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Letters to the Editor
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Value added tax
No VAT please, we’re pharmacists!
From Mr G. A. Boorman, MRPharmS, and Mr H. R. Patel, FRPharmS
Your coverage (PJ, 24 January, p77) of a commercially motivated campaign
over reduction in VAT on non-prescription medicines brought to mind the
professionally motivated submission of the North-East London Local Pharmaceutical
Committee to the Government in June 2000, during its National Plan for
NHS consultations. The LPC said at the time that over-the-counter medicines
that are of proven efficacy in priority areas of health promotion and children’s
medicines should be zero-rated for VAT.
Pharmacists already provide a health promotion and disease prevention role
as part of their current contract. However, this role could be significantly
extended and made more relevant to the particular needs of the local population.
Pharmacists can provide a valuable role in relation to primary prevention
(such as healthy lifestyles and smoking cessation) and secondary prevention
(for example, provision of aspirin and blood pressure/cholesterol monitoring
post myocardial infarction).
Given the marked differences in the demographic distribution of disease,
effective prevention policies are a vital component in the drive to address
health inequalities. Community pharmacy services can be an essential tool
in this endeavour. As has been noted, the use of pharmacy services is associated
with deprivation as is the mean dispensing volume per population. Thus,
local pharmacies are a particular resource for deprived populations. Studies
suggest that convenience of access is an important determinant for pharmacy
use and a third of patients arrive by foot — the need for pharmaceutical
services therefore may be higher in areas where car ownership is lowest.
This underlines the need to ensure that the distribution of pharmacies
is maintained in deprived areas of London and other cities.
Many OTC medicines are of proven effectiveness in addressing the health
priorities of the Government. For example:
· Nicotine replacement therapy to counter coronary heart disease and cancer
· Aspirin 75mg for secondary prevention of heart disease
· Folic acid supplements for pregnant women
· Liquid paracetamol to relieve fever and pain in infants and young children
The costs of such treatments, however, can be prohibitive, particularly
for those on low incomes. For example, NRT may cost £15 per week.
(Although this is cheaper than cigarettes it provides little incentive
to smokers to address their addiction.) Reducing the price of these treatments
may play a significant part in encouraging their appropriate use, with
consequent health benefits.
As part of a targeted health promotion strategy we recommend that the Government
designates these (and other selected OTC medicines) as zero-rated for VAT.
Glucose monitoring kits and nebulisers are already VAT-exempt if a patient
fills in an appropriate claim form. Similarly, all children’s medicines
must be zero-rated in line with current policy on shoes and clothes.
It is not too late, with a general election looming in around 18 months,
for the profession to collectively back the campaign and be seen as a champion
of the common man. But, whether community pharmacy seizes the opportunity
to lobby on professional grounds remains to be seen.
Gary Boorman
Chairman
Hemant Patel
Secretary, North East London Local Pharmaceutical Committee |
The
Pharmaceutical Journal