Topical views from an Onlooker's Notebook ...
Alistair Burt, the Heath Department Minister who has pharmacy within his portfolio, cried off at the last minute from attending the NPA’s triennial dinner in November last year. He apparently pleaded parliamentary business. But could it be that the pay cut for pharmacy that was shortly to be announced made him a reluctant attender. He could reasonably have expected that NPA chairman Ian Strachan would have made a strong case (as Ian did) for expanding the role of community pharmacists in the hard-pressed NHS and he surely would have known that pharmacy was about to face a severe haircut in the form of a reduced global sum. What could the Minister have said in his speech that would not have amounted to rank hypocrisy?
The government, as represented by NHS England, does, of course, see a bigger role for pharmacy. And this is spelled out in the letter it sent to the PSNC. But it does not want to pay for it; rather it wants to pay less than it does now. More for less – what kind of incentive is that?
The main problem, in my view, is that neither the government nor the profession in England has come up with a model for pharmacy practice in the 21st century. For all the airy fairy talk about optimising the use of medicines, NHS England’s big idea is hub-and-spoke dispensing, an untested macro system (which it supposes will save money), when medicines optimisation needs micro-management, ie, ensuring that each patient as an individual is taking the right medicine and is taking it properly. That is pharmaceutical care in its classic sense. But it is a practice that government has yet to support. There has been a bit of tinkering with MURs and the NMS, but nothing on a concerted scale.
NHS England seems to see potential for saving money though reducing the number of pharmacies. There are too many in some areas but government is far from blameless in this. A major reason was the changing of control-of-entry rules which led to the opening of many unnecessary 100-hour establishments. Governments create the problems and pharmacy suffers as it seeks solutions.
A rather sinister proposal concerns the possible introduction of a Pharmacy Access Scheme, which would provide more NHS funds to some pharmacies compared to others. How exactly would such a potentially invidious scheme work? How would worth be judged? I find the idea quite alarming.
There was no sign of any practising community pharmacists in the New Year Honours List yet again. Surely there must be some who go well beyond the call of duty and deserve recognition. There were, however, deserved OBEs for Norman Morrow and Bill Scott, recently retired chief pharmaceutical officers for Northern Ireland and Scotland, respectively. Bill Scott, in my view, could have got something one level up. His contribution to the development of community pharmacy in Scotland, with determined promotion of its clinical aspect, has been seminal if not revolutionary.
Also in the list of OBEs was Professor David Cowan, director of the Drugs Control Centre at King’s College London. Drug taking in sport is something that is always in the headlines. And it is worth reflecting that the late Professor Arnold Beckett, of Chelsea School of Pharmacy (now subsumed within King’s College), was a pioneer in sports drug testing. Prof Cowan is one of Arnold’s protégées.
I was sad to read that it is not only valuable silver that has been stolen from the Society, but also items from its museum collection (PJ, December 2015, p474). The museum losses, as with the silver (ICP, January 2014, p15), were noticed when cataloguing work was undertaken at Lambeth prior to the move to the new HQ at West Smithfield. Some retailers search staff as they leave the premises. Quite unbelievably, it would seem that our professional body would have benefited from having such a policy in place as well!