From Mr C. C. Cumming, MBA
SIR,—Contract limitation is there to save the taxpayer money and to give more efficient delivery of NHS services.
I was amazed at your correspondent (PJ, November 13, p783) suggesting that there is no call for contract limitation now that "cost-plus" has been abolished. One large pharmacy dispensing high volumes of prescriptions is always going to be more efficient to run, and cheaper for the NHS to fund, than three or four small pharmacies, irrespective of whether it is under the current practice allowance, fees and sliding clawback system of payment, or under a salaried system as Mr Nathwani proposed.
To abolish contract limitation would substantially increase the cost of pharmacy provision as there would be a flood of new pharmacies, none of which would need to be "necessary and desirable", but which could all claim practice allowances.
It would also reduce the average pharmacy turnover and hence raise the drug bill by reducing the average "clawback". Allowing Superdrug and others to obtain contracts where there is already adequate pharmacy provision would take money out of the system, which could be spent on improved patient care and adequate remuneration for existing service providers.
Nigel Cumming
Managing Director, Lindsay & Gilmour Chemists, Edinburgh