The Pharmaceutical Journal
Vol 275 No 7377 p652
26 November 2005

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Primary care in turmoil more
A warning from ‘The constant gardener’ more

Primary care in turmoil

Pharmacists are not alone, it seems, in struggling to come to terms with new working practices and health service reorganisation. The House of Commons Health Select Committee was recently warned that uncertainty over reorganisation is destabilising primary care and that the anxiety is affecting nurses as well as medical staff.

Last week’s BMJ (19 November, p1196) carries an article about competition in general practice, and draws doctors’ attention to the fact that the traditional configuration of a doctor serving his or her local population may be taken over by other models of care. As the editor points out in the same issue: “… the NHS revolution may be a wake-up call for doctors who haven’t yet seen the writing on the wall.” Replace “doctors” with “pharmacists” and we have a view with which many readers of The Journal will be familiar.

The Journal has written extensively about the opportunities on offer with the introduction of the new community pharmacy contracts and how important it is for pharmacists to be proactive and make sure that their primary care organisations know what they can do. We have also recommended that they develop stronger bonds with local GPs in order to fill the gaps in service that GPs are unable or unwilling to provide.

Traditional general practice appears to be under much greater threat than traditional community pharmacy but threats for some groups are invariably opportunities for others. Pharmacists could easily be the beneficiaries of the reconfiguration of primary care but they need to tread carefully and diplomatically. The first instinct of a group under threat is to behave defensively — which may partly explain the British Medical Association’s negative response to extended prescribing rights for nurses and pharmacists announced last week (PJ, 19 November, p621).

Nevertheless, ambitious and entrepreneurial pharmacists who play the game well should eventually come out smiling.

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A warning from ‘The constant gardener’

This week's News feature (p658) looks at the expansion of drug research and development in India. The article points out how opportunities have increased in recent years as India’s regulatory and R&D environment has changed in response to demands from international pharmaceutical companies. As a result, trials can be conducted more speedily than in the developed world, and companies in India are now seeing a surge in innovative research. This is good news for such emerging economies, provided that local populations — and not just patients and shareholders in the developed world — benefit from the opportunities. The recently released film ‘The constant gardener’, a meticulous recreation of the novel by John Le Carré, portrays how things may go wrong if greed becomes the driving force. Let us hope his fiction does not become fact.

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