The Pharmaceutical Journal Vol 267 No 7162 p261-263
25 August 2001

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Health statistics

Wrong figures

From Mr I. M. Caldwell, FRPharmS

It is not given to many editors to be able to embellish a well known quotation but you have now added to the adage “lies, damned lies and statistics” the extension “and some calculations by the Office of Health Economics”. I refer of course to your report of the launch of the OHE Compendium of Health Statistics and the claim that the UK has only 0.2 practising pharmacists per 1,000 of population (PJ, 21 July). Really? One does not need a profound understanding of the politics or economics of professional resources to question this bizarre conclusion, merely the arithmetic skills which my generation were expected to demonstrate at eight years of age. With a ratio of 0.2 pharmacists per 1,000 and a register of 44,000, we can prove that the population of the U.K. is 220 million. This is over 3.5 times what the current National Statistics website would lead me to expect. A crude comparison of the register (44,000) with population (59.8 million) yields a ratio of about 0.73 pharmacists per 1,000 people. Perhaps the OHE has used a formula to define a practising pharmacist — a full time equivalent? My own estimated FTE register for the Cardiff British Pharmaceutical Conference in 1999 would indicate approximately 30,000 FTEs from the current register. Even using this, the ratio only falls to about 0.5 per 1,000.

As well as being cavalier with the calculator, your report suggests some anomalies in the international comparisons. Figure 4.13 of the Compendium indicates that the comparators are from “selected OECD countries”, circa 1998. Had the broader EU membership been included, Denmark and the Netherlands would have been seen to be on a par and Sweden to have a ratio of about half of either of those (according to the Pharmaceutical Group of the European Union). It would be a brave man who suggested that any of these countries have anything less than progressive, innovative pharmacy. Outwith Europe, my own figures, drawn from source (BPC 1999), show Australia, Canada, New Zealand, the US and ourselves to have similar resources (range 0.61 to 0.73 per 1,000). The UK is firmly in the mainstream of pharmaceutical resources. I labour this point to emphasise the danger of equating numbers with any undefined concept of quality.

You quote Adrian Towse of the OHE as saying “the number [of pharmacists] will continue to decline”. What decline? There has not been any decline in the register over the past 40 years. Indeed the expansion of the capacity of the UK schools of pharmacy during the 1990s involved much investment in facilities and personnel and, since they get paid per capita and they attract other finance based on volume and quality, they are unlikely voluntarily to choose to contract after the four-year degree is finally implemented. Conventional wisdom holds that an annual increment of around 800 new pharmacists is enough to maintain the register at a static level, whereas registration is currently around 1,400 new registrants per annum albeit with a one-off blip for the change to a four-year degree in England and Wales.

Far from contemplating a decline in numbers, I can only repeat the warning I made at Cardiff, namely, that the overall challenge to the profession is to make certain that, in 20 years’ time, there are challenging, rewarding and worthwhile careers for over 30 per cent more pharmacists than we have today. We continue to attract some of the brightest and most dedicated graduates in Britain and we owe them at least that much.

From my time as chairman of the Royal Pharmaceutical Society’s Manpower Committee, I am well aware of the many nuances of the present recruitment and retention situation both in the UK and overseas. Misleading drivel from a normally authoritative source such as the OHE does nothing to help anyone involved in this sphere. I trust we can look forward to an early and widely disseminated correction by the OHE together with an explanation of its methodology.

I. M. Caldwell
Larkhall, Lanarkshire

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