From Mr B. D. Nathwani, MRPharmS
SIR,—The Superdrug document "The way forward" (PJ, September 11, p370) has received virtually universal condemnation as being self-centred.
As an occasional locum pharmacist I have no vested interest and only one agenda. To get a truly professional service, we should abolish pharmacy contracts and become a salaried National Health Service profession.
Let us look at the key issues the document addresses.
The rationale behind contract limitation was to stop the opening of too many small pharmacies in proximity because the "cost-plus" system of payment was costing the Department of Health too much. Cost-plus disappeared soon after contract limitation. The DoH had a game plan but the Pharmaceutical Services Negotiating Committee could not see it.
With cost-plus not an issue now, why not let 10,000 more pharmacies open? Surely these will open where there is a need or else they will run at a loss. That is simple commercial logic.
Contract limitation was supposed to help even out pharmacy distribution, moving pharmacies away from clusters and on to deserted council estates. Can the PSNC show us in concrete terms if this has happened and give 50 examples.
The freezing of contracts prevents demographic and shopping pattern changes to be served by pharmacies and creates an artificial barrier of entry for those with a real interest in broadening the range of services pharmacies can offer. If pharmacy contract limitation was removed pharmacies would open where they were needed, offering services that were needed. Why else would anyone waste their (or their shareholders' cash) in opening a pharmacy ?
The PSNC says that Superdrug is motivated by profit not patients, as if the other companies represented in the PSNC were not.
If we as a profession wanted to serve the public and were not motivated by profit, why not accept a fixed rate of return from the DoH? No more messing about with the Drug Tariff and parallel imports. Therein lies the crux. We have small-time businessmen and big corporations whose motivation sits at odds with what is a health care profession.
Profit is not an ugly word, but can we blame the DoH in not taking the profession seriously when the selling of sandwiches or nappies takes prime space in many pharmacies rather then the provision of professional services?
I am afraid that there are still far too many powerful and deeply entrenched interests who will stop real progress. The prognosis for the profession is clear: a slow and painful death with long and bellicose wailing last gasps.
B. D. Nathwani
Pinner, Middlesex