GPs face greater scrutiny over pharmacy ownership

Business Despite the GMC ramping up its guidelines in an effort to ease concerns over dubious business ethics, law firm Charles Russell was uncertain how closely the regulator would monitor GP-owned pharmacies.

The General Medical Council (GMC) is facing increasing pressure to address dubious business ethics, a leading healthcare lawyer has warned, as the regulator sets out further guidance on doctors' financial dealings with pharmacies.

David Reissner, head of healthcare at law firm Charles Russell, cautiously welcomed the GMC's decision to update its guidance later this month to give more detail on doctors' business interests in pharmacies.

"There is no real evidence that GP pharmacies act in any different way to other pharmacies"Laurence Buckman, BMA

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The GMC told C+D last week that the new guidelines would build on previous guidance, which had emphasised the importance of patient choice and warned against directing prescriptions.

But Mr Reissner said it remained to be seen whether the GMC would take action on its guidelines, due to be published on March 25.

Earlier this week, Charles Russell reported receiving an "increasing number of enquiries" about GPs' commercial activities, including allegations of directing prescriptions and anti-competitive prices.

"It's good news to know that the GMC is going to address these issues in more detail, although we will have to await the new guidance to know what protections will be in place to address inappropriate financial conduct by GPs," said Mr Reissner. "The GMC may find it is increasingly asked to step in to address such conduct in future, and we will have to see if it is willing to take action."

Last month, pharmacy leaders expressed fresh doubts over the ethics of GP-owned pharmacies, as LPCs and C+D readers reported dubious practices.

But the British Medical Association (BMA) maintained that conflicts of interest in GP-owned pharmacies were already "closely monitored on all sides".

"For GPs, there is the added stipulation that failing to declare an interest when taking a prescribing decision is a GMC offence, as well as a breach of BMA guidelines," said Laurence Buckman, chair of the BMA's GP committee. "There is no real evidence that GP pharmacies act in any different way to other pharmacies."

Mike Dixon, GP and chair of NHS Alliance, told C+D he had not personally come across GPs behaving unethically in their dealings with pharmacies. But he stressed that the GMC should come down hard on anyone breaching their guidelines.

"I don't think, in principle, I see a problem with [doctors owning pharmacies] but, in practice, it's all about transparency," Mr Dixon said. "I think the GMC will need to get tough where people are clearly taking financial advantage and patients aren't aware of what's happening."

The GMC previously covered doctors' interests in pharmacies in its Good Medical Practice guidance. On March 25, it will publish separate guidance on financial and commercial dealings and conflicts of interest, which will include a section on pharmacies.

What areas would you like the forthcoming GMC guidance on commercial dealings to cover?

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John Randell, Non Pharmacist Branch Manager

When was the last time you went to your area/regional meeting and were given information on how to focuse more on patient outcomes.

Most often the word patient is replaced by customers. And you are given targets to hit and judged by KPIs and NOT WEATHER THAT ONE MUR YOU DID ACTUALLY SAVED A LIFE..Do GPs really want this life.the key word is RETAIL pharmacy.

Nat Mitchell, Community pharmacist

To suggest that the directing of prescriptions does not happen is simply ridiculous. A GP owned pharmacy has opened near to the pharmacy where I work and the incidences are truly endless. PCT's are either unwilling or unable to police the situation and the GPHC don't seem interested.
You try and not lower yourself to the level of people who surprisingly don't seem to understand ethics or care where patient choice comes into decisions about their health. I guess when you are used to telling people what to do and making decisions for them, it is logical to tell them which pharmacy to use.

Amal England, Public Relations

Guidelines are not good enough, there is clear conflict of interest here and the GMC is allowing it to go ahead as it means more money for its members. Mike Dixon you are either blind to what is going on around you or you choose to be oblivious- many doctors are unethical on a regular basis, I have personal experience of this and I also have testimonies from patients that prove this, sitting in your well paid well oiled cocoon how would you hear about unethical doctors and doctors leaving patients in limbo. The GPhC and PSNC need to pull their finger out and prevent this conflict of interest, its up to pharmacists to stand up against this as no doctor or NHS bodies or GMC will never block an idea that puts more money in the pockets of these greedy gremlins. I keeping saying this- the NHS is ruled and governed by a cartel of doctors who want as much NHS money as possible. To test this theory a pharmacist should try and open a pharmacy in a surgery near a medical centre, hire a GP to work the surgery. The first group to scream out against this will be doctors at the medical centre and they will prevent it via the local PCT, which will be run by a doctor. Pharmacists and pharmacy bodies need to act now against the doctor stronghold over the NHS otherwise doctors will also gain a stronghold of pharmacy and pharmacy law and ethics. We should not let this happen, just look at the state of the NHS- its crippled, its archaic, its disease ridden, all this while doctors have been in control.

Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

A big shakeup needs to happen.

Jatin Morjaria, Community pharmacist

Sadly it is and ever be all about money!!!!! Greed rules the day!!!
Where is the poor patient fitting in all of this- it seems that the caring professions- both pharmacy and GPs equally are equally bad. The contractors cry wolf when their incomes are threatened and the GPs? Well how long is a piece of string? And those that can cahootze with each other's profession are as smug as bug in a rug!!!
Caring professions!!!! ha that's a joke

Farm Assistant, Community pharmacist

so £120,000 a year isn't enough? my father was a doctor and he used to say "money and medicine should never mix". sadly he lived in a different world whereas now the pursuit of money by any means is the aim of too many people. so we have payday loans at 2500%, online gambling, people trying to rip you off on the phone etc. and just look at how happy the world is.

Geoffrey Swift, Locum pharmacist

I can remember in the dim and distant past pharmacists being dragged over the coals for attempting to open up above or next door to doctors surgeries.Remind me...wasnt it part of the early Acts of Parliament which forbad colusion between the two professions?How times have changed!!!As ever the call of the wallet rules the day!!Your writer is correct....let doctors diagnose and the chemist will dispense.
Geoff Swift.51416 Now retired....very tired!!

Nick Hunter, Community pharmacist

It will be very interesting to hear the GMC actually follow through and take action. I'm not sure what circle Mike Dixon and Laurence Buckman work within, but the issues they claim there is no evidence of is reported to me on a increasing basis and sounds similar to the experience of David Reissner

Stephen Eggleston, Community pharmacist

I think it seems very simple to me - leave GPs to diagnose (and only diagnose) and stop them owning/having an interest in pharmacies; It is similar to the commissioner/provider conflict for services - true transparency comes from genuine distance between the separate arms of the process

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