Leading Article

In the spotlight

Emergency hormonal contraception has been in the spotlight again, even though Levonelle has yet to have its official launch. The media, consumer organisations and politicians are watching developments in this area closely, as we predicted (PJ, December 16, 2000, p871). The latest agent provocateur investigation by the Daily Mail highlighted cases where the paper felt that guidelines were being breached (see p101). The Royal Pharmaceutical Society is reminding pharmacists that its guidance on the handling of EHC sales is mandatory (see p108).

The Daily Mail’s investigation raises several important points. The first of these is that pharmacists must be seen to be following the Society’s professional guidance, for the sake of the profession as well as patients. Women, particularly young women, asking for EHC are a worried and vulnerable group and deserve to be treated in a professional and courteous manner. Detailed distance learning material covering some of the sensitive issues which need to be raised was distributed with The Journal last week and should be studied, however daunting it looks.

Increased availability of non-prescription medicines through pharmacies was one of the promises set out in the pharmacy plan for England. This promise will not become a reality if pharmacists cannot be trusted to discharge their duties in a professional manner. EHC is a high profile test-bed. If its reclassification is successful, then the Government may look favourably on other switches and on other pharmacy-based projects. Pharmacists must keep their side of the bargain.

Another point is the sale of EHC to girls under 16 years of age. The pilot studies, which used patient group directions, did not specify a lower age limit. The marketing authorisation for Levonelle, as a pharmacy product, technically prohibits sale to those under 16. However, young people will not be put off having sex by a few words on a package insert.

Young people are those most likely to be inhibited from approaching clinics or family doctors. Politically inspired restrictions with no medical justification should not be placed in the way of those in need of urgent help. Health care is political. The Government sets the overall budget for health care and decides which products can be sold, as private transactions, outside of this budget. The decisions about which patients receive which treatments, in all areas, should be left to professionals.

EHC is in the spotlight. The profession must give its best performance when dealing with it, otherwise it might not be given another chance.

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