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It’s unclear what efficiencies the Pharmaceutical Society of Northern Ireland has made to reduce operating costs and mitigate its dire financial position, says Terry Maguire…

Before his resignation as health minister, Mike Nesbitt completed a consultation on increasing pharmacy premises fees in a plan to financially stabilise the Pharmaceutical Society of Northern Ireland (PSNI).

The regulator is in significant financial trouble recording losses of over £200,000 annually in recent years which is clearly unsustainable.

In the current year, fees for pharmacists rose from £398 to £477, bringing in over £200,000 in additional funding which, if my maths is correct, largely addresses the current funding deficit but with little headroom to address future developments.

Now the plan is to raise premises fees from the £155 per year to possibly over £1,000. The minister set out six options; from do nothing (option one) to fees that reflect those paid for premises in the Republic of Ireland. This latter option (option six) would bring in an additional £500,000 to PSNI’s coffers. As with most government consultations, this one is a sham.

The Department of Health (DoH) already knows that option four will be chosen and in January 2027, premises fees here will be aligned with those currently paid in Great Britain, raising an additional £200,000; a similar amount as the rise in pharmacist fees this year, providing some fiscal relief and putting PSNI comfortably in the black. 

The DoH has undertaken this consultation since, under the Medicines Act 1968, it has responsibility for setting pharmacy premises fees. I found this decision somewhat unusual if not somewhat disingenuous.

The PSNI has responsibility for premises regulation under the Medicines Act and should have undertaken the consultation. The DoH, of course, has the final say on all pharmacy fee increases, so why the micromanagement in this case?

Over the years, the DoH and PNSI shared the premises fee, the argument being that DoH employed the pharmacy inspectors. Now, all premises fees go to PSNI, reasoning that the cost of regulation has substantially increased, as has the complexity of fitness to practice cases and operational costs.

It is a crude and awkward way of addressing a financial deficit and places the funding of PSNI firmly on contractors through what is essentially a stealth tax. Contractors, who largely pay the fees of their employee pharmacists as well as premises fees, need to cough up an additional £400,000 a year to keep PSNI in business.

GPs and dentists do not pay any premises fees. Regulation of their premises is undertaken by the Strategic Planning and Performance Group with the support of other agencies and out of existing government budgets. Pharmacy premises regulation does not consume much resource but we now find that the fees are to be used as a tool to subsidise the wider regulation of pharmacists.

I fully accept that pharmacy needs to be regulated. Regulation needs to be of the highest standard and funded in a sustainable way. So, no matter what angst and anger emanates from contractors, this cost needs to be paid.

I responded to the consultation by stating that simply throwing money at a problem seldom provides a satisfactory long-term solution. The consultation was much too limited in scope and failed to consider the underlying issues. Perhaps that wider consultation is to come later. The PSNI has failed over the last 15 years, and not because of a lack of money, to properly regulate and promote pharmacy and pharmacists as is required in its statutory objects.

It has to be considered whether, in its current form, pharmacy regulations in Northern Ireland are fit for purpose. More options than simply raising money should have been considered. It is unclear what efficiencies PSNI have made to reduce operating costs and mitigate its dire financial position. We were not privy to the budgets created to drive its five-year strategic plan, if indeed they exist.

It would be reassuring at least to know that our money will be used to best effect. Consideration should have been given to the General Pharmaceutical Council taking over pharmacy regulation in Northern Ireland, as this would reduce the overall cost of regulation.

With the Northern Ireland Pharmacy Forum about to stand down and PSNI deciding not to regulate pharmacy technicians, its viability as a regulator must now be seriously questioned. On this, the DoH seems largely in denial. I found option six somewhat mischievous. Why include an option from a jurisdiction where the funding of pharmacy is much more generous?

The Irish pharmacy regulator, the Pharmaceutical Society of Ireland, might be an example of a small regulator but pharmacy is much better off where it charges its fees.

As with the consultation to increase pharmacists’ fees, where over 90 per cent strongly objected but were ignored, Nesbitt will, I’m sure, say he has listened very carefully to what we have said and then impose the option he wanted in the first place – aligning our premises fees with GB.

To crudely paraphrase Benjamin Franklin; In this world, nothing can be said to be certain, except death and ‘stealth’ taxes.

Terry Maguire is a leading pharmacist in Northern Ireland.