills and uncompensated business rates liabilities while their income remains tightly capped by fixed Government tariffs. To ensure that our primary care network remains resilient, I urge the Minister and her team to take away the four core priorities raised today: reforming the medicine reimbursement model and concessionary pricing mechanisms; updating the community pharmacy contractual framework; collaborating with Treasury colleagues to address the rising overheads; and ensuring that the NHS long-term workforce plan safeguards high street community pharmacy capacity. Community pharmacies keep our constituents well, relieve acute pressures on our GP surgeries and A&E departments, and bring vital commercial life to our local high streets across Leicester East and the entire nation. They are one of the most cost-effective assets in our primary care system, but they require a stable economic foundation to survive. I urge the Government to give our independent local pharmacies the financial certainty, fair treatment and long-term backing they so urgently need and deserve. <em>Question put and agreed to.</em> <em>Resolved,</em> That this House has considered Government funding for local pharmacies.
The privacy of a woman is non-negotiable, and I hope the Minister will agree that we need to carefully monitor technological advancements to ensure that appropriate safeguards are in place, in particular with regard to AI tools being used to undress women and children without consent. What steps is the Minister taking to ensure the continued protection of women and children?
It is a pleasure to serve under your chairmanship, Mr Betts. I thank the hon. Member for Dagenham and Rainham (Margaret Mullane) for her eloquent and important speech, for securing the debate and for her work <span id="407WH" class="column-number" data-column-number="407WH"></span>campaigning for a better SEN system for her constituents. I commend her for bringing as many local voices into the debate as possible, because if we are to deliver the system that children, young people and parents deserve, we must ensure that we listen to a wide range of voices. I was pleased to be reappointed as shadow Minister, not least because I can continue to stand up for SEND families, but I was also pleased that the Minister was reappointed to her position—I genuinely mean that. I will work with her on any reforms around pica, given the nature of the condition, and around SEND reforms more broadly. As has been said, pica is a condition where people, usually children, routinely ingest non-edible items. It is often associated with autism spectrum disorder, and reportedly affects between 9% and 25% of children with developmental difficulties, including autism. Although children with pica may eat non-food items that are relatively harmless, others ingest much more potentially harmful substances, including soil, sand, hair, toothpaste and faeces. Non-food items can, on occasion, pass through the child harmlessly, but there are significant health risks—risks that no parent is ever willing to take. The items can cause blockages in the gut, infections, choking and dental problems, to name but a few of the risks. Parents of children with pica can understandably find their behaviour distressing, and often have to go to great lengths to prevent harm to their children—locking cupboards, removing potentially harmful items, and auditing their home and garden to ensure that the child can play safely. That will inevitably lead to a sense of isolation for not only the parents but their child. Parents may not know what kind of support is available or be unsure about how to support their child, and it is often said that children with pica feel marginalised and excluded at school and in social settings. There are indications that, with the right support and treatment, many children overcome pica behaviours, but not all do. That is why training is incredibly important. Getting to the root of the underlying cause is important, and in some cases can be transformative. For some children, pica behaviours may arise from certain nutritional deficiencies, so identifying those factors can be important. For many, it is not always clear what has happened. That is why parents and teachers need more awareness and clear, signposted support. Parents and carers can benefit from a range of online resources, including the National Pica Advisory Service, which was established in 2023. I pay tribute to the work of the organisations, including those in attendance, that provide essential resources and a support network to parents and families, helping them to navigate their child’s condition. I understand that the National Pica Advisory Service is aiming to expand its services so that there is a support hub in every NHS trust. What discussions has the Minister had, or will she be having, to help to improve awareness and support for families affected by pica? It is important to get the right support not only at home but at school. Successfully implemented support plans can help to safeguard children and support them to move away from pica behaviours. That is why teacher training is incredibly important. What conversations has the Minister had with officials about the practical <span id="408WH" class="column-number" data-column-number="408WH"></span>steps that the Government can take, as they do their SEND reforms, to enhance teacher training in this space? Teachers who are trained in pica are not only better equipped to put in place safety interventions in the classroom, but better placed to identify pica behaviours in the first instance. Teachers and school staff are uniquely positioned to notice unusual eating behaviours during school meal times, missing non-food items in the classroom, or physical symptoms such as choking and stomach pains. Given the significant safety risks involved in this condition, including choking and poisoning, it is right that we look at the current training offer for educational staff. There are a number of training certificates that teachers and early years practitioners can obtain, but their discretionary nature means that there are bound to be discrepancies and regional variations, which is particularly important at a time when our schools are being put under significant financial pressure. What is the Minister’s assessment of the adequacy of pica training for teachers, teaching assistants, special educational needs co-ordinators and school safeguarding leads? Pica can lead to incredibly heartbreaking situations, such as the case of 19-year-old Owen Garnett in a school in Stratford-upon-Avon, which the hon. Member for Dagenham and Rainham mentioned. Owen’s tragic death came days after a near-identical miss that should have provided a wake-up call to staff and that the Health and Safety Executive inspector said should have triggered remedial action. Although the school was fined, at the heart of the tragedy was a lack of specialised training for staff and a failure to reassess and reinforce preventive strategies. Has the Minister taken a look at that incident? What lessons will she learn from that as the Department undertakes its reforms? Although I understand that personalised treatment is often at the heart of successfully helping children with this condition, what consideration has been given to the potential merits of nationally recognised training? What discussions has had the Minister had with the Department of Health concerning pica, especially with the SEND reforms? I have asked about that before, as it is important that the gap between health and education is overcome. As the Government implement their plans for SEND mainstreaming, gaps in the quality of pica awareness training are bound to become more apparent and pressing. How will the Government ensure that pica is taken into account when SEND is brought into mainstream settings? How is the Minister’s Department working to support a joined-up approach between parents, health professionals, schools and specialist organisations to ensure that pupils with pica have an updated risk management strategy that evolves with them? Will training on pica form part of the Government’s support for mainstream teachers as their schools take in more SEND pupils? How will funding for pupils diagnosed with pica follow them throughout their education journey? Will that be adaptable in those SEND reforms? To conclude, today’s important debate has highlighted the need to raise awareness and improve support for families affected by pica. When talking to people before the debate, I had to explain what pica was and how it affects so many different aspects of society—in this case, children with special educational needs. There is a real need to reassess the training and safeguarding <span id="409WH" class="column-number" data-column-number="409WH"></span>procedures currently developed within schools. Our focus must be on keeping children safe and ensuring that they have the best chance to thrive both within the current system and as the Government implement their mainstreaming reforms. Parents, carers, pupils and teachers will be listening, and they deserve clear answers. I hope the Minister can provide some.
In my constituency we have Jaguar Land Rover Solihull. The Minister will know that Jaguar Land Rover and the automotive sector are in the DNA of my constituents in the west midlands. I agree with him about the global headwinds, but there is a massive issue with the high <span id="1088" class="column-number" data-column-number="1088"></span>levels of red tape owing to the Employment Rights Act 2025 and the national insurance rises, which will inevitably destroy consumer demand and make our automotive sector less competitive. Will he at least acknowledge that that has had an impact?
It is a pleasure to serve under your chairmanship, Mr Betts. It takes me back to the days when as a junior Minister I had to answer to you as chair of the Housing, Communities and Local Government Committee. It is also a great pleasure to follow the hon. Member for North Somerset (Sadik Al-Hassan), who has spoken repeatedly with enormous authority on these matters. He deserves all our thanks for championing pharmacies. I congratulate my hon. Friend the Member for Leicester East (Shivani Raja) on securing the debate and for her detailed compelling speech. I know she does a terrific job representing her constituents locally because my mum is from Leicester and my family are still there, so I get regular reports. I am here today because my mum was a pharmacist and I spent my childhood working in her pharmacy. I saw at first hand the incredible role that independent community pharmacies play in their local area. With flexible opening hours, their location and no need for an appointment, they can be an easy first port of call for families when they need help, care and advice. I am struck that community pharmacists always want to go above and beyond for their patients. One of my first jobs for my mum was to ride around on my bike in the evenings delivering prescriptions to elderly patients who could not make it in or needed them urgently. That was a sign for me of the role that pharmacists play in their local areas. That is why, extraordinarily, about 80% of those over the age of 65 have visited their local pharmacy over the past three months, which speaks to the role they play. I see that in my constituency. We have great national pharmacies as well as brilliant independent ones, such as Coopers in Great Ayton, the Village Pharmacy in Catterick, Stokesley pharmacy and Central Dales pharmacy in Hawes, providing vital healthcare in a sparsely populated rural area and reinforcing the lifeline that pharmacies provide. A benefit of knowing pharmacists for the majority of my life is that I have seen the transformation in the role they play. Originally, they just dispensed prescriptions for GPs. My dad was a GP, so I also saw that side of it. They have transformed to being the first port of call for primary healthcare and treatment for minor illnesses. That evolution had various moments, which the hon. Member for North Somerset will also have experienced. Starting in about 2000, the introduction of hypertension and blood pressure services made a difference. Medicine use reviews were a big statement of trust in what pharmacists could do. The ability to dispense urgent repeat prescriptions made a huge difference to patients. More recently, there has been the introduction of oral contraception and smoking cessation services, as well as flu jabs, catalysed by covid and now accounting for about 30% of those dispensed, which is a huge increase. That evolution over the past 25 years demonstrates the faith that successive Governments of all stripes have had in pharmacies. Patients and local communities <span id="375WH" class="column-number" data-column-number="375WH"></span>place faith in their pharmacists because they trust them and value what they do; they know that they can provide healthcare in an accessible way. That is why, when in government, we introduced Pharmacy First, of which I am very proud. Pharmacists were enabled to provide medication for seven common conditions, including sinusitis, sore throats, ear infections and urinary tract infections. Obviously, that got off to a slower start than we would have liked, but it now has almost 100% take-up among pharmacies. When I last checked the stats, something like 7 million consultations had taken place and more than 5 million prescriptions had been supplied. High satisfaction in the service is growing by 30% to 40% year over year. It has continued the evolution of increasing trust in pharmacies and providing care closer to people in their communities. I have three questions for the Minister about how to continue that journey and re-emphasise support for pharmacies. The first is about raising awareness and trust. In the last debate on pharmacies here, which I think the hon. Member for North Somerset secured, the Minister gave some stats about the high awareness of the Pharmacy First scheme. Anecdotally, that did not quite jibe with my personal experience. Is there something we can do collectively to raise awareness of Pharmacy First and, as was touched on, make sure that the healthcare system is on the same page, so that people get the same message from 111, their GP or the hospital about what is available at the pharmacy, and so they can trust their pharmacist to deliver that service? Secondly, we should look at expanding Pharmacy First, which, in a welcome fashion, the Government have indicated they are minded to do. There are a couple of options for that: we could consider whether the existing restrictions for the seven services, which are limited in part by gender or age, can be expanded. We could also look across the border to Scotland to see what other conditions the service could be expanded to.
Of course. I am sure when the Minister looks at what services can be expanded, she will make sure they are funded properly and will look at where they will relieve strain elsewhere in the healthcare system. If we look at system costs, pharmacies can help save money. Some of the other conditions covered in Scotland include eye issues such as conjunctivitis, dermatological conditions such as acne, and chest infections. Finally, the hon. Member for North Somerset touched on joined-up care. If we want a truly joined-up primary care service, we need single patient records. Examining whether pharmacies can be integrated into GP Connect is worth exploring. I thank the Minister for being a champion for pharmacies inside the Government. Obviously, the issue is personal for me, but there is widespread support for pharmacies among colleagues and society. They deserve our gratitude and support, and I urge the Government to continue to back them.<span id="376WH" class="column-number" data-column-number="376WH"></span>
The point of order and its content are not a matter for the Chair. I have not been notified of any Minister coming forward at this point, but I have only just come into the Chair. If the hon. Gentleman needs to seek further advice, there is no doubt that the Speaker’s Office can let him know where he needs to go to further his point of order.
I call the shadow Secretary of State.
Order. Before I ask any other Members to contribute, I need to set the record straight. Government statements are within the gift of the Government. Urgent questions are the result of private and confidential conversations between Members and the Speaker, and whether one will be granted should not be speculated on, inside or outside the Chamber.
I call the Liberal Democrat spokesperson.
Order. I will now announce the result of today’s deferred Division on the draft Plant Health, Seeds, Seed Potatoes <span id="1117" class="column-number" data-column-number="1117"></span>and Plant Propagating Material (Amendment) (Northern Ireland) Regulations 2026. The Ayes were 371 and the Noes were 100, so the Ayes have it. <em>[The Division list is published at the end of today’s debates.]</em> I call Luke Taylor.
As we now all reflect on the size of our baggage, I call Amanda Hack.
After last week’s session, the country was thrown into confusion over whether the Prime Minister was or was not going to fund 3% for defence by 2030. After today he will have another five weeks off PMQs, but there are some serious threats to national security that cannot wait. His Chancellor resigned as Defence Secretary because the Labour Government would not increase defence spending to 3% by 2030. Does the Prime Minister think that he was right to quit?
The Prime Minister wants to talk about the past on defence spending, so let me refresh his memory and that of the House. I remember when he was the shadow Home Secretary, when the then Labour leader wanted us to leave NATO, disarm our nuclear deterrent and defund the Army, so I will not be taking any lectures from him.<span id="1036" class="column-number" data-column-number="1036"></span> The Prime Minister says the target is 2035. That is a decade away. If he cannot get to 3% by 2030, why should we believe he will get to 3.5% by 2035? The spending review is next year. Last week, I set out how we would get to 3% by 2030. The threats are now. Argentina is threatening the Falklands—now. Russia is threatening us in the North sea—now. The Prime Minister did not answer my question. I asked him if the Chancellor was right to quit. The Chancellor was right to quit, which is why it is so wrong that he is not sticking to his principles. The Chancellor used to say that not hitting 3% by 2030 would put our troops at risk. He also said that Keir Starmer was “unable”, and the Treasury “unwilling”, to provide that funding. So is the Prime Minister unable, or is he just unwilling, to get that money by 2030?
It is unbelievable that the Prime Minister would say that. He is clearly unwilling. We need to fund our defence, not spend all our money on welfare. I cannot believe that he would actually say that. He is clearly unwilling, but there are ways to do this—he is not unable. On Monday, Chris Rokos, Britain’s third biggest taxpayer, announced that he was leaving the country. That is £330 million of taxes walking out the door because of this Labour Government—every year, £330 million. His taxes could be going on defence. The Prime Minister is talking about spending more on welfare. The benefits bill is set to rise by £32 billion under him—that is not all of it; that is the rise. That money could be going on defence. The Prime Minister will not approve the Rosebank oilfield—£1.4 billion of tax revenue that could be going on defence. So, will the Prime Minister tell the country: where is he going to find the money to fund our defence?
No, it is not. The truth is the Prime Minister does not know where he is going to find the money. He is talking about anything except defence, including council housing. He will not fund the military. I will tell you what he is funding though, Mr Speaker—Keir Starmer’s £35 billion surrender of the Chagos islands and its crucial military base. That is British sovereign territory. That is a weak decision, and it is no wonder that Argentina is now threatening the Falklands. We need to project strength. We need to show that British sovereign territory is non-negotiable. So why, just like Keir Starmer, is he planning to surrender the Chagos islands?
We are talking about paying £35 billion to give away British territory, and all of that is happening while the Prime Minister’s Government are cancelling £30 million of vital training for British soldiers. He may be new to the job, so let me tell him what may not be in his briefing paper. Last year, defence funding fell in real terms—that is on this Government. To govern is to choose, so why is he choosing to send £35 billion to Mauritius when they cut the money to train our troops?
The Prime Minister seems to think that the last Government were a Conservative Government. The last Government were a Labour Government and they failed, which is why Keir Starmer resigned. He keeps talking about their record as if it was fantastic. If it was, then why is Keir Starmer not sitting there? Where Britain needs leadership, what we have at the moment is just vibes. He said he appointed the Chancellor because he cares about defence, but he will not fund it. Other countries are making claims over our sovereign territory. They smell weakness. He is pretending that he is the change candidate, but the fact is he is still failing to cut welfare, he is still paying to hand over a sovereign territory, and he is still not funding defence. On the issues that really matter, is he not just continuity Keir?
I thank the right hon. Lady for her comments and for recognising the NATS issue. However, given its importance to the House, will she make a statement tomorrow so that questions can be asked then, rather than during a Second Reading debate? Members across House have lots of questions about this serious matter.
Before I turn to the Bill, let me comment on the events of the last 24 hours, which have shown just how important effective oversight of our aviation sector is. The shocking failure at NATS has left hundreds of thousands of passengers in the lurch, and serious questions have been raised about the resilience of our air traffic control system and aviation infrastructure. As we consider legislation that gives further functions to the CAA, we must ensure that proper parliamentary scrutiny and ministerial accountability are not lost. When something goes wrong this badly, the House must be able to demand answers. Having spoken to Mr Speaker earlier today, it was my understanding that urgent questions requested by my party and by the Liberal Democrats were not accepted because the Government gave assurances that a statement will be made in the House tomorrow. The Government could have chosen to make a statement today, but they chose to prioritise other matters. If the Secretary of State would like to intervene to say that tomorrow there will be a statement in which all Members can ask proper questions about what has happened, I would welcome that. A Second Reading debate is not the right place for questions and answers, and only one hon. Member from the Labour Benches intervened on her. This is not an appropriate moment to have that discussion, so perhaps the Secretary of State would like to confirm that there will be a statement tomorrow. If not, I am afraid it looks like there has been a serious miscommunication between the Speaker’s Office and those on the Government Front Bench. <em>[</em><em>Interruption.</em><em>]</em> Sorry, does the Minister want to speak from a sedentary position, or does he want to come to the Dispatch Box and speak?
Okay. If he does not want to answer the questions, we will have to drag him to the House tomorrow.
If the Minister would like to speak, he can stand at the Dispatch Box. No, he does not want to do that—fine. We will have him here tomorrow, then, as we were told today that our urgent question would not be accepted because the Minister would be making a statement. We will have to see whether that actually happens. Having said all that, I welcome the engagement from the Secretary of State and Ministers in the other House on this Bill, and the engagement that has taken place on this matter. I would like to see that engagement continue, and I hope that it can. The Conservatives agree with the stated aims of the Bill—namely, to promote economic growth and infrastructure development, to strengthen consumer rights and protections, and to enhance aviation security. For that reason, we will not divide on Second Reading. I also agree with the Secretary of State’s observation in her letter to colleagues on 1 September, in which she said that the contributions of the Lords have helped strengthen the legislation before the House today. At its core, this is broadly an administrative Bill. We on the Conservative Benches recognise that certain measures must be taken following our exit from the European Union to ensure that regulatory gaps are filled and continuity is maintained in a way that ultimately keeps Britain’s aviation industry working safely, as the Secretary of State highlighted. The Bill pays much attention to consumer rights and associated protections, and the Conservatives welcome parts of that agenda. Indeed, I appreciate the Department showing some flexibility on these issues, particularly with regard to safeguarding disabled passengers. However, given the violent agreement between the Secretary of State and me on these matters—I confess that it is not always this way across the Dispatch Box—I am slightly puzzled by one item. Why on earth did her party whip Members in the other place to vote against a review of airport drop-off charges? Why are passengers paying such exorbitant drop-off charges? It would appear that the Government do not want us to know that. Why is it, as <em>The </em><em>T</em><em>imes</em> has reported, that charges at Gatwick have now reached £10 for 10 minutes, while Luton’s, under Labour-run Luton council, have increased from £2 to £7?
The hon. Lady makes a very clear case for why such a review of airport parking charges is necessary. One has not happened for a decade. It was great to get the support of the Liberal Democrats in the <span id="1106" class="column-number" data-column-number="1106"></span>other place in backing Lord Moylan and the Conservative proposals in that space. Now that the provision is in the Bill, I hope the Government will not seek to remove it. There are obviously concerns about the impact that surface access targets have had on some airport parking charges, especially when, as the hon. Member has made clear, genuine alternatives often do not exist properly or are incredibly expensive. I genuinely find it difficult to believe that the Secretary of State does not herself believe that there is a simple link between Gatwick having a minimum target of more than half of passengers getting to and from the airport by public transport and the soaring drop-off charges. I hope that this perfectly reasonable provision for a review that puts passengers first will not be removed from this Bill. It would be great to hear from the Minister winding up whether the Government intend to stick with that important review, which was inserted against the Labour party’s wishes in the House of Lords. Another point worth mentioning is that the Bill, for all the powers it rearranges and the regulations it enables, offers remarkably little vision for where British aviation should be heading. The Government have talked a lot about growth, yet have refused to set tangible targets to deliver it—whether in this aviation Bill, or indeed for passenger growth in the Railways Bill. The Opposition understand that economic growth and the competition that fuels it are essential not merely to the success of individual airports and airlines, but to maintaining Britain’s global reputation as one of the world’s outstanding aviation nations. Yet too often this Government appear to regard the aviation industry less as an engine of growth and more as an ATM. Indeed, Labour Members seem to be beset with Tigger-like pleasure at finding new costs to impose on businesses, while growing the welfare bill rather more successfully than they are growing the economy. Ministers must understand that every additional burden and every tax—air passenger duty or business rates—is having huge impacts on aviation. I was with Manchester Airport Group recently, which is now facing an effective tax rate of 77%, when corporation tax and business rates are combined, after facing a more than 100% increase in its business rates. Manchester is not alone; airports up and down the country are facing huge increases in tax. It will be really important for Ministers to address that as part of the broader concerns about growth. Every charge deters investment and makes new jobs, new routes and greater passenger choice that little bit harder to deliver. That principle must also apply to the new powers given to the CAA. Can the Minister assure the House that significant new regulatory, safety and airspace decisions will be evidence-based, proportionate and subject to the proper assessment of their costs and benefits?
I thank my hon. Friend for that. Obviously, the air space does not exist within the Bill alone. The tax changes will have huge implications, whether at Blackpool airport or at Humberside airport, which I visited recently. They face life-and-death pressures that will decide whether they continue to be going concerns. This is not just about airports and the jobs that they create directly, but the connectivity that they provide for entire regions. He makes an incredibly important point. As has been the case with too much legislation of late, the Bill leaves plenty of questions up in the air. Where are the measures to secure the future of the workforce—our mechanics, engineers and next generation of skilled workers? Where are the measures to ease the burdens surrounding apprenticeships, an issue raised with me directly by the apprentices I met at Heathrow recently? Why is there no indication of how to champion our excellent aviation colleges at airports, such as the one at Stansted that I had the pleasure of visiting recently? Where is the plan to tackle pilot shortages? Has the Secretary of State not received representations calling for the Government to assist with pilot recruitment, or is she turning a deaf ear to them? Where is the vision for Britain being a world leader in single-aisle aircraft manufacturing, something for which the industry, as she knows, is clamouring to the rafters? I know that the Secretary of State is incredibly busy selling out taxpayers in her latest meetings with union barons who have her over a barrel; she was apparently too busy to join me and many of the shadow ministerial team at the Farnborough air show. My understanding is that not a single Minister from the Department for Transport went to Farnborough this year. Perhaps she could correct me if I am wrong. It is Europe’s largest airshow, a symbol to the world of Britain’s openness and our leading edge in aviation, so it does seem quite bizarre that, while they were all sat there waiting for the reshuffle, none of them popped down. Maybe that shows the Government’s general view of aviation—they are just not interested. <em>[</em><em>Interruption.</em><em>]</em> It seems shocking that the ministerial team did not get there. <em>[</em><em>Interruption.</em><em>]</em> If they do not want to do the job, then rather than shouting at me from a sedentary position, we could just swap sides of the House. Too often, it seems, the Department is in the business of delaying Bills. It leaves drafting to the last moment, and then tables reams of amendments to its own legislation, before expressing surprise that the Opposition might wish to scrutinise what has happened. We will not oppose sensible measures simply for the sake of it. Of course, we welcome stronger passenger protections where they are needed, and of course we want the highest possible standards of safety and security, but we also want a Bill that backs Britain’s aviation sector—a Bill that is backed by a ministerial team who also back Britain’s aviation sector. We want a Bill that gives the sector the space and the economic environment in which to succeed, and that creates the conditions in which competition, innovation and enterprise can thrive. I look forward to the opportunity to table amendments in Committee. Hopefully, we can work together to improve the Bill, as Opposition Members in the other place did, to ensure that British aviation remains safe, is more competitive and remains world leading.
Will the Minister give way?
I just wanted to make it very clear that I was in no way questioning what Mr Speaker decided. When he spoke to me, he made it very clear that his understanding was that the Government were going to <span id="1145" class="column-number" data-column-number="1145"></span>make a statement. <em>[</em><em>Interruption.</em><em>]</em> Government Front Benchers may shake their heads, but that is what I was told by Mr Speaker.
Thank you very much, Madam Deputy Speaker. The point I was making was that I was basically being accused by the Minister of saying something that I had not said. I just wanted to make clear what was said, because the real question here is one of parliamentary scrutiny.
On a point of order, Madam Deputy Speaker. Members have not had the chance today to properly raise the NATS blackout, which has affected over 100,000 passengers and cost UK aviation tens of millions of pounds. The Secretary of State has not indicated that the Government will provide a statement today in the Chamber. Madam Deputy Speaker, can you tell me what those of us on the Opposition Benches, and all Members interested in raising issues that affect their constituents, can do to get answers from the Government?
It is a pleasure to serve under your chairmanship, Mr Betts. I congratulate my hon. Friend the Member for Leicester East (Shivani Raja) on securing such an important debate. Supporting our pharmacies is one of my long-standing commitments; I have spoken about the issue many times in the Chamber. Pharmacies are at the heart of primary care, and I am grateful for the contribution they make to our community—dispensing medicines, delivering vaccinations, offering advice for minor conditions and providing clinical services that would otherwise need to be delivered elsewhere. Pharmacies are accessible and embedded in our high streets. For millions, they are the front door to the NHS. I have had the pleasure of speaking to pharmacists from across my South West Hertfordshire constituency, visiting Abbey pharmacy in Abbots Langley, Boots in Kings Langley and Esom pharmacy in South Oxhey, and even undertaking work experience at Riverside pharmacy in Rickmansworth. As I have said in Parliament before, my discussions have made it clear that our pharmacies are under unsustainable pressure as a result of the Labour Government’s continued attack on retail businesses. I welcome the commitment in the Government’s 10-year health plan to move more healthcare responsibilities from hospitals into our communities, but that is not feasible unless pharmacies receive the necessary financial support. It is important to note that community pharmacies have not been exempted from any of the Government’s harmful economic policies against retail businesses. Since the Government’s announcements at the autumn 2024 Budget, their employer national insurance contributions and national living wage have increased, and their rate of business rates relief has reduced. Pharmacies now face significantly higher operating costs.