The Northern Irish government will not suspend the clawback of millions of pounds from community pharmacy, health minister Mike Nesbitt has confirmed.
In a parliamentary debate on March 24, Democratic Unionist Party politician and member of the Northern Ireland Assembly (MLA) Peter Martin raised that almost 90% of Northern Irish pharmacies were unable to pay their wholesaler bills in January.
Nesbitt responded that he has “been made aware that pharmacists are feeling particular pressures from price points at the moment”.
Read more: ‘Suspend the clawback’: 90% of NI pharmacies can’t pay wholesalers
He said the government has “regular negotiations and conversations” with Community Pharmacy Northern Ireland (CPNI) but “have yet to find a joint landing space” when it comes to the investment community pharmacy needs.
“I am not happy that we are not in the same place,” he added. “I therefore want those discussions to continue until we are in agreement.”
“A bridge too far”
Sinn Féin politician and MLA Philip McGuigan also told Nesbitt that along with medicine supply, “clawback and core funding are key concerns” for the pharmacy sector - and asked whether he will “commit to engaging directly” with pharmacists “to try to resolve some of the outstanding issues”.
Nesbitt said the health department “has worked with the Scottish government to gain a greater understanding of their funding arrangements”, and found that the “recurrent core funding levels in Northern Ireland and Scotland are broadly comparable”.
Read more: ‘Appalling’: NPA slams ‘bombshell’ £158m NHS clawback
He added that Scotland’s “suspension of generic discount clawback has been feasible only because of legacy differences between Scotland and England’s drug tariff prices, which are now beginning to align”.
“There is a request from CPNI to adjust or remove long-standing discount clawback arrangements to allow in excess of £20m to be retained by community pharmacies,” he said, “but with no additional service provision or benefits for patients or the [NHS]”.
“I am afraid that that is a bridge too far.”
Read more: Govt proposes regulation changes for ‘fairer’ pharmacy payback
Nesbitt noted that the “actual annual margin achieved by community pharmacies in Northern Ireland has significantly exceeded the guaranteed level”.
“When that is coupled with the fact that any excess in margins is not recouped by us,” he said, “we cannot consider the removal of discount clawback at this time.”
“Going to collapse”
Social Democratic and Labour Party politician and MLA Colin McGrath warned Nesbitt during the debate that community pharmacy is “going to collapse” without more funding.
He also questioned the health minister’s suggestion that the £20m set to be deducted from pharmacies would need “to be connected to new services” if retained.
Read more: Pharmacy retained margin funding £120m less than decade ago
“It was put to me recently that that is like giving nurses a pay rise but asking them to work a Saturday and a Sunday; it does not make sense,” McGrath said.
“Will the minister undertake to sit down with representatives of the community pharmacy sector and hear exactly what the situation is in the community?”
Read more: ‘Depressing’: pharmacies funded a ‘brutal’ £800m less than decade ago
Responding to McGrath, Nesbitt stressed that he has “sat down and listened to the community pharmacy people about their concerns”.
He said he “would love to do more for community pharmacy”, adding that community pharmacists and GPs “are central to the shift-left agenda”.
“I want everybody, when they wake up in the morning, to feel content and to look forward to delivering [NHS] services, but that is not where we are,” he said.
Read more: Pharmacies losing millions a month due to NHS ‘underfunding’
It comes after CPNI chief executive Gerard Greene last month flagged the issue of pharmacies’ unpaid wholesaler bills to the Assembly Health Committee, and called on Nesbitt to “suspend the clawback that the department deducts from our drug payments”.
“We are not looking for more money,” Greene said at the time. “We’re asking for this funding to be left in the system so that we can pay our monthly medicine wholesaler bills.”
