News

• Patients should pay towards medicines
• Government might change Controlled Drug rules
• Further EHC training arranged in south Wales
• Second call for SGM over PJ editor post
• NHS guide replaces Patient's Charter
• Information pack on new preregistration requirements in hospital pharmacy
• Alzheimer's treatment funding discrepancies

Patients should pay towards medicines

National Health Service patients should pay between £60 and £120 per year towards the costs of their medicines, according to a paper produced by the Adam Smith Institute, an economics think-tank.

The paper, "Paying for medicines", was written by Mr Ian Senior, a senior adviser at National Economic Research Associates. In it he suggests that the United Kingdom should adopt a co-payment scheme, similar to those already used in Sweden, Belgium and the Netherlands.

For example, in Sweden, patients pay the equivalent of the first £60 of the cost of any medicines they need during the course of a year. After that they pay a proportion, related to income, until a limit of the equivalent of £120 is reached, after which all further prescriptions are free. Patients have a smart card which holds details of the amounts already paid.

Mr Senior says that virtually everything is wrong with the current UK prescription charge system, set at a flat fee of £6 per item, because

It raises only a fifth of the costs of medicines prescribed in the community because most patients are exempt from charges
It is ineffective at containing demand for medicines, despite being raised every year since 1982
It denies patients knowledge of the cost of their medicines, denying them any possibility of choice
It does not promote social solidarity because both the rich and the poor pay the same charge

The report says that adopting a co-payment scheme at around the same level as the Swedish one would raise £2.2bn a year. This money could be used either to fund the availability of new and expensive medicines or to upgrade existing NHS facilities. Mr Senior estimates that at a threshold of £60 a year, a family of four in the lowest income group would be paying £3.40 a week for their medicines — only 16 per cent of the average discretionary spending on alcohol, tobacco and leisure.

The report is available from the Adam Smith Institute, 23 Great Smith Street, London SW1P 3BL (tel 020 7222 4995, www.adamsmith.org.uk).

Government might change Controlled Drug rules

The Government has indicated that it might make some changes to the prescribing of Controlled Drugs following representations by the Royal Pharmaceutical Society and the Police Foundation.

The suggestion that changes would be made came in the Government's response to the Police Foundation's report on the Misuse of Drugs Act 1971 and drug-related crime, which was published last year (PJ, April 1, 2000, p499). The report called for a general down-grading of the most common drug-related offences and reclassification of some Controlled Drugs, such as cannabis and ecstasy.

In relation to pharmacy practice, the Government says that it has asked the Advisory Committee on the Misuse of Drugs (ACMD) for fresh advice on adding items of "paraphernalia" to the list of exemptions under Section 9A of the Act. The ACMD is scheduled to discuss this at its meeting on May 31.

Amendments to the Misuse of Drugs Regulations are also under consideration, the Government says, in the light of a report produced by the Royal Pharmaceutical Society (PJ, March 21, 1998, p418) which the Police Foundation said should be given urgent and sympathetic consideration.

The Government describes the Society's report as "worthwhile in terms of the contribution community pharmacists can make to the delivery of an effective treatment service for drug misusers". It says that changes might be made to allow computer generated prescriptions for CDs and for computerised CD registers. On pharmacists amending CD prescriptions, the Government says that the Society's proposals are understandable but it wants to make sure a proper balance is struck to avoid improper prescribing. The views of doctors are being sought, it says.

The Government's detailed response to the Police Foundation report was published by the House of Commons Home Affairs Committee on February 6. The Government takes a hard line, specifically rejecting reclassifying cannabis, ecstasy or LSD, although it says that it might reconsider its view on cannabis in the future.

Drugs and the law, second special report. Home Affairs Committee. The Stationery Office, London. ISBN 0-10-207801-7. Price £4.75.

Further EHC training arranged in south Wales

The Welsh Centre for Postgraduate Pharmaceutical Education has arranged an additional training evening for pharmacists in south Wales in response to requests it has received.

The new session is to be held at the postgraduate medical centre at the Royal Glamorgan hospital, Llantrisant, on March 13, starting with a buffet at 6.45pm and the training at 7.30pm. The evening will also feature a presentation from Theatr Fforum Cymru.

Those interested in attending the training evening can contact the WCPPE on 029 2087 4784 or by e-mail at WelshCPPE@cf.ac.uk.

Second call for SGM over PJ editor post

The Royal Pharmaceutical Society has received a second request for a special general meeting to be held to discuss members' concerns over the appointment of a non-pharmacist as editor of The Pharmaceutical Journal.

Mr Ashwin Tanna, a former member of the Society's Council, told The Journal on February 21 that a written request for an SGM had been submitted to the Secretary and Registrar on February 20. It had been signed by 84 pharmacists.

The request calls for a meeting to be held on a convenient Sunday afternoon to discuss the motion: "This meeting has no confidence in the elected members of the Society's Council for offering a non-pharmacist the post of editor of The Pharmaceutial Journal."

Mr Tanna said that he wanted the meeting to be held as soon as possible. However, he would be out of the country between March 29 and April 16 and, since he was the proposer of the motion, he hoped that the Council would take this into account when deciding on a date.

The Society's Byelaws [Directory and Yearbook 2000, p33] say: "Upon the requisition in writing of not less than 30 members requiring the Council to convene a special general meeting for the purpose specified in the requisition, such a meeting shall accordingly be convened within such reasonable time as the Council shall think fit."

Mr Tanna said that he had written directly to the editor of The Journal (Miss Olivia Timbs) to say that the motion was not questioning her ability, merely that the Council had not taken into account the concerns of the membership when it had made its decision to appoint her.

Asked what he felt Miss Timbs should do if the motion was passed, he said that it would be up to the Council to decide. However, he added that he did not want the Council to resign en masse if it lost the vote of no confidence.

"I have only one issue here — The Pharmaceutical Journal. I do not want to bring the Council into disrepute," Mr Tanna said.

Mr Tanna said that he had also submitted motions for discussion at the Society's annual general meeting in May. He was also considering standing for election to the Council.

The Secretary and Registrar (Miss Ann Lewis) confirmed that a request for an SGM had been received. Miss Lewis said that she would be speaking to Mr Tanna about the request as soon as possible.

NHS guide replaces Patient's Charter

The Department of Health has published a new booklet, entitled "Your guide to the NHS", which replaces the Patient's Charter.

The guide was drawn up following reports produced by Mr Greg Dyke (director general, BBC) and the King's Fund. It sets out rights and responsibilities for both patients and National Health Service staff.

The guide starts with the 10 core NHS principles set out in the NHS plan. This is followed by nine commitments for patients, including self-care, listening to advice on treatments and medicines and paying prescription charges, and tips for healthy living.

Pharmacists are listed in the guide as a source of advice on minor illnesses and medicines. The guide says that pharmacists may ask questions to see if medicines are safe for patients to use and that patients should tell pharmacists about any medicines they are already taking.

In relation to prescribed medicines, it says that pharmacists will be able to give out medicines and information straightaway or tell patients when they will be ready to collect, often the same or following day.

The guide says that in the future NHS Direct will have details of when pharmacies are open in the evening or at weekends. By 2004, patients with chronic conditions will be able to pick up repeat supplies of their medicines from pharmacies without having to visit their general medical practitioner.

The guide will be evaluated in 2003 after which a revised version will be published.

Individual copies of the NHS guide are available in

English
Arabic
Bengali
Cantonese
French
Greek
Gujerati
Hindi
Polish
Punjabi
Turkish
Urdu
Vietnamese

by calling 0800 555 777 (8am to 6pm). Braille and audio versions are also available.

Bulk orders can be made on the NHS response line on 0541 555 455.

Information pack on new preregistration requirements in hospital pharmacy

A recent seminar organised by the National Health Service Pharmacy Education and Development Committee has led to the production of an information pack to help the implementation of the revised preregistration training requirements in hospital pharmacy. A major part of the seminar consisted of working group session in which participants debated and planned the way forward for implementing the new requirements.

The information pack, containing details of presentations plus the materials produced at the seminar, has been collated and copies are available from the committee's chairman, Professor Theo Raynor (D.K.Raynor@leeds.ac.uk).

Alzheimer's treatment funding discrepancies

A survey, by three London pharmacists, of the use of anticholinesterases in Britain has indicated "unacceptable discrepancies" in the funding by health authorities of these drugs for Alzheimer's disease (see p263).

Since the survey was carried out, in April, 2000, guidance on the use of anticholinesterases in Alzheimer's disease has been issued by the National Institute for Clinical Excellence (PJ, January 27, p103). That guidance said that the drugs should be made available on the National Health Service and prescribed under protocol. However, the survey of 95 health authorities throughout Britain has revealed that in the first half of last year only 28 per cent of them were providing funding under an agreed protocol.

The authors, from the South London and Maudsley NHS trust and Tower Hamlets primary care group, say that if health authorities are to comply with the NICE guidance, more that 70 per cent of them will need to alter their funding or prescribing arrangements in respect of these drugs.

They conclude: "Our survey has revealed unacceptable discrepancies in the funding and prescribing of drugs for Alzheimer's disease. Since NICE judgments are designed to aid such discrepancies, it will be interesting to evaluate the expected change to uniformity over the next few months."