Statutory Committee

Striking-off ordered for pharmacist who cheated NHS

A Sunningdale, Berkshire, pharmacist who was jailed for making false claims for payments under the NHS Essential Small Pharmacies Scheme is to be removed from the Register of Pharmaceutical Chemists on the direction of the Statutory Committee.

In deciding to strike off Rajiv Kumar Sarna (registration number 76820), the committee also took into account drink-driving convictions, a dispensing error that had put a patient into hospital, a large number of inappropriate sales of codeine linctus and the dishonest procurement of payment for smoking cessation services that had not been provided.

The committee also reprimanded Sarna Enterprises Ltd, of which Mr Sarna was a director and superintendent pharmacist at the time of the offences and the misconduct. The company owns two pharmacies in Basingstoke, Hampshire, and one each in Reading and South Ascot, Berkshire.

Drink-drive convictions

The committee’s decisions were made on 20 and 22 September after an inquiry that had begun a year earlier. At a hearing on 20 September 2004 (PJ, 5 February 2005, p160), which concerned Mr Sarna but not the company, the committee learnt that Mr Sarna had been convicted of driving offences on three occasions. The first was for driving while under the influence of alcohol, for which he had been fined £1,800, ordered to pay costs of £750 and disqualified from driving for two years. On that occasion an accident had also occurred and personal injury was caused. Mr Sarna had been fined £865 for failing to stop after the accident and ordered to pay compensation of £200.

The second occasion was another conviction for driving under the influence of alcohol, for which he was fined £800, ordered to pay costs of £69 and disqualified from driving for three years. After he completed a drink-driving rehabilitation course the disqualification period was reduced by nine months.

On the third occasion, Mr Sarna was convicted of driving while disqualified. He also had no appropriate insurance.

In addition, the committee considered a complaint from the Council of the Royal Pharmaceutical Society about a dispensing error in 2003. In response to a prescription for 28 bisoprolol tablets, to be taken once daily, Mr Sarna dispensed 28 bumetanide 5mg tablets labelled as bisoprolol with the instruction “please follow the directions given to you by the doctor”. As a result of taking the diuretic instead of the beta-blocker, the elderly patient suffered a severe angina attack and spent about nine days in hospital. The Council also complained that Mr Sarna had failed to give an adequate explanation of the error when the patient’s daughter wrote to him about it.

Giving the committee’s determination at the 2004 hearing, the chairman, Lord Fraser of Carmyllie, QC, said that Mr Sarna’s convictions appeared to arise from social drinking rather than a serious alcohol problem. The committee would postpone its decision for 12 months to allow him to “address his alcohol consumption and gain an insight into his weaknesses”.

Further offences

When the inquiry resumed on 19 September 2005, the committee was asked to consider further convictions and allegations of misconduct by Mr Sarna. It also included Sarna Enterprises Ltd in the inquiry.

The committee learnt that on 25 April 2005, at Winchester Crown Court, Mr Sarna had pleaded not guilty but had been convicted of 12 counts of false accounting, in respect of which he was sentenced to six months’ imprisonment (concurrent) on each count. The charges related to an abuse of the NHS Essential Small Pharmacy Scheme. Mr Sarna had overclaimed £7,500 by pretending that the company’s Ascot pharmacy had dispensed the qualifying low numbers of prescriptions when he had transferred the surplus prescriptions to the company’s other pharmacies.

The committee also considered a complaint by the Council that inappropriate supplies of codeine linctus had been made from the Reading pharmacy, where Mr Sarna was pharmacist in charge for about one day a week. An investigation by one of the Society’s inspectors had found that some 1,746 200ml bottles of codeine linctus had passed through the pharmacy during 2004. The Council alleged that Mr Sarna had permitted the inappropriate sales, had failed to ensure that non-pharmacist staff received training in the sale or supply of medicines and had failed to provide staff with specific instructions on the sale of pharmacy medicines, including codeine linctus. In addition, he had failed to ensure that his knowledge was of a high quality and up to date, and had admitted being unaware of the responsibilities of a superintendent pharmacist, despite having held that position since May 2001.

The committee also received a complaint from the Council alleging that in 2004 Mr Sarna had submitted to Reading Primary Care Trust a false claim for payment for nicotine replacement therapy supplied through the Reading Stop Smoking Service He had submitted a claim form accompanied by 16 vouchers that were said to relate to supplies of NRT to each of four participants in the service over four weeks. In fact, three of the patients had requested and been supplied with only one week’s NRT and the fourth had received no NRT. The PCT had paid the company £225.52, which was the total of the cost of the NRT claimed to have been supplied plus a £4 dispensing fee for each voucher.

The Council alleged that the convictions and misconduct were such as to render Mr Sarna unfit to remain on the Register. It also alleged that the false accounting convictions, the sales of codeine linctus and the false claim for NRT supplies were such as to render Sarna Enterprises Ltd liable to disqualification.

Counsel for Mr Sarna told the committee that the pharmacist admitted all the convictions and accepted that being erased from the Register was inevitable.

The committee heard that Mr Sarna had been a director of Sarna Enterprises Ltd from 15 June 1999 to 10 June 2005 and had been superintendent from 22 May 2001 to 31 May 2005. He had resigned from the company in June. His wife, an optician, now ran the family business with her mother. The company had a new superintendent pharmacist and Mr Sarna was no longer allowed on any of the premises.

Mrs Sarna begged the committee to allow her to keep the business. The pharmacies offered a great service to the community, she said. There had been “shame and disgrace” in her husband’s conduct, but integrity was uppermost for her family. She added that the pharmacies were now checked regularly by inspectors from three PCTs.

Reprehensible conduct

On 20 September, giving the committee’s determination in relation to Mr Sarna, the chairman said that the year’s adjournment had produced no evidence of an underlying problem with alcohol but it had produced no fewer than three other major matters to indicate that Mr Sarna was unfit to be on the Register. The first was the supply of “massive quantities” of codeine linctus to known drug abusers. Secondly, he had cheated the NHS of monies available under a scheme to stop people smoking. Most seriously of all, he had been convicted on no fewer than 12 charges of fraudulent claims on the NHS during 2002.

“In all these matters cumulatively,” said the chairman, “Mr Sarna has fallen so far below the professional standards of a pharmaceutical chemist that he warrants removal from the Register. … Mr Sarna’s conduct as a pharmacist has been reprehensible. … The passage of time has revealed that he has been milking the NHS of hard-pressed NHS funds and has acted with scant regard for the best interests of unattractive drug addicts, and has acted only to the benefit of his pocket.

“ Our direction is then for the removal of his name from the Register, and he would be ill-advised to make early application for restoration. He has shown himself to be utterly unworthy of the profession of pharmacist.”

Mr Sarna was told that if he wished to appeal he had three months in which to do so.

On 22 September, giving the committee’s determination in the case of Sarna Enterprises Ltd, the chairman said that, given the previous conduct of the company, it was clear that the three PCTs would keep a close eye on it and would take steps if there were any more breaches. For the time being, therefore, the committee would restrict itself to a reprimand; it would not disqualify the company from owning retail pharmacy premises.