From Mrs M. M. Mortimer, MRPharmS
SIR,-Over the past few weeks there have been many letters concerning the possibility of emergency hormonal contraception (EHC) being made available as a pharmacy (P) medicine or using a protocol. Philip Walton of Manchester ably put the case for a protocol (PJ, May 27, p808).
When reviewing the branch representatives' motion (PJ, May 20, p766), the lack of knowledge displayed is alarming. Presenting the motion as a "defining moment for the profession", Mr Charles Butler stated that EHC was used to prevent the misery . . . of unwanted pregnancies, including those caused by the failure of other contraceptive methods.
But EHC is used in the absence of other contraceptive methods. The "ample evidence" of the success of EHC is, and can only be, an intelligent statistical estimate, as at that stage no person can know if fertilisation has taken place.
Schering very wisely did not seek a P classification of Schering PC4. I am sure many pharmacists have counselled worried mothers of previously healthy daughters who are curled up in pain on their bed, haemorrhaging and subsequently anaemic, for reasons completely unknown to the mother, or assisted a husband whose wife is collapsing with severe vomiting and he cannot contact the doctor. As pharmacists we have no access to case notes and no ability to prescribe effective counter measures.
How our insurance would cover such eventualities or the occurrence of pregnancy in spite of EHC I do not know.
Twenty years of experience with Levonelle-2 may not yet have shown the effects on lipid problems or breast cancer rates. Mr Nathan, at the special Council meeting (PJ, May 20, p762) honestly acknowledged that this debate had now become a political death trap. Only Mr Darling mentioned "the protection and well being of the woman".
The arguments the Community Pharmacy Action Group propose to defend the retention of resale price maintenance only fourthly mentioned that pharmacists' advice in the correct use of medicine is essential. Medicines are not on a par with other consumables.
I would hope that pharmacy's "defining moment" would come from more dignified professional and honourable subjects, eg, providing monitoring of medicines for the elderly, proper oxygen services, etc, not the administration of powerful drugs to healthy women who probably do not need them and encouraging irresponsible attitudes to sexual activity.
We seem to be saying that, as long as they recognise and pay us, we will do anything.
Monica Mortimer Enfield, Middlesex