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Clarity counts in this world!

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Clarity counts in this world!

The Northern Ireland Health Committee is not the forum for negotiation but the Community Pharmacy Northern Ireland delegation should have been clearer, says Terry Maguire

 

A Community Pharmacy Northern Ireland delegation appeared before the Northern Ireland Health Committee on March 6. The reception from the committee was without exception supportive.

Members of the legislative assembly (MLAs) reiterated the importance of community pharmacy to local communities and the wider delivery of healthcare by voicing concerns that pharmacies might close. But this audience was a pushover and perhaps we need to be a bit sharper next time when addressing those less impressed or frankly unbelieving of our precarious position. 

Our CEO was, as always, steady and business-like in his introduction and overview and then the microphone was passed to our chair who did a great job relaying to the committee the unreasonable complexity of the community pharmacy funding model. I was grateful to him as I thought I understood the funding model until he successfully disabusing me of that arrogant notion.

Our vice-chair next spoke to outline how necessary pharmacy will be to the transformation of our health service mainly through services designed to take pressure of other sectors. She failed to get into detail and kept it too simple for the MLAs.

We all know that 123,000 people visit pharmacies each day but this figure is over 20 years old and much too low. It might have been good to say something about Pharmacy First and Living Well and their benefits but again details didn’t seem to be in the brief. Anyway, in MLAs’ questions, Nuala McAllister MLA helpfully asked about Pharmacy First. That might have been a good time to provide facts, figures and details but nothing.

Our CEO did make an excellent point that for every £1 invested into pharmacy there is an £8 return. Now that was a compelling figure but needed to be tied down and referenced. The minister and his officials will know this figure and will know its limitations, so might not be as impressed.

Then Lawerence O’Kane had a say. Like Lawerence, I wasn’t at all sure why he was there. He is a passionate community pharmacist engaged in his community and struggling to pay the bills, he told the committee. He was fortunate, he confided, that he was quite entrepreneurial over his career and has a lot of other successful businesses so doesn’t need to worry.  He has plenty of money to keep his failing pharmacy business afloat.

However, he hopes to hand it over to his pharmacist daughter and I suppose for that reason he feels she should be able to turn a fair and reasonable profit.

Then, finally, something worthy of the setting. CPNI Board member Turlough Hamill addressed the committee and spoke with compelling articulacy. This is a man who knows the detail and can communicate it. It was a stunning performance by any standard.

This is the board member who stays away for generalities, anecdote and sentimental mawkishness and gets to the facts. This is what we needed and this is what saved the day.

It was, at times, difficult to know exactly what was being asked from the committee beyond sympathy and a slap on the back. I know that this was not the forum for negotiation but a bit more clarity on the ask would have helped.

MLA Diane Dodds sensed this. She was supportive yet pragmatic asking what exactly CPNI was doing making its case where it mattered with Department officials and the Minister. 

Our team rightly complained that during Covid, the sector had £155 million invested a year now it is working off £128 million with costs of running a business skyrocketing.

They were asking for the claw-back to be cancelled and for an additional £15 million to stabilise the sector in the current year with discussions on a renewed contract (Drug Tariff?) for next year.

They were asking for a contract that takes account of the additional cost pressures pharmacies in NI have compared to colleagues elsewhere in the UK. That should not have taken one hour 20 minutes.  

Health Minister Robin Swan appeared before the committee on 14th March. The chair Liz Kimmins MLA informed him her committee had met with CPNI and asked what was being done, conveying the committee’s concerns.

Robin Swann has been with the health portfolio for some time and his brief comment on pharmacy was sympathetic but business like. He had already injected £10.1 million this year bringing the investment up to £145 million.

That took roughly two minutes. Then, on April 25, came a revised funding letter to contractors announcing a 14.8 per cent increase to the pharmacy budget, adding, it claims, an additional £19 million for 2024-25 to a total investment of £147 million.

So, I really don’t understand our funding model!     

 

 

Terry Maguire is a leading pharmacist in Northern Ireland.

 

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