With proper leadership from government and pharmacy bodies, pharmacies’ place on the high street could be more secure, our correspondent suggests…
If there was one thing I was grateful for in November, it was that I felt no need to do anything about Black Friday.
Apart from being an American concept (which makes it suspect from the outset), this year it has struck me more than ever as a desperate rearguard action to stem the onslaught of the online shopping juggernaut.
While 2018 has been another annus horribilis for community pharmacy, there is a danger you can get too wrapped up in your own little universe and miss some of the other seismic changes that are being inflicted on the high street.
There is little doubt that things are changing rapidly out there. BHS, Carpetright, Homebase, House of Fraser, HMV, Maplin, Marks & Spencer, Mothercare, New Look, Toys R Us and Woolworths are all big name retailers that have either folded completely, been taken over or closed a substantial number of stores in attempts to save cash.
While the growth in online shopping is undoubtedly a major factor reshaping our high streets, it is not the only factor. As many commentators have noted, business rates don’t help, since the amount levied in local taxation is frequently disproportionate to earnings.
The rate is based on the rental value of a business property with relief available to smaller businesses. But in April the government began increasing business rates – and bills don’t always reflect a property’s current value. Even where there have been cuts to business rates, these weren’t always in proportion to drops in a property’s rental value.
The British Retail Consortium is blunt. “The business rates bill is having a dramatic effect – since 2015 there have been 3,200 store closures and over 50,000 job losses. Worse, it is hindering the successful reinvention of our high streets as it is a cost that few start-up businesses are able to bear,” it said.
Of course, the demise of the high street has been forecast before. The last big threat was our love affair with out-of- town shopping, led by the big supermarkets. Easy access and plentiful parking made it an attractive option, aided by local planning policies. Now out-of-town is feeling the pinch and forward-thinking local councils are looking more closely at their town centres, and in some cases working hard to make them welcoming.
Since I am generally an optimist, I am not forecasting the end of the high street. Television has not killed the cinema, cars have not seen off the train. People may no longer want to rent videos or endure what passed for customer service in their bank but the internet will not kill off the high street.
It is reshaping it, though, and it is instructive to see what is surviving, prospering even, in the changing environment. Hairdressers, convenience stores, fast food outlets, farmers’ markets and charity shops all seem to be thriving if I look around my town centre. Existing retailers are diversifying – and that includes pharmacies.
Essentially, high streets are switching to offering people-focused services that cannot be supplied by Amazon or Deliveroo. And we should not forget humans are sociable animals and town centres have always provided that opportunity to congregate and socialise.
Of course, a more sympathetic and supportive regulatory environment would help the high street evolve as the social institution that I suspect we all want it to be, even if we do shop online. However, the government has got other things to worry about at the moment, so enlightened legislation might be too much to hope for.
Overall, though, a more people-focused high street should be good news for community pharmacy. I might lose some scripts to the internet (until I get my own online operation set up, of course) but good healthcare is still driven by effective personal interactions.
During the ICP Awards in October, Wales’ chief pharmaceutical officer Andrew Evans said: “On every high street in Wales pharmacies are among the key institutions that keep our societies together, build a sense of community, promote longevity and create health.”
It seems to me that in the context of our changing high streets he has hit upon a key point.
Prime Minister Theresa May has outlined plans to make a significant investment in primary and community healthcare in a bid to ensure patients can receive care close to home. Community pharmacy needs to be part of that investment.
Health secretary Matt Hancock has set out his vision to put prevention at the heart of the nation's health. His argument is that in the UK, we are spending £97 billion of public money on treating disease and only £8 billion preventing it.
He is right to say that “a focus on prevention and predictive medicine isn’t just the difference between life and death, it’s the difference between spending the last 20 years of your life fit and active, or in constant pain from a chronic condition. So our focus must shift from treating single acute illnesses to promoting the health of the whole individual.”
All this suggests to me that with some enlightened leadership from both government and community pharmacy bodies, our place in the high street is more secure than a focus purely on dispensing remuneration might suggest.
There is no room for complacency, though, and there will need to be changes in the way pharmacies operate within the NHS envelope.
So as 2018 drifts to an unsatisfactory end, I am trying to persuade myself that in the great scheme of things, my situation could be worse. And what will 2019 bring?
I suspect that after the shambles of the last two years, next year will see a ramping up of pressure to revise the community pharmacy contractual framework.
From memory, the last time there was such pressure for change back in the early 2000s, it took around five years to see an outcome. There will be other things to lose sleep over in the meantime.