It has been genuinely hard to write a column about the main parties’ manifesto promises on health — and in particular for the pharmacy sector. This is depressing because health and social care in general — and more specifically, pharmacy — are not in a pristine and shining state. What is written in these manifestos is, at very best, a ‘vibes’ guide.
Of the three main parties, the manifesto from the Liberal Democrats has the greatest degree of detail, despite being traditionally viewed for many decades as the one party certain not to achieve an outright majority. Although, depending on how complete the Conservative Party’s implosion turns out to be, thanks to their own performance and the degree of tactical anti-Conservative voting, some of the MRP opinion polls suggest that the Liberal Democrats could feasibly become the official opposition.
The Liberal Democrats’ manifesto pledges to “work towards a fairer and more sustainable long-term funding model for pharmacies and build on the Pharmacy First approach to give patients more accessible routine services and ease the pressure on GPs”. This is by far the most comprehensive statement in the three main documents.
It is, of course, framed largely through pharmacy as a means of easing the crisis in general practice. Helpfully, it does not overclaim for Pharmacy First, which as we have already seen has not been without its teething troubles.
Perhaps all three parties now converge in faith that the invisible hand of the free(ish) market will sort out medicine supply issues
Their plan to work towards a fairer and more sustainable long-term funding model sounds promising, given cuts and freezes to pharmacy budgets since 2016. They also mention moving to give qualified pharmacists greater prescribing rights and a remit to offer public health advisory services: these too are framed as ways to free up more time for GPs.
The Conservative Party proposes to expand the remit of Pharmacy First — the scheme they nicked from Scotland’s innovation — to also cover menopause support, contraception and treatment for chest infections. To fund this expansion, they pledge an extra £1.7bn a year by 2029/2030, which will also fund GP surgeries, community diagnostic centres and mental health services. It is not clear what share of this would be reserved for Pharmacy First.
Their other mention of the sector is more of a generalised allusion: they plan to invest proportionately more in out-of-hospital services over time. How much investment, over how many years and where the acute sector disinvestments will lie are all unclear.
Labour’s main mention is of its aim to set up a ‘community pharmacist prescribing service’, giving more pharmacists independent prescribing rights where appropriate. This will of course bring us back to the rather important issue of training supervision, which we have covered.
What is missing? Any mention of the significant closures that we have seen in the pharmacy sector over recent years. This feels like a curious omission. The loss of a local pharmacy has been an issue on more than a few aspiring local MP candidates’ campaigns.
Likewise, the manifestos do not address the ongoing shortages of medicines, which this column has also covered. Perhaps all three parties now converge in faith that the invisible hand of the free(ish) market will sort out these supply issues, as supermarkets successfully did with their food supplies during COVID-19 and energy companies did with natural gas since the war in Ukraine.
If that is their conclusion, and thus reason for inaction, then it is remarkable. Price rises have occured alongside both of those other sectors’ adjustments, feeding into the cost-of-living inflation crisis that has hit us all hard over recent years and necessitated interest rate hikes that make government debt more costly to service, leaving less money for highly strained public services.
The pharmacy sector deserves better attention than it has received in this general election campaign. It all feels a bit ‘know your place’.
