Peers have urged the government to review regulations that prevent GPs from dispensing to patients who live within a mile of a pharmacy.

The 'one-mile rule' could help force the closure of many rural GP practices, said Lord Lea of Crondall, one of five members  who raised the issue in the House of Lords last week (July 8).

Under regulation 48 of the NHS Local Pharmaceutical Services Regulations 2013, a GP can provide pharmaceutical services to a patient in a rural area only if the patient lives more than one mile (1.6km) away from a pharmacy.

Lord Lea proposed that NHS England should apply this only to new patients in order to minimise the "double whammy" effect of the 'one-mile rule' combined with the gradual withdrawal of the government's minimum funding guarantee for GP practices.

Lord Hunt of Kings Heath said the 'one-mile' rule had resulted in an "uneasy truce" between the British Medical Association and pharmacies, which often meant that the "public were the losers".

The Countess of Mar said it was causing "extreme unrest" by forcing patients to collect prescriptions from pharmacies, while Baroness Brinton said the rule also posed an obstacle for elderly or disabled patients living in rural areas, who found it difficult to access pharmacies due to poor transport links.

Pharmacy minister Earl Howe defended the policy and said the government was not aware of "significant closures" of rural dispensing practices. There was "not an appetite" from either pharmacists or GPs to open up the issue for further debate and the government had no plans to review the "long-standing" rule, he said.

The regulations included an exemption to allow elderly or infirm patients to continue to have their prescriptions dispensed by a GP, he added.

	What do you think about the peers' proposals?