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The Pharmaceutical Journal Vol 267 No 7178 p848
15 December 2001

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Promises and platitudes — a false dawn for community pharmacy

By Bob Arora, Jignesh Patel and Shiv Bagga

A kick in the teeth is a kick in the teeth. But since this kick has been administered over and over again in the past decade it cannot be viewed as accidental. While dentists are rewarded by having their overpayment written off, pharmacists are being told to "get lost". This is unjust and smacks of prejudice against pharmacists.

Hazel Blears has refused to write off the £8m "over-payment" for dispensing an additional volume of prescriptions written by general practitioners. Yet there is a precedent. According to the Financial Times, the Government has written off nearly £500m overpayment made to dentists over the past decade. This Government is run not by firm and abiding principles, but by delivering what the Treasury wants in the short term and what it can get away with. The Government is more interested in political spin than in justice and fairness. In short, we have a Government that is dishonest, unprincipled and anti-professions.

The "settlement" for community pharmacy is a disgrace, and the claim that the global sum has increased by more than 4 per cent in 10 years is an insult to pharmacists who have increased productivity by enormous amounts without volume increases being taken into account. For a Minister to boast that "in real terms the average pharmacy's income from this year's global sum will be around 4 per cent greater than a decade ago" shows that she has no understanding of actual costs of running a business let alone a pharmacy. Apart from dispensing prescriptions, pharmacists have had to finance the growth in cost of prescriptions which have been running at around 10 to 12 per cent a year.

In July 1998 (PJ, 4 July, 1998, p14), the then Secretary of State Frank Dobson said: "I have decided that the time for platitudes is over. I want to see pharmacists providing advice and care as well as dispensing. I know that extending the role of pharmacists in the community would command the support and encouragement of doctors and nurses. Not enough use is being made of the professional skills and training of community pharmacists. There is a new and extended role far greater than before, particularly with the prospect of new and more complex pharmaceuticals and the fact that non-pharmacists would find it harder and harder to keep up with developments. The time is right that the full potential of community pharmacy was exploited."

Well, community pharmacists are now fed up with the "kidology" and it is time to say stop exploiting community pharmacy.

In September 2000, more than two years after Mr Dobson Spoke, Lord Hunt published his strategy for pharmacy: a strategy without resources, but with milestones; a strategy that does not address the issues of workforce and technology; a strategy full of vagueness and promises. There is the question of whether community pharmacists will be able to prescribe on the National Health Service (which was Mr Dobson's strategy) but this has not yet been addressed.

We now have a new Secretary of State and a new Health Minister in Hazel Blears.
I can see signs that the various milestones are not going to be met (eg, electronic prescription transfer pilots, pharmacist prescribing). Ms Blears has kicked pharmacy in the teeth, but she must not get away with it.

We have to kick back by damaging the Government's credibility in areas of health care. Locally every story of an NHS mishap and inadequacy should be brought to the public attention by locally produced posters describing instances of NHS failure. At every opportunity in the pharmacy, we must expose the inadequacy of the NHS. Every delay in supplying a drug must be blamed on the Labour Government. Every delay in getting a hospital appointment must be portrayed as the Government's failure to deliver on promises made at the election. With over six million people a day visiting a pharmacy we must ask the public, "Whatever happened to the NHS?"

The public must be told, where appropriate, that we have to, due to Government policies, collect prescription charges that are greater than the cost of the medicines.

Staff must know why they cannot have a pay rise. And neighbouring businesses must be told about increasing Government-imposed workload and lack of resources and how this Government is against small business.

At every dinner party, meeting or gathering, at least once, a pointed reference must be made about this unjust and story spinning Government. War should be waged to change perceptions and to reinforce the negative images portrayed by the opposition against the Government. The Minister believes pharmacists are "can do" people. Let us prove her right!

Our campaign must be consistent, hard hitting and prolonged. Labour's Achilles heel is health and education. Now, we must act in a co-ordinated way right round Britain. We must take decision making for such activity out of the hands of our national leaders and place it in the hands of local leaders. Nationally implemented local action is more effective than nationally devised strategy.

Past health ministers have given us promises and platitudes and nothing else. Lord Hunt gave us an unresourced strategy. And now insincere Hazel Blears is in the slow process of redirecting us so that no new money has to be found during her tenure in office as Health Minister. She is now asking us for more new ideas to practise in a manner similar to dear old Frank before he moved on into obscurity. Soon there will be another minister telling us how much the public appreciates us and how much the Government values pharmacy. Colleagues, if you lack self-respect and are satisfied with the "settlements" over the years — particularly now — then do nothing. Otherwise, pressure local organisations into action and be relentless in pursuing the objectives outlined above.

If we are going to go down then we must drag the "story spinners" with us. The current settlement is not about rewarding pharmacy; it is about humiliating and insulting a sector of demoralised pharmacists.

The authors are from The City and East London Local Pharmaceutical Committee

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