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Letters to the Editor
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Community pharmacy
Threshold could force pharmacies to close
From Mr H. Gitter, MRPharmS
I could not agree more with Mark
Griffith’s letter “PSNC
is simply out of touch with reality” (PJ, 16 February 2008, p180).
One serious aspect of the Pharmaceutical Services Negotiating Committee’s
so-called negotiations, which has received relatively little press, is
the implementation of the iniquitous and irrational escalating prescription
items per month threshold.
The points made in Mr Griffith’s letter apply equally to low dispensing
volume pharmacies (LDVPs), which face a £20,000 annual shortfall
after March 2008 in borderline cases. If they are forced to close local
communities will be deprived of a valued service.
The rising threshold can only be interpreted as a deliberate agenda to
close several hundred smaller pharmacies.
How has this situation arisen? About two months before the ballot, PSNC
chief executive Sue Sharpe said that the new contract was to fund essential
services and that it was unacceptable that contractors should have to
depend for essential income on primary care trust commissioning.
The
new community pharmacy contract framework is not equitable and LDVPs
are now being told that they must supplement the shortfall in core funding
by approaching PCTs.
At a subsequent meeting involving myself, David Kent, another pharmacist,
and Glenda Jackson (our MP) with the then minister of state for health,
Rosie Winterton, the minister stated that the threshold concept had been
suggested by the PSNC and, as the new contract had been voted in, the
government assumed it to be acceptable. The PSNC claimed that it was
the government that had wanted thresholds and cut-off points.
So who are we to believe? Soon after the ballot, Mrs Sharpe wrote that “attempts
to discredit the new contract were regrettable”, and “those
that have most to lose shout the loudest”. Is this surprising?
Mrs Sharpe claimed a 92 per cent yes vote in the ballot. Untrue. The
turnout was 70 per cent, and 92 per cent of these voted positively — 64
per cent of all pharmacists. Of these, 52 per cent were multiples, national
or independent.
Mrs Sharpe’s claim that there would be an equitable share-out before
the ballot can only have two explanations. One is that she was trying
to instil a false sense of security into pharmacists, lulling them into
a “yes” vote, the other was that the PSNC actually believed
that this was going to be the case.
Subsequently, David Kent and I met Mrs Sharpe, and discussed three cost-neutral
funding alternatives. She promised to consider these at a forthcoming
PSNC meeting. One was rejected out of hand and the other two were not
considered.
And yet, in a recent spot on Radio 4’s You and
yours (11 February 2008), she had the audacity to claim concern
for smaller independents. Her behaviour shows the opposite to be the
case.
At a subsequent meeting on the issue, the PCT stated that it had no money
to supplement core funding via local pharmaceutical services or anything
similar.
So here we are. April 2008 is looming and I share with many others the
prospect of years of excellent service being rewarded with ruin. Is there
something rotten in the state of Aylesbury?
Harry Gitter
London
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SUE SHARPE, chief executive officer, PSNC replies:
The PSNC
has agreed with the Department of Health to cap the threshold
increase, in each
of the first two years of the new arrangements, to 3 per cent, significantly
below average prescription volume growth of about 5 per cent.
It is not correct that the threshold concept had been suggested by
the PSNC and I understand the DoH official who was present at the meeting
has written to Mr
Gitter or Mr Kent to clarify what was said by the minister. The PSNC gave careful
and full consideration to proposals put forward by Mr Gitter and Mr Kent, but
it did not agree with them.
I told the You and yours interviewer that closure of pharmacies is sad for
the pharmacists and also for patients who have established relationships with
their
pharmacist. That accurately reflects my views. |
IPF seeks emergency funding
Mr F. G. McCaul, MRPharmS
As an independent pharmacy contractor, I was astonished by the unhelpful
and dismissive reply to Hitesh
Patel last week from Pharmaceutical Services
Negotiating Committee chief executive Sue
Sharpe (PJ, 1 March 2008, p242).
Independent pharmacists
like Mr Patel are hitting the financial buffers in increasing numbers
as a result of a clawback about which there was
no warning and whose effects are indiscriminate, inequitable and unfair.
The Independent Pharmacy Federation (IPF) contends that there has been
no increase in net profits in community pharmacy since the introduction
of the contract in 2005. The profit to which Mrs Sharpe refers has been
invested in building an infrastructure that can deliver the promises
of the contract. The new contract is significantly more expensive to
service than its predecessor.
Rather than attempting to justify the unjustifiable, Mrs Sharpe and the
PSNC should be acknowledging that the new contract has failed to deliver
stability and a fair economic return for contractors. It has equally
failed to deliver the promised benefits to patients and is, therefore,
not fit for purpose.
Category M appears to be based on factory gate prices not available to
independents so that it primarily drives price reductions rather than
reimbursing what we have had to pay for medicines.
The sum of £500m
is insufficient to support the level of service being demanded of contractors,
nor is the concept of retained purchase profits designed to benefit all
contractors.
Over the coming weeks the IPF will be doing all it can to lobby for the
interests of disadvantaged independents in this inequitable situation,
which appears to be more than many of the “representative” bodies
seem to be doing.
For further information and advice, readers can visit the IPF
website or e-mail theipf@btinternet.com
Fin McCaul
Chairman,
Independent Pharmacy Federation |
The
Pharmaceutical Journal