Over the counter not over the top

Country Life Every Week - - Letters To The Editor - Fol­low @agromenes on Twit­ter

EVER alert to threats to ru­ral ser­vices, Agromenes read with con­cern press re­ports of sig­nif­i­cant cuts to the net­work of com­mu­nity phar­ma­cies. The news­pa­pers head­lined the fact that the Chan­cel­lor has slashed £200 mil­lion from the sub­sidy for these chemist’s shops. They also re­vealed pri­vate let­ters to Theresa May from the Trea­sury and the Depart­ment of Health that seemed to suggest bud­get cuts would mean large-scale ru­ral clo­sures. There were dark hints of the Prime Min­is­ter’s per­sonal con­cern. The scene was set for a cam­paign by the Coun­try­side Cru­sader.

How­ever, there was some­thing a bit fishy about those sto­ries. The clar­ity with which health min­is­ters claimed that no se­ri­ous re­duc­tion is ex­pected made Agromenes pause. It was just too de­ter­mined to be dis­missed as, in­deed, was their claim that a spe­cial aid scheme would largely pre­vent ru­ral clo­sures. Are we be­ing fright­ened un­nec­es­sar­ily or is this a Gov­ern­ment cover-up? Agromenes set out to find the truth.

This phrase ‘com­mu­nity phar­macy’ gives the im­pres­sion that we’re talk­ing about some spe­cial cat­e­gory of par­tic­u­larly lo­cal and benev­o­lent ser­vice provider. It’s just a smart name for chemist and there are more than 11,600 of them across ev­ery part of the coun­try, ur­ban and ru­ral. Im­por­tantly, the num­ber has in­creased by 1,555 since 2007, which doesn’t suggest they’re ex­actly be­ing squeezed.

Nev­er­the­less, cam­paign­ers claim that be­tween 500 and 900 are li­able to close. This is a much smaller num­ber than they trum­peted last year and has tum­bled from 3,000 in May 2016 and 1,600 last Oc­to­ber. The clo­sure threat has di­min­ished to be­tween 4% and 8% of a to­tal that has only re­cently in­creased by 15%. In­deed, it turns out that 89% of the pop­u­la­tion has to walk for less than 20 min­utes to col­lect a pre­scrip­tion.

Un­sur­pris­ingly, all this costs the tax­payer a great deal of money: £2.687 bil­lion for this year alone. That puts the Chan­cel­lor’s re­duc­tion of £200 mil­lion into con­text. Of course, phar­ma­cists have a long train­ing and do an im­por­tant job. In ad­di­tion to dis­pens­ing medicines, they are in­creas­ingly tak­ing some of the weight off hard-pressed GPS. The law has been changed to al­low them to pre­scribe and this has en­hanced the con­tri­bu­tion they can make.

How­ever, mod­ern pack­ag­ing has made dis­pens­ing sig­nif­i­cantly less com­plex. It still de­mands great care and in­tegrity, but, thanks to com­put­ers and the in­ter­net, the doc­tor’s il­leg­i­ble hand­writ­ing is no longer the prob­lem it was.

That doesn’t mean they shouldn’t be paid prop­erly for NHS work, but it does mean that Min­is­ters should look care­fully to see that they’re get­ting re­ally good value for the vast sums it costs. Foot­fall in re­tail is every­thing and it’s the NHS pre­scrip­tions that gets cus­tomers into the shop. The whole sys­tem is a great ad­van­tage to the own­ers of chemist’s shops and en­ables qual­i­fied staff to be paid an av­er­age of £40,000 a year, which com­pares with teach­ers on about £35,000 and den­tists on £47,000.

The real pic­ture be­gins to emerge. A grow­ing net­work of prof­itable busi­nesses and prop­erly paid staff cries wolf over a very lim­ited cut in their NHS pay­ments. Ef­fec­tive spe­cial ar­range­ments for truly ru­ral prac­tices are put in place. The scream­ing head­lines turn out to be ex­ag­ger­a­tion to the point of un­truth. The real story is not about cuts, but about a sys­tem that could do with some whole­sale re­form to bring it up to date.

‘Min­is­ters should look care­fully to see that they’re get­ting re­ally good value for money

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