The Pharmaceutical Journal
Vol 268 No 7188 p311-320
9 March 2002

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Community pharmacists must build future, locally and nationally, LPCs told

Community pharmacists must build their own future, Pharmaceutical Services Negotiating Committee chief executive Sue Sharpe told the 2002 conference of local pharmaceutical committee representatives on 4 March.

"It is quite simply too important to leave to others. We sit back and wait for others to do it at our peril," she said. "The PSNC must be the engine of change at national level and you, in the new LPCs, must be the engine of change locally."

She explained that what the PSNC would be looking for in the new contract was a remuneration model that reflected the cost of providing National Health Service services, did not permit cherry-picking, retained incentives for contractors, offered rewards to marginally viable, but efficient, pharmacies and did not include the flaws inherent in the current global sum system.

"We need a common basis of understanding with the Department of Health on how much it costs to provide services and make them worthwhile." Hazel Blears, the Minister responsible for pharmacy, had expressed her own concern over a lack of information about costs and income, Mrs Sharpe commented.

Mrs Sharpe expressed the view that the Department of Health did not accept that the finances of community pharmacy are balanced on a knife-edge. Commenting on this year's remuneration imposition, which led to an immediate 10p cut in the dispensing fee, she said that it took the Department six months to come up with offers of 3.5 per cent and 3.7 per cent with no allowances for additional workload generated by Government initiatives, such as the National Service Framework for Coronary Heart Disease. The response to requests for a remuneration increase that reflected the additional workload was: "The global sum reflects the overall value of the service." This was followed by an imposition with no concessions for the extra work the Government had created.

"I believe this reflects a deep-rooted cynicism in the Department about the finances of community pharmacy contractors," Mrs Sharpe said.

The Department's view is of fundamental importance to the future of pharmacy, she went on. This was because proposals for reference pricing or central tendering for generics were likely to eliminate any chances for competitive purchasing, and thus, the income pharmacies could gain from it.

"We cannot support any unilateral changes to income streams for pharmacy," was Mrs Sharpe's view.

Turning to the Office of Fair Trading inquiry into competition in the pharmacy market, Mrs Sharpe said that the OFT was sceptical about all arguments that a particular market was special. The PSNC view was that health service planning should take precedence over competition policy, particularly given that the Government wanted to integrate pharmacy into health service planning. Hazel Blears was generally supportive of NHS contract restrictions, except as stated in the pharmacy plan regarding out-of-town shopping centres.

Mrs Sharpe said that the PSNC would need to develop its team in order to meet the challenges that lay ahead. There would be a new head of NHS services and a public affairs officer, plus commissioned reports on pharmacy finances. The cost of this would lead to an increased levy on contractors, amounting to an extra £26 a year for the average contractor.

Responding to questions, Mrs Sharpe said that she did not expect to ask contractors for more money each year, but she could not guarantee that further investment would not be necessary. She was not proposing a PSNC cost inquiry in order to prove to the Department what it cost to run pharmacy services. What was wanted was a cost of service model which could be used for the current and possible new contracts. Hazel Blears had been very positive about such a model.