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Now we've lost the argument...


Now we've lost the argument...

Well, it’s official. The pharmacy cuts are unfair, the Department of Health didn’t consult properly, access to healthcare will be affected, pressure on GPs and A&E departments will increase, but... the cuts are legal – just about. I’m saddened, but not surprised.

The problem is – at least as far as the Conservatives are concerned, and, I suspect, the other major parties as well – we’ve lost the argument, and we’ve been losing the argument for years. And yet we carry on with the same mantra clinging to an almost childlike belief that if we keep repeating it, we will somehow manage to change people’s minds. We know we’re right – eventually they will have to believe us. I think it was Einstein who said the definition of insanity was doing the same thing over and over but expecting to get a different result.

Nothing illustrates this more than the recent NPA ‘statement of core beliefs’ about community pharmacy. Is there anything new here? Sadly, not a thing. NPA chairman Ian Strachan has tried to put a positive spin on it. According to him, this is “a simple, but hopefully meaningful statement that we can all rally around and use as a reference point for everything people say and do in the name of community pharmacy”.

It’s no such thing. It’s a collection of platitudes that will convince nobody, especially not politicians during the heat of an election. When I read it, to say I felt disappointed would be the understatement of the year. “The link between supply and service is our history and our future,”it says. What drivel! Supply is a service, in case the NPA had forgotten, and it’s the dominance of payment for supply over any other service, that the NPA and PSNC have both pushed for consistently for years that has led us to the sorry state in which we find ourselves.

The Conservatives certainly don’t see us having a strong future in supply. Mr Strachan seems to have forgotten that Philip Hammond is of the view that community pharmacies are inefficient and over-subsidised and that we must “shift away from the traditional bricks-andmortar business model towards scaled-up innovative supply solutions employing digital technology, where Government expenditure is minimised”.

Yet the NPA still thinks supply is our future. Seriously? The Conservative manifesto did not have much to say on the subject. Naturally, there was no mention of cuts (what a surprise!) It said: “We shall support more integrated working, including ensuring community pharmacies can play a stronger role to keep people healthy outside hospital within the wider health system”. These were weasel words. They were worse than meaningless. They attempted to suggest a considered policy with a pledge that was so vague that nobody would be able to hold them to it.

The only way to judge a politician or a political party is by what they do should they ever come to hold office: judge them by what they actually do, not by what they promise to do, and we all know only too well what the last Conservative government did to us and what they might want to do again.

And yet... I think it must be human nature to cling to hope in the face of adversity. The parliamentary All-party Pharmacy Group (APPG) only very recently published a report that says “pharmacy and Government must work together to develop new patient services”, and that community pharmacy is well-placed to play a part in meeting some of the biggest challenges facing the NHS.

It makes seven recommendations: a national minor ailments service; better integration with other primary care services; most, if not all, pharmacists should be prescribers; full access to GP patient records; implementation of the Murray Review of community clinical pharmacy services; sustainability and transformation plans to involve pharmacy closely; policy-makers to have a better understanding of pharmacy.

Woeful silence
One single recommendation – implementation of the Murray Review – is immeasurably more important to our future than the “link between supply and service” could ever be, but the NPA and PSNC remain woefully quiet about it. Why? The APPG report should be music to our ears, except that it has no official status, and it may well have been lost in the smoke of the election. But it’s something. An important and influential group has listened, weighed the evidence and reached a well-considered series of recommendations.

So why, oh why, is the NPA diverting attention away with its hopeless statement of core beliefs? The APPG report and the Murray Review are what the NPA should have been sending out to all its members with instructions to every one of them to find their local candidates and demand their support for both of these documents, and, if the candidate would not, to put them on the spot and to demand to know why not.

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