Lawyers representing health secretary Jeremy Hunt have defended his decision to slice more than £320m off the community pharmacy budget in England.
James Eadie QC, representing the secretary of state for health, told the High Court on 22 March 2017 that the cuts were a vital part of NHS efficiency savings that had to be made.
Eadie was presenting evidence on the second day of the judicial review being brought against the government by the Pharmaceutical Services Negotiating Committee (PSNC), which represents community pharmacy contractors in England, and the National Pharmacy Association (NPA), a membership body for independent pharmacy owners.
Lawyers for the two pharmacy organisations argue that Hunt’s decision was taken after a flawed consultation on the basis of inadequate data.
Eadie acknowledged that Hunt was aware that the cuts would create “a risk of some pharmacies becoming unviable and having to close”, but argued that it was not necessary for him to seek to determine how many pharmacies would close as a result of the reduction in funding.
“The [funding] changes constituted a package of interlinked measures aimed at increasing efficiency whilst protecting patients’ access to pharmacies,” he said.
“The context was a need to make efficiency savings in the NHS budget and they involved high-level, macro-economic and political judgments about how best to implement that need and where NHS funding should be directed.”
But Eadie added: “[Jeremy Hunt] gave extensive consideration over a lengthy period to the impact of the proposals, including the risk of closures.
“In the context of a macro-economic decision of this kind, it was not necessary for [Jeremy Hunt] to seek to determine how many pharmacies would in fact close or reduce their services as a result of any particular level of funding reduction.
“Nor would it have been possible for the secretary of state to do so.”
Hunt had used information available from Companies House to assess the likely impact on the community pharmacy sector, but Eadie acknowledged that the information only gave a limited picture of the finances of individual pharmacies.
Eadie also argued that the PSNC had been “consulted extensively” and was “fully aware” that Hunt was “actively seeking to manage” the impact of the cuts.
Alison Foster QC, representing the PSNC, has attacked the cuts as “unprecedented” and an “irreversible step towards complete re-shaping of the sector without proper debate or analysis”.
In a statement issued on 22 March 2017, the NPA said that it had emerged in court that UK chancellor Philip Hammond had written to prime minister Theresa May in August 2017 to suggest that “traditional bricks and mortar pharmacies” should be closed, giving way to “scaled-up, innovative supply solutions employing digital technology, where government expenditure is minimised”.
In the statement, Ian Strachan, chair of the NPA, said: “This is a smoking gun. We have been warning for months that there are elements within government that want to see the end of the community pharmacy network that has served so many patients so well for so long… The Treasury is clearly motivated by the notion that centralised medicines supply is cheaper; it is not in the slightest bit interested in the quality of patient care.”
The hearing continues.