All the talk about turf wars between pharmacists and GPs is quite funny really. It’s referred to so often that it’s assumed to be true. But I’m not sure if it is – funny or true, I mean.
Admittedly, I come at this from the point of view of a non-dispensing doctor, so I can’t comment on that particular territorial spat. It may, I guess, be a real source of strife, albeit only affecting the minority of GPs that actually dispense.
And, yes, last year there was an unseemly row about the first national pharmacy flu campaign affecting GPs’ own flu offering. That was hardly surprising – on the one hand, pharmacists were only pursuing a legitimate slice of the flu action, while on the other, we GPs were understandably cheesed off by competition appearing so late in the day that we risked being stuck with surplus stock.
The real culprit – and, therefore, enemy – was, of course, the government, because it was the politicians who belatedly came up with the idea. But if my local experience is anything to go by, GPs and pharmacists on each side of the divide were too entrenched to realise that ‘healthy competition’ had escalated into messages and counter-messages between pharmacies and GPs that were more lengthy and heated than those generated by, say, a manufacturing shortage of Manevac.
But that’s a really rare example, given that it involved two groups of frontline professionals in an unseemly fight over the same pot of money. Most of the time, it’s not like that at all – not least because the majority of GP income is based on patient numbers, rather than activity. Unlike pharmacists, GPs are paid whether or not patients attend.
So if it sometimes feels like, to cope with stress and workload, GPs are perfectly happy to keep patients at bay, that’s probably because we are. Which means we have absolutely no issue with patients attending the pharmacy for their minor illness or blood pressure check. You’re welcome to the work, so it’s a turf giveaway rather than war.
When we do get aerated, it’s really not about being territorial – it’s simply exasperation that effort is being duplicated and NHS funds wasted. Take the new medicine service or medicines use reviews, for example. These cost us nothing in terms of finance and very little in terms of territory. But they do make us wonder about the logic of replicating a service that any self-respecting GP builds into his consultations whenever a prescription is issued.
In other words, if there is a conflict to be resolved, it’s about defining, exactly, who is doing what, so that services aren’t duplicated or omitted, and resources aren’t frittered away. And that requires not war-war, but jaw-jaw. So let’s stop pseudo-squaring up over turf and instead get round a table.