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I don’t think the technology to dispense medicines to everyone in the UK in a dramatically more efficient and less costly way exists, says Peter Kelly…

In late November, it was reported that GP leaders from local medical committees voted in favour to terminate pharmacy blood pressure checks with immediate effect and put the money into pharmacy dispensing fees instead.

The motion was overwhelmingly carried, which meant it will now become official British Medical Association policy.

I have to say, I kind of agree with this sentiment. I think pharmacy should focus on trying to get more money for dispensing rather than trying to constantly get new services commissioned.

There has been a vision for a long time that dispensing can somehow disappear from pharmacies and that through technology, automation and magic, it can be done somewhere else.

Pharmacies as little clinics focused on services? I see issues with this

In the vision, it can be carried out more cheaply and efficiently, allowing pharmacies to become little clinics focused on services. I see a few issues with this vision.

The British economy is not in good shape. On his podcast, the Irish economist David McWilliams said it is not inconceivable that Britain could find itself bust and on the receiving end of a visit from the International Monetary Fund (IMF).

Britain’s growth is slow. Brexit has been a disaster. The UK’s cost of borrowing has gone up.

In his podcast, he discusses how Britain has been too reliant on financial services and has had poor productivity for a while.

If Trump pushes ahead with his trade wars and America First at all costs policies, this could be another sucker punch to an already struggling economy.

When the IMF comes to town to clean up your mess, all they do is cut, cut, cut. In a future world where pharmacies are dependent on government-funded services to survive, that is a very precarious position to be in.

Dispensing is the only leverage pharmacies have

The implementation of austerity is never easy. Anyone who finds themselves in a position where they have to cut funding will look for the lowest hanging fruit. I think pharmacy services would be an easy target.

Pharmacies would have little leverage. Dispensing is, in my opinion, the only leverage they have. A government that’s desperate for savings would not be frightened to cut pharmacy services.

Nobody is going to take to the streets if services delivered through pharmacies are cut because you can just say services are still available through GP surgeries.

It makes sense to me that GPs are against pharmacies doing consultations because that is their leverage.

Dispensing gives pharmacy leverage but the terms of supplying the public with medicines can be changed. The government can charge more people a dispensing fee.

It can also increase the current fee but I think it would really struggle to scrap paying the bulk of the medicines bill for the nation. A move like that would get people out on to the streets.

Now private services, on the other hand, are golden. If you have a travel clinic or vaccination clinic, it doesn’t matter how skint the government is. They can’t cut that, although demand might fall if the economy collapses.

Pharmacy should concentrate on getting best deal for dispensing 

Pharmacy should concentrate all its energy on getting the best deal possible for dispensing and maybe build some private services on the side.

Focusing on acquiring NHS services and getting yourself into a situation where your main source of income is government-funded services, I believe is the equivalent of building castles made of sand.

Politicians love to offer solutions to problems with non-existent technology. On The Rest is Politics podcast in the US, Anthony Scaramucci talked about Donald Trump’s deputy chief of staff Stephen Miller.

Miller wants to deport millions of people from America. He wants to deport every illegal migrant from the country. When asked who will pick the food in the fields in such an event, he said automation. But the automaton doesn’t exist.

When Boris Johnson was asked how Britain and Northern Ireland could have a border with the EU without a hard border on the island of Ireland, he said technology. But it doesn’t exist.

I don’t believe the technology to dispense medicines to everyone in the UK through technology and automation in a dramatically more efficient and less costly way exists.

Not all technical innovation is good. In an interview with the New York Times recently, Bill Gates said he once reviewed the book Homo Deus by Yuval Noah Harari. In the book, Harari is sceptical of new technologies.

He doesn’t believe they are always good. Gates took offence to this because at the time, he believed advances in technology were always good. Gates now thinks he was wrong and Harari was right.

Often, new technologies just get different people to do the same job for less money and with less rights and protections. Dispensing is our leverage. We should guard it and leverage it.

Peter Kelly is a community pharmacist based in London and a stand-up comedian.