The Pharmaceutical Journal Vol 266 No 7151 p784-787
June 9, 2001

  Code of Ethics
  RPM
  Medicines promotion
  Parallel imports
  Patient packs
  Disillusioned youth
  Veterinary medicines
  Travel medicine
  Nurse prescribing
  Working conditions
  Mutual recognition
  Disinfection techniques

RPM (2 letters)

Financial ruin

From Mr R. B. A. Johns, MRPharmS

In the light of the abolition of resale price maintenance on over-the-counter medicines, I am thankful that I retired from community pharmacy five years ago. I say this not only because were I still in business I would now be faced with financial destruction at the hands of the supermarkets, the two main multiples and the Department of Health, but also because the ethical framework within which a pharmacist was required to operate has been progressively (or should I say, retrogressively) eroded.

Since the “morning-after pill” controversy, it has been apparent that a pharmacist having reservations (moral, religious or, as mine would have been, practical) regarding the supply of that product was faced with the unenviable choice between stifling those reservations or losing at least a sale and possibly a degree of customer goodwill. Now it seems that even if the principles governing the sale of medicines generally are abandoned (principles inculcated during training, incidentally) there is an almost certain guarantee that not one but very many sales will be lost, and without any compensating benefit.

The article by Michael Thompson (PJ, May 26, p703) illustrates the point with depressing clarity. He quotes the chairman of the Pharmaceutical Services Negotiating Committee, Wally Dove, as expecting the Government to compensate for the loss of OTC business by an increase of “20p–30p” in dispensing fees. Is it really likely that a manifesto commitment to 10,000 extra doctors and 20,000 extra nurses during the next four years will allow even a halfpenny increase even if the will were there?

Mr Dove also says that pharmacists “must not assume that people will keep coming to them for OTCs” and that “there are going to be major shifts in who sells the majority of OTCs”, but at the same time they “will have to work twice as hard to hold on to market share”. I fail to see how they can work twice as hard to secure business from people who have stopped coming to them.

Mr Thompson then tells us that “only time will tell whether deep price cuts” (initiated by Boots) “will be maintained”. Since it has long been the case that that company could afford to sell many items at prices lower than those at which I could buy them, I suggest that any optimism on that score would be misplaced.

It is similarly discouraging to learn that pharmacists will not be behaving unprofessionally if “they choose to compete with the supermarkets”. As if! For the reason just stated, competition with the supermarkets can only come from the likes of Boots and Lloyds, which thus are the only beneficiaries of the revision of the Code of Ethics.

As regards the particular example of Boots’s “three for two” offer, I have seldom read anything so absurd as the suggestion that it is intended to do anything other than encourage a purchaser to buy more than his or her immediate needs dictate. And is it seriously suggested that the offer will be given no publicity, indeed will be kept so secret that a customer might unwittingly ask for two packs rather than one?

Finally, the biggest joke of all. It is not so very long since the permitted pack sizes of certain relatively innocuous medicines were reduced to safeguard the public. Is Nurofen really so much safer than aspirin?

R. B. A. Johns
Boston, Lincolnshire

Professional future beyond the end of RPM

From Mr J. E. Hill, FRPharmS

So resale price maintenance is at an end in Britain (PJ, May 19, p666). Already the black crape is being draped in memory of independents who will “find it much harder to maintain their professionalism in the face of competition from commercially driven, non-pharmacy outlets”. Yet, the very next paragraph has pharmacy outlets like Asda, Tesco and Sainsbury — led by none other than Boots — making efforts to increase market share through price-cutting tactics. The two sentiments (if we may call them that) are at odds with each other. 

Similarly, is community pharmacy (high street and supermarket) at odds with reality when it seeks to be credited as a health care provider while practising as a shopkeeper? Today the two are incompatible. Just because the mix was logical 50 years ago does not mean it will always be so. Nostalgia never begat anything but a green field on the other side of a fence. 

It is difficult to swallow the platitude that “many pharmacists will not be able to survive”. Survive what? There is a world-wide shortage of pharmacists. They, not managers, hold the reins. They will survive come what may — and we old consumers of pharmacists’ services can only hope for it — as providers of health care as against products. I made my first stab at that in 1961 (albeit in Canada) when the ruling belief was that “pharmacy cannot survive on the sale of prescriptions alone”.

I provided only prescription and counselling services, and with nothing else for sale, way before pharmaceutical care. And still running and still financially and professionally successful 40 years later, I have proved that dictum to be totally false.

So will those pharmacists in Britain who, undaunted by Britain’s abandonment of RPM, seek their true professional future outside product distribution, even outside pharmaceutical care.

John Hill
Ontario, Canada

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