The Pharmaceutical Journal
Vol 279 No 7478 p565
17 November 2007

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• Retention fees (3)
• Pack sizes
• Supervision (2)
• Safety (3)
• Locum pharmacy
• NHS and pricing (3)
• The Society (2)

Letters to the Editor

NHS and pricing

NHS is surely required to exhibit restraint with taxpayers' money

From Mr N. M. Cameron, MRPharmS

Having worked in the UK for some months, I was somewhat disturbed by a company directive to dispense paracetamol 500mg in a 32-tablet pack size, which has the effect of doubling the payment from the NHS. The same applies for co-codamol, co-dydramol and tramadol.

We also were directed to get our unapproved medicines from a new supplier which charged four times the price of our former supplier. Incidentally I was not surprised to discover that the local dispensing doctors were also using small pack sizes for the same reasons.

It is the duty of every business to make as much profit as legally possible but these mechanisms should be equally robustly rebuffed by the NHS, which surely is required to exhibit restraint with taxpayers’ money.

We get the hoary old chestnuts about paying pharmacy, not for dispensing, but for some impossible-to-quantify service. This has not worked with doctors and the result has been more money for GPs and reduced service.

A sick person is no longer anything other than an anomaly and needs to be shunted off somewhere else as soon as possible. Our local GP actually sent a patient, requesting emergency contraception, home advising her to come back the following week.

The British costs are approximately three times per capita the expense of some eastern European countries that provide better levels of health care.

This would seem to indicate that the NHS is just throwing money at problems and is funded past its optimal level. This is difficult to fix since the expensive deadwood tends to be defensive. That the NHS fails to insist on getting the best bang for its buck is puzzling. The price of many drugs is artificially inflated and of no concern to the NHS.

In New Zealand the NHS pays 21p (in pounds sterling) for a 20g tube of clotrimazole, whereas in the UK the tariff price is 292p, more than 10 times the price. Salazopyrin costs 349p per 100 tablets in New Zealand but in the UK the price is 1,807p for 112 tablets, which is 4.6 times the New Zealand price per tablet.

I was told that I failed to see the larger picture. If this headless chicken state continues, nothing can save the NHS.

Neville Cameron
Coromandel, New Zealand

Conspiracy against the laity

From Rev G. J. Weeks, MRPharmS

Letters have been sent to The Journal that criticise changes in Category M. For years I wondered why tariff prices bore little relationship to the real prices at which I purchased drugs for the community pharmacy I manage. Then I was told the reason was a trade off. When we lost the on cost the negotiators settled for unreal prices.

The NHS can pretend it is paying what major wholesalers charge knowing full well pharmacists can buy at cheaper prices. Proprietors get profits hidden from the public and are happy. The NHS can say it has economised with no on cost.

Never has it been more obvious to me that a profession is in a conspiracy against the laity.

Graham J. Weeks
Greenford, Middlesex

Nationally agreed SLAs

From Mr P. M. Kirby, MRPharmS

I was at a meeting recently and realised how many millions of pounds could be saved within the NHS with regard to proposals for new enhanced services.

Currently service level agreements (SLAs) need to be adopted locally and only apply to a specific primary care trust. Therefore, the cost implications nationally are huge (due to unnecessary repetition) and, in addition, pharmacists working across various PCT boundaries need to comply and register with different PCTs.

Is it only me who can see the ridiculous situation we find ourselves in? Why not have a nationally agreed SLA for different enhanced services.

When a PCT decides to adopt a new enhanced service it could adopt the approved format. Pharmacists could then do the required training and register nationally on a register so they can work in any PCT.

Paul Kirby
Billingham, Cleveland

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