Health Bill [HL]

The noble Earl, Lord Howe, seeks to amend this clause by requiring piloting and evaluation of pharmaceutical needs assessments. He is joined in this by the noble Baroness, Lady Tonge. I have listened to what the noble Earl has said, am not convinced of the strength of their case for piloting and hope to convince them about this. In the Bill, primary care trusts will be required to undertake and publish their assessments of pharmaceutical needs in accordance with regulations. These regulations would set out the structure and content of these assessments and how primary care trusts should carry them out. They would also enable the Secretary of State to set out the circumstances under which a primary care trust must make a new assessment. The department expects to work closely with interested parties, including NHS and contractors’ representatives, on drafting these requirements. When primary care trusts first developed their pharmaceutical needs assessments in 2004-05, they were not piloted. I am not aware that any strategic commissioning tools which PCTs have been tasked with developing, such as joint strategic needs assessments, were first piloted and evaluated. Of course, before this duty went live, there would have been wide discussion and consultation on specific requirements. We do not propose to act differently here. I well understand the concern that primary care trusts do not yet have sufficient capacity and capability to produce these assessments across the piece, but we have already put in train—with NHS Employers and as promised in the pharmacy White Paper—a comprehensive support programme for primary care trusts. The first element of this, Pharmaceutical Needs Assessments (PNAs) as Part of World Class Commissioning: Guidance for Primary Care Trusts, was published by NHS Employers on 7 January this year. Further resources will be available later this spring to include guidance on how to commission pharmaceutical services and more detailed advice on the information that these needs assessments should contain. A formal piloting and evaluation programme would mean a delay of at least two years, and probably longer, in achieving the goal of universally strengthened local assessments of pharmaceutical needs. That is not a delay that we would wish to see. I will not address the amendments of my noble friend Lady Gibson, as they have not been spoken to. I am sure that she will bring them back at an appropriate time if she so wishes. The second amendment of the noble Earl, Lord Howe, in which he is joined by the noble Baroness, Lady Cumberlege, proposes a requirement for the Secretary of State to publish guidance on the manner in which commissioning of pharmaceutical services may be informed by the results of an assessment. The virtue of producing guidance to support the regulations is that it can go much wider if it is not tied to the regulations. It can explain what is—and, importantly, what is not—in the legislation. I would not want to fetter this freedom in any way. I referred earlier to the comprehensive support programme for primary care trusts that we are putting in place. Given the action already under way, we are not convinced of the need to bolster that with a new legislative duty. The noble Earl referred to new pharmacy contracts awarded as a result of the PNA. No information is currently held on that centrally. Under the current legislation, PCT decisions are not required to be based on PNAs—hence the proposals in the Bill. I hope that I have been able to reassure noble Lords sufficiently on these matters and that the noble Earl will feel able to withdraw his amendment.