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One year on: confusion reigns

Does the DH genuinely want anything positive to come out of its discussions with us?

Withering writes:

Is it really a year since the election that saw in this Conservative government? I remember giving a qualified welcome to Alistair Burt, the new health minister with responsibility for pharmacy. Naively, as
subsequent events have shown, I made some suggestions regarding how we could help with a number of problems that the Health Service was facing then and is still facing now.

I don’t flatter myself that this column is high on Mr Burt’s reading list, but perhaps it should be. I suggested that, for patients with mental illness, community pharmacists could play a role in improving access to repeat medicines and supporting adherence. I made this suggestion because mental health services were struggling, with too few beds and patients who relapsed too frequently, with many patients ending up on units hundreds of miles away from their homes before being discharged without adequate support. Since then, if anything, the situation has become even worse.

Then there was the pressure on A&E departments. The ‘Four or More Medicines’ study found that national implementation of a community pharmacy service for elderly patients taking multiple medicines would have several benefits, including reducing general hospital admissions and, specifically, reducing admissions to A&E departments as a result of fractures sustained in falls. Such a service would save more than it cost.

Finally, in concert with many groups in pharmacy, I pointed out the potential benefits from a national minor ailments scheme, possibly based on the one that had already successfully been established in Devon, with pharmacists even able to supply antibiotics under a PGD. However, one year on and we have gone not forwards, but backwards.

The situation is both troubling and perplexing. On one hand, we have the Department of Health demanding ‘radical’ ideas for the future of community pharmacy. Yet, at the same time, the Department of Health gives the appearance of being either oblivious to all the positive suggestions we have made over the years, or is wilfully misrepresenting the situation. I can’t help wondering what is going on. Is it the intention to spark a needless conflict such as happened with the junior doctors? One could be forgiven for being cynical.

It’s legitimate to ask whether the determination of the DH to cut pharmacy funding, with the closures that will ensue, is part of a wider pattern. Does the DH genuinely want anything positive to come out of its discussions with us, or is the developing situation simply a ploy designed to camouflage their true intentions?

I never believed for one second Jeremy Hunt’s assertions that the new contract for junior doctors was intended to improve patient safety by progressing to a seven-day NHS. It doesn’t make sense: it has to be impossible without increasing the number of staff, but it made for good soundbites and obfuscated whatever the true intentions behind this conflict are.

The deliberate closure of local pharmacies while at the same time ignoring sensible ideas that would help both to relieve pressures on the Health Service and save money seems every bit as crazy. I can’t think of a rational explanation that has health improvement at its heart. The destabilisation of the NHS has become a fact and I fear that community pharmacy is simply the next stage.

Withering is the pen name of a practising independent community pharmacist. Withering’s views are not necessarily those of ICP




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