The Pharmaceutical Journal
Vol 269 No 7218 p500
5 October 2002

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UniChem convention 2002 summary

Pharmacy profession is best prepared for diversity of supply, patient choice and competition in NHS

As Alan Milburn tries to recreate and evolve the National Health Service internal market and as Gordon Brown tries to control him, they must know that pharmacists are the clinical profession best prepared for diversity of supply, patient choice and competition, Kenneth Clarke, former secretary of state for health and senior non-executive director of Alliance UniChem, told conference participants.

He pointed out that the effect of national pricing was that a legal black market has been created in which entrepreneurs buy a product in a country where it has a low price, in order to sell it in another country where it is high priced. "In theory this price competition should all go to the benefit of the pharmacist," Mr Clarke said.

He believed that drastic reform is called for and said that the aim must be to get more sensible control of total costs while getting better quality of service and better value for money. "Pharmacists must be encouraged to use all their clinical skills to provide a full range of advice and a specific range of clinical services to patients who use them as one of their primary care gateways into the health care system."

He added that governments have acknowledged the desirability of this. But said they have unfortunately tried to achieve expansion of the pharmacist's role within the confines of complete and detailed control of the price.

"This system tends to destroy a lot of the incentive that pharmacists might otherwise have to control drug costs or to develop their service. The direct control of prices and rewards that the Government tries to achieve — as if high-street chemists were a profession employed directly — produces sub-optimal results." He added that Ministers would have to be prepared to persuade their Departments to give up detailed control. "The fact that a professional group prospers and earns more than is predicted should not be seen as a problem so long as they are prospering by raising their performance."

He went on to say that Alan Milburn, the current secretary of state for health, was now trying to revive some features of the GP fundholders scheme within primary care trusts. "As the new PCTs include all primary care and not just medical general practice, he should include some proper role for pharmacists."

He added that if pharmacists could take responsibility for repeat prescribing and at the same time lower costs, then they should be encouraged by allowing them to keep a fair share of the savings. In addition, if generic substitution and the proper control of quantities could lower costs, he asked why the bulk of the savings should be clawed back from the pharmacist.

"Ministers will have to rid themselves of any ideological fears that any financial incentives to independent contractors will somehow be bound to be at the expense of patient care and professional standards," he said.