The Pharmaceutical Journal Vol 267 No 7179 p881-884
22-29 December 2001

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  Remuneration
  The Profession
  The Council
  The Society

Letters to the Editor

The Council

Light at the end of the tunnel

From Mr M. E. James, FRPharmS

Some 20 years ago, when cuts in contractor remuneration were discussed, I, as one who was then a contractor, took the same view as many of your contributors. However, being in a somewhat different position now I recognise that the Government has logic behind its case, and we should do well to consider it. In any event, it is always wise to try to put oneself in the other side's shoes, and try to view the situation as they appear to see it.

In this connection there were four interesting interventions in the Council's debate (PJ, 15 December, p872).

The first came from Kirit Patel, who urged the Society to support the Pharmaceutical Services Negotiating Committee's stance. This appears to be that pharmacy will go to the wall unless there is a rapid change in Government actions; why then is Mr Patel (PJ, 15 December, pA6) seeking to buy more pharmacies? The point has been made on many occasions: Department of Health (and perhaps appropriate Treasury) staff read the PJ. Which Mr. Patel should they believe?

Secondly Peter Curphey stated that parallel imports were not the fault of pharmacy. I am only a bit older than Mr Curphey and I can clearly recall that it was pharmacists who recognised the profits to be made from PIs so went out and found them. If he does not recall the debate over whether it was ethical to use them, I certainly do.

The third important intervention came from Dr John Evans. It would appear, from the two earlier comments, that a pharmaceutical contract is a desirable economic good. Although, it must be admitted, the effect of the present contract, with its stimulus to "beat the average" must have a limited life, at the end of 2001 a contract, in the right place, still sells for good money. In fact, the reapings are wider than just from parallel imports. The PSNC has, over the years, described the present contractual arrangements as satisfactory and if one looks at these arrangements then, in a situation of rises in prescription numbers, the present situation is bound to occur.

One contributory factor, I would suggest, is the growth in the number of weekly prescriptions in order to pay for monitored dosage systems. A recent paper (PDF* 80K)from the division of academic pharmacy practice at the University of Leeds (PJ, 1 December, p784) estimated that there might be some 100,000 patients in Britain receiving MDSs. If 75 per cent of these are receiving weekly prescriptions that represents around four million FP10 forms or 16 to 20 million items. This is 12 to 15 million items more than if monthly prescriptions had been written. Further, who gave MDSs away? I do not recall a clamour from homes for free MDSs. They were offered and indeed encouraged to accept them. I am also not aware of pressure from the PSNC to have schemes for these properly remunerated.

The last, hopeful, intervention, came from Digby Emson. If large companies are beginning to question whether the public-private partnership that is pharmacy is now economically doubtful, then maybe there is light at the end of the tunnel.

Finally, I must object most strongly to the overtly political tenor of "Broad Spectrum" last week (PJ, 15 December, p848). The current Government may not at present be community pharmacy's friend, however, although one can hope, it would seem that the likely alternative is the party which presided over this mess through the 1980s and most of the '90s. There is a place for political canvassing; The Journal is not it.

Miall James
Coggeshall, Essex

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