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Remuneration
Forced to drop supply function altogether
From Mr A. R. Korsner, MRPharmS
Stephen Axon (PJ, 11 October, p491) misses the point of my
letter (PJ,
4 October, p448). I queried the fact that there appear to be more swings
than roundabouts. Mr Axon asserts that individual reimbursement would be
both difficult, expensive and maybe impossible. It would, however, be fair
.
What I was asking was “why did we ever agree to an averaging system
in the first place?”. It makes running a pharmacy a gamble with the
odds stacked against the contractor.
In my opinion we are only seeing the tip of the iceberg. There is now another
consultation document that needs serious reading and response entitled “Reimbursement
prices for four generic medicines” (see PJ, 18 October, p533). It
has already been estimated that if our negotiators agree to this one sided
imposition and vision for the future by the National Health Service, it
could lose the average pharmacy around £500 per month. Of course,
under the averaging system, 50 per cent of contractors might beat this
and make extra profit; the other 50 per cent could lose even more heavily.
The averaging system benefits the large contractors with buying power and
cash flow, while small contractors suffer. The averaged discount taken
from large contractors is reduced by the lower discounts obtained by the
small independents, but of course the small independents only get small
discounts. Eventually, with sufficient and constant attrition, half of
contractors could be forced out. The profession can never move forward
while contractors are forced to scrabble ever harder for the lean pickings
of a tiny so-called professional fee mooted to drop further in the next
few years.
If Mr Axon’s claim that averaging was brought in to prevent pharmacists “cherry
picking” is true then it is an insult to the profession. I have never
come across a pharmacist who refused to dispense an item, win or lose.
I see averaging only causing the opposite by cherry picking items that
would otherwise have to be supplied at a loss.
If the new contract does not take this into consideration, then I can see
pharmacies forced to drop the supply function altogether and concentrate
on the new roles rapidly becoming available. The Government should select
a method that is fair and equitable to all.
I shall be taking Mr Axon’s advice and responding to the consultation.
I recommend that all do likewise.
Adrian Korsner
London N20 |
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