Jeremy Hunt slams subsidies for 'clustered' pharmacies

Hunt: The pharmacy sector has to make efficiency savings
"It does not make sense" for the NHS to fund pharmacies that are “very close" together, the secretary of state for health has argued in a parliamentary debate.

Jeremy Hunt, Conservative MP for South West Surrey, claimed that “40% of pharmacies are clustered in groups of three of more”, so the NHS should not "continue to subsidise pharmacies that are very close to other pharmacies".

“Our reforms are designed to ensure that where there is only one local pharmacy that people can access, that pharmacy is protected,” Mr Hunt said during a parliamentary debate on mental health and NHS performance yesterday (January 9).

The health secretary was responding to a question put to the House of Commons by Labour MP Michael Dugher, who asked if the “significant cuts” to the community pharmacy budget could make “an appalling [NHS] crisis even worse”.

Mr Dugher suggested that pharmacy closures could result in more patients turning to GPs for medical advice, and “in desperation” some could turn up at the local hospital. 

Mr Hunt replied that community pharmacy has to “make efficiency savings”, as with “all parts of the NHS”.

"Fragmentation and lack of integration"

During the same debate, Dr Philippa Whitford, Scottish National Party MP for Central Ayrshire, compared the winter A&E crisis in England to the situation in her country.

“In Scotland, we face the same problem of increased demand and shortage of doctors, yet 93.5% of our patients were seen within four hours in Christmas week,” Dr Whitford said. She contrasted this with some areas of England, where she said only 50% of patients are seen within the four hour target.

The difference is down to the "fragmentation and the lack of integration [in England]”, Dr Whitford added. “There are things that can be done. We can use community pharmacies and GPs, and try to bring the NHS back together.”

In response, Mr Hunt admitted that Scotland has “gone further” in the use of community pharmacy, “which is to be commended”. But he added that the government in England has increased investment in general practice.

30 Comments
Question: 
What do you make of Mr Hunt's comments?

R Patel, Community pharmacist

Also, look into who is making up the clusters--in my area within 3 mile radius there are  4 Boots and 2 Day Lewis, and  2 Lloyds. The  independent pharmacies who are trying to survive these competitors are the casualties and they are actually the ones who provide the most efficient services and personal healthcare to their loyal patients. Mr Hunr, please do your research accurately before generalising.

Sau Sheung Yuen, Pharmacy Area manager/ Operations Manager

Just a matter of interest, how do you calculate the "efficiency" of your services?

Dave Downham, Manager

Strange - most people make a different error in spelling Jeremy's surname...

john thompson, Community pharmacist

The government is hitting back at Boots smash and grab on MUR money which has gone to American shareholders. Sadly the weaker groups and independents will go to the wall first, however Boots will lose business and shares will drop in value which will be the government's revenge.

Shaun Steren, Pharmaceutical Adviser

How many pharmacies have closed? How many are currently in financial dire straits? Are we about to see a wave of closure this year? If so, does anybody have any estimates for the likely numbers involved?  

P M, Community pharmacist

the cuts haven't hit yet..

Dave Downham, Manager

I thought the estimate was 1-3,000. Of course there's been not many closures yet as the cuts won't be felt by bank balances until early March. And it won't be a wave, but a steady decline as the cuts drip drip and owners cling on as long as they can.

Jupo Patel, Production & Technical

We shall see....

Jupo Patel, Production & Technical

You know as well as I do that was propaganda and scare mongering. A nice easy way for contractors and multiples to drive pay down. something they were doing anyway well before any murmur of cuts etc...

Jupo Patel, Production & Technical

Obselescence is the best word to sum up community pharmacy

john thompson, Community pharmacist

Obselescence in the current form. E scripts and robotic dispensing with an Amazon style delivery will see the numbers culled in the not too distant future.

Andrew Harwood, Pharmaceutical Adviser

Typical cluless statement from people who are so far removed from whats really happening! Pharmacy should be at the forefront Healthcare, give them a proper Minor Ailments contract, reimburse them accordingly and free GPs to deal with chronic conditions. The solution stares the NHS in the face but yet they can't see it and talk about slashing pharmacy numbers and therefore further reducing access to a Healthcare Professional. Get your act together Hunt!

Brian Austen, Senior Management

Government Policy is obvious. More Pharmacists working in primary, community, urgent and social care and less Community Pharmacies. After 3 years the GPs are paying the full costs of employing the Pharmacists. Good deal and cost effective for NHS England while at the same time reducing funding for community pharmacy. They know exactly what they are doing. By 2020 there will be no cost to NHS England for Pharmacists working in GP practices and no establishment payments to community pharmacies.

john thompson, Community pharmacist

Perfectly stated Brian Austen. 

Andrew Harwood, Pharmaceutical Adviser

What does the average GP Appointment cost the NHS, £70? How many GP appointments are taken up by minor ailments that can be dealt with by antibiotics, 60%? The simple soulution is that Pharmacy could deal with the minor ailments at a fraction of the cost of a GP appointment and anything more chronic the Pharmacy can signpost to the GP. This is a far better solution, saves the NHS money and free's up the GPs time. All that is needed is a Minor Ailments contract for Pharmacy!!

john thompson, Community pharmacist

But that Minor Ailment contract could be given to a "surgery" pharmacist as opposed to a community pharmacist. The surgery pharmacist could have a local PGD to issue antibiotics and be available all day at the surgery.

Sau Sheung Yuen, Pharmacy Area manager/ Operations Manager

I fundamentally disagree with the idea that we should become the cheap alternative to GPs; are we first class pharmacists or second rate clinicians? What about our professional pride? Is it necessary that all pharmacists do are oriented towards making everything cheaper. Remember that Lee Evans joke about pharmacists and Neurofen?

Valentine Trodd, Community pharmacist

But I wonder how many GP surgeries will choose to keep on a full time pharmacist once the funding has been pulled? I think a lot of practice pharmacists will see their hours cut or job disappear from under them in a couple of years.

john thompson, Community pharmacist

Well spotted Valentine Trodd, especially when they can pay a nurse less money to run a minor ailment service. The other probability is pharmacists getting a lower wage in the future if they want to keep the jobs.

Jupo Patel, Production & Technical

Shame pharmacy doen't fight like Rail unions do for their members.

Valentine Trodd, Community pharmacist

That would require a strong union.

Jupo Patel, Production & Technical

But for instance you don't see or hear of train drivers trying to shaft station attendants.

C A, Community pharmacist

"Mr Hunt replied that community pharmacy has to “make efficiency savings”, as with “all parts of the NHS”."

Why can't we have the same efficiencies as the GPs? An extra 4%? All in it together... sure

Susan M Shepherd, Community pharmacist

Clustering of pharmacies may have something to do with clustering of population and of other NHS practitioners. For example within a 1 mile radius of our town centre there are 4 multiple GP practices serving a total of approximately 45000 patients, 13 NHS dental practices (with multiple dentists at each), an NHS Clinic (principally Nurse and Midwife run) and a Mental Health Service. Plus the District Nurse Service. All of which issue NHS prescriptions.

Plus all the people who work in town or live in the surrounding villages which have no pharmacy or GP surgery, so come into the town centre for their prescriptions. And the care home, residential home and sheltered housing patients in the area.

So yes, there is more than 1 pharmacy. Exactly how much work does JH expect?

Valentine Trodd, Community pharmacist

well said.

Grumpy Pharm, Community pharmacist

Todays "clustering" was only a few years ago called "choice" so make your minds up. But of course all GPs exist as sole practioners...

S Morein, Pharmacy Area manager/ Operations Manager

There is a huge difference between competition i.e choice and subsidy. The Secretary of State mentions subsidies ie paying additional premiums for clusters. He does not suggest that unsubsidised competition is not wanted

Ian Kemp, Community pharmacist

So, let's just get this clear, this 'Pharmacy Area manager' is suggesting that when establishment payments are abolished [ which may be sooner than later judging from the tone of the Secretary of State] any restrictions on awarding new contracts will go as well, even if that leads to more clustering/choice/competition.

Really? Wow, Superintendent Pharmacist

 

The last comment here where Hunt says they have invested in GP's rather than Pharmacy to help the problems is surely answering his own questions isn't it? 

In Scotland its working (or at least helping).... and in England it is not?!

Albert Einstein said; “The definition of insanity is doing the same thing over and over again, but expecting different results”.

Meera Sharma, Community pharmacist

The mind boggles - they want pharmacy to be a part of the primary care structure, be more involved and yet the numbers should be slashed?! If you're cutting pharmacy numbers, surely anyone can foresee the next problem - the same stretched service that GPs, hospitals are having. How is this helping the patients?? Honestly, no wonder we are having the worse crisis ever - with Mr Hunt completely blind to what goes on!!

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