The Pharmaceutical Journal
Vol 279 No 7476 p498-499
3 November 2007

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Letters to the Editor

Community pharmacy

Draining the profits of contractors large and small

From Mr I. R. Aldred, MRPharms

Since selling my business about two and a half years ago I have relocated and become a locum. What I see on a day-to-day basis reassures me that I made the correct decision. Examples are as follows:

• Nursing homes and home care agencies insist on monitored-dose packs for patients in their care

• District nurses present prescriptions for large numbers of expensive dressings

• Hospital outpatient departments are prescribing 90-day treatments

• Patients can elect to have prescriptions collected from the surgery and delivered to their homes

• GPs are prescribing 12-month supplies of oral contraceptives and hormone replacement therapies, three-month supplies to patients who pay levies, three-month supplies to a 90 year old, which includes 692 paracetamol tablets and, to another, 500 loperamide capsules

With all this and more happening on a daily basis, draining the profits of contractors large and small, there is the ignominy of the £400m clawback by the Department of Health, which set the price of drugs in the first instance.

How will it all end?

Ivan Aldred
Paignton, Devon

A collective body representing the majority of working pharmacists

From Mr G. Diamond, MRPharmS

Paul Francis (PJ, 27 October, p466) suggests that contractors take strike action regarding the NHS contract, which is no doubt well intentioned but is both a romantic and an achronistic attitude to the current situation in community pharmacy.

Happier days, when pharmacies were owned by individual proprieters, have long since disappeared and the economic and social environments have moved on too. Complex patterns of pharmacy ownership from global conglomerates to the sole trader currently exist.

Unity and collective industrial action are the dreams of the 1970s and the limited preserve of the British Medical Association.

Hard-pushed employee community pharmacists need to become more unified in a professional representative body akin to the BMA or the Royal College of Nursing, in a body that represents their interests as employees and as a profession.

Medium-sized companies and major multiples may need to be dealt with by a collective body that represents the will of the majority of working pharmacists on their needs as a profession and as employees.

However, the Prime Minister has signed up to a new constitution for the EU but has refused to sign up to the Charter of Fundamental Human Rights that would have facilitated a better collective bargaining power for employee representative bodies. So to some extent this has limited the impact of making any headway for hard-pressed community pharmacists, perhaps under intense pressure to meet targets.

However, pharmacy is only one profession feeling overburdened. My partner is a nurse and his profession has seen up to 50 per cent of its membership leaving nursing due to low pay and increased responsibilities. They have a much worse time of it than pharmacists.

Also, a fellow officer in the Royal Army Medical Corps has complained about the low salary as a practice nurse in the community as GPs expect even more in terms of clinics, prescribing and additional administrative duties too. So we are not alone.

Perhaps the answer is to form a broader coalition of professions allied to medicine to have our voices heard more effectively in the future. Ultimately, in a profit-driven environment we become aware of the price of everything and the value of nothing.

Gerry Diamond
Manchester

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