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Letters to the Editor
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PSNC
Why is the PSNC so unsure of its position?
From Mr D. R. Kent, MRPharmS
Your report on the revelation by Sue Sharpe, chief executive of the
Pharmaceutical Services Negotiating Committee, that in 2006–07
there are likely to be fewer
than 260 independent pharmacies dispensing
between 1,100 and 2,000 items monthly (PJ, 1 April, p372) and that fewer
than 100 may close in 2008, cannot pass without comment.
This claim was made at the local pharmaceutical committees’ conference
on 22 March and, when it was challenged, the conference was told that
it had come from the Department of Health; further details when requested
were withheld.
The latest published figures (Statistical Bulletin 2006/01) indicate that in
2005 there were 873 pharmacies dispensing fewer than 2,000 items per month,
of which approximately 600 dispense between 1,100 and 1,999 items per month;
there is no published evidence of the substantial drop which would be necessary
to support the PSNC’s claim. If we assume the same proportion of independent
and company pharmacies in this target group as in the total number of registered
pharmacies then there were 288 independent pharmacies during the period to
which the bulletin refers. This is, in fact, probably an underestimate.
Where, then, have the 188 or so missing independent pharmacies gone?
The answer could be that the PSNC expects them to close between now and the
end of the so called “period of protection” with the final 100
closing at that time; and if this does in fact take place it will be a direct
consequence of PSNC remuneration policy. With these independents dispensing
between 1,100 and 1,999 items per month standing to lose up to £20,000
of their net profit with no reduction in expenses it is likely that the majority
will fail.
There is no logic to the PSNC putting off a decision on varying the current
remuneration model when pharmacies, by the PSNC’s own admission, will
fail. If there is cause to vary the current remuneration model in 2007 or 2008
then that also pertains today. In the meantime, the lower dispensing volume
contractors are living with the stress of not knowing whether they will have
a viable business in 2008.
The PSNC suggests that these contractors serve no purpose; they are wrong.
To put their contribution into perspective, a pharmacy dispensing 1,800 items
per month is dispensing for about 48 patients per day or about double the number
of patients seen by a GP. Has anyone suggested that GPs with smaller lists
should also have their remuneration severely reduced? These pharmacies provide
a valuable personal service to their patients; it is not their fault that their
better placed colleagues
take most of the available prescriptions.
Another unexplored consideration is where the young aspiring independent contractor
will find an affordable first pharmacy after 2008. The PSNC
is pushing our profession further into the company-dominated scenario.
To come back to my opening premise, one really has to ask why the PSNC is so
unsure of its position that it has to put forward unsupported, and plainly
ludicrous, statistics to support an untenable position. The question of whether
the PSNC acts in the best interests of all those from whom it collects levies
also needs answering. The lifeline you report is illusory; these pharmacies
may be “on the agenda” but being on an agenda is a euphemism for “do
not worry us now” or possibly in the future.
David Kent
Secretary
Camden and Islington Local Pharmaceutical Committee
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SUE SHARPE, chief executive, PSNC, replies:
Mr Kent is confusing
figures. As the article to which he refers makes clear, the numbers
I referred to are those for England alone. The figures he quotes are
those in the NHS Statistics for England and Wales.
I estimated that in 2006–07 there will be fewer than 100 independently
owned pharmacies in England that are not essential small pharmacy LPS pharmacies,
that will dispense between 1,100 and 2,000 items. Analysis of the Statistical
Bulletin he cites tends to support this.
The Statistical Bulletin provides figures for the numbers of independent
pharmacies in England and Wales dispensing between 1,001 and 2,000 items
monthly (this
figure is calculated by deducting the number of pharmacies owned by chains
of more than five pharmacies from the total number of pharmacies, for this
dispensing volume):
1999–2000
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798
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2000–2001
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701
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2001–2002
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564
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2002–2003
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497
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2003–2004
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435
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2004–2005
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383
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If, as Mr Kent assumes, 10 per cent of these dispense between 1,000
and 1,100 items, those dispensing between 1,100 and 2,000 items in 2004–2005
was around 345.
The trend over the past five years has been an annual average of 20 per cent
reduction of pharmacies dispensing these volumes (due largely to prescription
volumes generally increasing — the statistics to which Mr Kent refers
confirm that over that five-year period, the total number of pharmacies has
remained fairly constant). Assuming that the trend of reducing numbers continues,
by 2006–07 the number of independent pharmacies in England and Wales
dispensing between 1,100 and 2,000 items would be 221. Wales has about 7 per
cent of the pharmacies, so 15 of these could be in Wales, leaving 206 independent
pharmacies in England dispensing between 1,100 and 2,000 items.
There is an estimate of 230 essential small pharmacies entitled to the ESP
LPS that are protected through the ESP LPS scheme negotiated by the PSNC. A
substantial portion of the ESP
LPS pharmacies would be dispensing between 1,100 and 2,000 items.
My estimate, therefore, seems eminently reasonable. |
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The
Pharmaceutical Journal