The Pharmaceutical Journal
Vol 268 No 7200 p763-765
1 June 2002

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  Control of entry
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Letters to the Editor

Control of entry

Unrecognisable scenario presented by Mrs Sharpe

From Mr B. N. I. Bloom, MRPharmS

I simply do not recognise the scenario envisaged by Sue Sharpe (PJ, 25 May, p705). I can only believe that these remarks were made as part of a larger article.

Should there be any loss of control of entry, the loss of pharmacy services to the public is potentially catastrophic. Does Mrs Sharpe believe that the disposition and ownership profile of pharmacies will remain as at present? If so, she is naive at best. Pharmacy at large may well disappear as doctors take on dispensing, and are thereby able to reduce their patient list. There will also be relocation of those major multiple pharmacies that are performing less well to high streets or into health centres. The weight of money will ensure these chains obtain the best locations. Service to the patient will not count for much since the new supermarket pharmacies offer little in the way of add-on services; as we see in Leeds, Boots now charges for monitored dosage systems. I would remind Mrs Sharpe of the unique position of pharmacy allowing immediate access to a health professional.

The potential of new professional services only has merit if pharmacy serves the whole community and is not confined to small areas of the population. I agree with Mrs Sharpe that the Department of Health will have to reconsider its attitude to the provision of pharmacy services, but they will then be in the hands of a few large groups, without a vibrant private sector to keep these leviathans honest.

Within the present planned structure there is considerable opportunity to bring new services to all of the public.

Bryan Bloom
Leeds

Loss of control of entry cannot drive up standards

From Mr G. S. Phillips, MRPharmS

I read the report (PJ, 25 May, p705) in last week's Journal of Sue Sharpe's speech to the Nucare convention with a degree of concern. If ever pharmacy were to score an own goal with the Office of Fair Trading then surely, this was it.

As a community pharmacist I have invested everything I have in my pharmacy, so much so that I was proud to demonstrate recently to the Society's Secretary and Registrar (Ann Lewis) just what that commitment of resources means in terms of physical infrastructure, staffing and IT (PJ, 18 May, p700).

I have done this in pursuit of the sort of future envisioned by Lord Hunt's pharmacy programme. I have been able to finance the investment essentially because my bankers can see a long-term future for my business.

I have also been able to take up my positions as primary care trust prescribing lead, executive committee and board member, secure in the knowledge that my pharmacy would not be leap-frogged in my absence. I have enjoyed the full support of my local community pharmacist colleagues (both independents and multiples) who trust that my agenda is to promote the services of all the local pharmacies, not (divisively) my own.

This in turn has altered the perception of community pharmacy by the entire primary care team.

To suggest that the abolition of contract limitation would drive up pharmacy standards is about as logical as suggesting that Angus Deayton should be appointed to a Government think tank tasked with driving up family values!

The simple truth is that quality services requires investment, and that investment requires security. Neither of these will be possible if we lose contract limitation and return to the bad old days of pharmacy leapfrogging. The Hunt programme would be dead in the water, and with it all the aspirations of "Pharmacy in the future"

Mrs Sharpe, as chief executive of the Pharmaceutical Services Negotiating Committee, knows this better than anyone and, I am certain, would never have suggested otherwise.

Graham Phillips
St Albans, Hertfordshire

PSNC’s view on the loss of control of entry clarified

From Mrs S. Sharpe

The headline and opening words of your report of my talk to the Nucare convention, "Loss of control of entry could act as a catalyst to drive up quality of services" do not reflect accurately the Pharmaceutical Services Negotiating Committee's views and the point I was seeking to make to the convention. Loss of entry controls could be very damaging to pharmacy and patients.

As stated in the article, we believe that control of entry is important in securing access to pharmacy services, and that the National Health Service is best able to ensure high quality services for patients within a system that allows planning of pharmacy service provision, both for basic and for additional services. This also allows best use of the community pharmacy workforce.

In my talk I predicted that if control of entry were to go and there was no possibility of health service planning of pharmacies, the Department of Health might respond by reducing payments for "bare minimum" services, ie, dispensing, and switching funds towards a limited number of pharmacies providing new "quality" services. In this context, I said: "Even if we lose control of entry that would simply act as a catalyst to a complete drive that we all face towards quality." Far from driving up quality of services across pharmacies generally, this could mean that many pharmacies would be starved of the income needed to support a good pharmacy service for their patients.

The Pharmaceutical Services Negotiating Committee is fully supportive of developing new, high quality services for provision by community pharmacies, and is working with the Department to prepare a new national contract implementing the pharmacy programme. But it is essential that pharmacies' incomes are adequate to fund the present and future service properly.

Sue Sharpe
Chief Executive Officer,
Pharmaceutical Services Negotiating Committee

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