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	The Pharmaceutical Journal Vol 269 No 7212 p247-249 24 August 2002	This page Reprint Photocopy
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EHC

Sad example of profits before patients

From Dr N. J. Gray, MRPharmS, and Mrs K. L. O’Brien, MRPharmS

It is disappointing for the profession that Tesco has bowed to the bullying of a vociferous political pressure group by suspending free supply of emergency hormonal contraception (EHC) to clients under the age of 16 (PJ, 27 July, p124). Young women in need of emergency contraception are among the most vulnerable and anxious of our patients. One of the greatest challenges of setting up the Manchester EHC scheme was to send a clear message to under-16-year-olds that the scheme was open to them, and now those messages will be mixed.

It was to be expected that pro-life groups would object to the provision of this service to these clients, but it was hoped that pharmacists would put the welfare of any patient coming to them for advice before the self-interest of one small section of the population, especially when we fought hard for the right to make these supplies in the first place. It would be interesting to know how individual Tesco pharmacists feel about this sad example of profits before patients.

There is one patient group direction approved in an area, and no one provider can introduce new exclusion criteria. If problems occur, providers must work with the commissioner to preserve the integrity of the scheme. It is worrying that Tesco issued a press release to its consumers announcing its decision, but has failed, as yet, to give direct notice to commissioners. This would have permitted a co-ordinated approach safeguarding the needs of patients. For all these reasons, Tesco pharmacies have been removed completely as providers by commissioners of the Manchester patient group direction scheme.

National Health Service onlookers must be considering the credibility of the profession. Anyone within the public sector who suspected that corporate bodies within pharmacy would compromise patient services to protect their business will not be impressed by Tesco falling at the first hurdle. It is to be hoped that this has not caused wider damage that will compromise further service development.

Supermarkets have repeatedly stated how useful it is for them to include pharmacies, and indeed by virtue of their extended opening hours they have become crucial access points for women. But Tesco has failed to provide commissioned services — not on the grounds of conscience, but of profit. It would be interesting to see Tesco's reaction if the 36,000 women who have used the Manchester EHC service chose to boycott its stores.

Nicola Gray
Karen O'Brien
Founder Project Managers
Manchester EHC Scheme

PENNY BECK, superintendent pharmacist, Tesco Stores Ltd, replies:

Our decision to withdraw from supplying EHC to under 16s was in response to the concern expressed by a sizeable number of customers. Their concerns were mainly about EHC being supplied to under 16s without the knowledge or consent of their parents. The changes we have made reflect how we listen to customers and react to their concerns.

We believed that the debate about EHC was more likely to proceed on a rational basis if it moved away from the disproportionate focus on one retailer and the widely held public misconception that Tesco was solely responsible for the pilot schemes. Tesco was one of many community pharmacies that were involved.

We have liaised regularly with the PCTs in the areas where we are participating in the schemes. We informed them individually of the decision to withdraw from under 16s supply and also gave advance warning to the Department of Health.

It is regrettable that as a result of the situation, we are no longer able to be part of the scheme in Manchester.

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