The Pharmaceutical Journal
Vol 269 No 7206 pp53-57
13 July 2002

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  Repeat dispensing
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Letters to the Editor

Remuneration

An insult to pharmacists

From Mr D. M. Cane, MRPharmS

Leslie Kong's letter regarding locum rates (PJ, 6 July, p15) should have been headed "An insult to pharmacists" rather than "An insult to employers".

From his letter, I assume that in his pharmacy the only work carried out is the dispensing of NHS prescriptions — no private dispensing, no sales of pharmacy only medicines and no advice to customers that may lead to the sale of a P or GSL medicine; not even a simple discussion with a patient creating the goodwill that would lead to future custom.

The rate of pay for locum pharmacists compared to that of plumbers, car mechanics or even locum opticians is a pittance.This may be a cliché; nevertheless, it is true. May I suggest that if a proprietor can only afford to pay £15 per hour, his return must be so small that he would be better off becoming an employee.

Derek Cane
Bushey Heath, Hertfordshire

What is the big deal about £19 per hour?

From Mr R. B. Reynolds, MRPharmS

Why do we still value a pharmacist in terms of the number of prescriptions dispensed? Surely a locum pharmacist contributes a lot to the goodwill of a pharmacy, in terms of over-the-counter sales and advice. The value of a locum would be identified if the pharmacy had to close for the day.

In hospital pharmacy, the thinking is pharmacist-free dispensaries. In community pharmacy, the situation is pharmacists in their own dispensaries. Is this to do with good practice or money? I rather suspect the latter.

What is the big deal about £19 an hour (PJ, 6 July, p15)? I have an advertisement in front of me where a nursing agency is calling for district nurses at £21 per hour.

Robin Reynolds
Telford, Shropshire

Underpaid staff just will not do

From Mrs A. Morant, MRPharmS

In his letter "An insult to employers" (PJ, 6 July, p15), Leslie Kong, when questioning the affordability of locums, comes to the heart of the matter: "There are so many services that we provide without payment and many more we are being asked to do."

I do not question his statement that a locum would have to dispense 25 items per hour for an employer to break even. However, since the true costs of a staff pharmacist (taking into account holidays, National Insurance etc) are similar to those of a locum, the reality is that a staff pharmacist must be similarly burdened.

Under these circumstances, the urgent need is to reassess the structure of pharmacy remuneration. It should be based not on a non-stop dispensing treadmill but on a system where the value of the pharmacy, and of the pharmacist, to the community is recognised.

Do not forget that, when handing out a prescription, we already counsel the patient (or his or her representative). So it could be argued that the precedent already exists even though the over-the-counter dispensing of advice is currently valued by the Government at even less than the derisory dispensing fee.

This should be brought to the fore in negotiations. We need to open the door for suitable remuneration for a whole range of services that we provide to the patient free at point of delivery. But who are parties to these negotiations with the Government which is, after all, operating a monopsony in this area via the National Health Service? The Pharmaceutical Services Negotiating Committee, which unfortunately does not seem to be very effective, works on behalf of contractors and not locums.

On the other hand locums and owners/managers negotiate freely without duress on a one-to-one basis and, while the contract is often for no more than just a few weeks, both parties generally deal fairly with one another. After all, the locum wants repeat booking while the owner wants to be able to leave the pharmacy in the knowledge that it is good hands — irrespective of whether there will be 50 items or 250 items dispensed per day — and that customers will be happy despite the regular pharmacist being absent.

However, the over-riding caveat is that in the pharmacy the customer is only concerned that the pharmacist is able to provide the help required. Underpaid and overworked pharmacists — be they staff or locums — just will not do.

Annette Morant
Edgware, Middlesex

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