HM Treasury – the real power of government – has just presented to Parliament a document entitled A better deal: boosting competition to bring down bills for families and firms. It focuses on a number of service areas of interest to consumers including water, banking, broadband, legal services, energy and mobile phones.
Of particular interest to us is the inclusion of pharmacy. The document suggests that the government will examine the NHS community pharmacy market to ensure that the regulatory framework and payments system are efficient, encourage competition and innovation, and facilitate online delivery services including click-and-collect. It goes on to say that, despite the popularity of the internet, less than 10% of adults ordered their medicine online.
The document – in keeping with so many other government missives – suggests an alarming lack of knowledge about the realities of pharmacy practice. The clear inference is that pharmacy is inefficient and does not represent a good deal for customers. Nothing could be further from the truth.
There is also a connection between this document and some of the recent commentary about making pharmacy more “efficient”, including the apparent necessity for pharmacies to close in England, the need to explore hub-and-spoke models and then the imminent publication of the second part of the rebalancing consultation which will have (yet another) go at “supervision" in pharmacies.
All in all, pharmacy faces a huge agenda for change. Change is a given and there is always need for improvement, but it is difficult to identify where pharmacy is supposed to be so inefficient. Although prescription growth has slowed over the past 12 months, pharmacy has absorbed year-on-year prescription growth over the past 10 years with more or less no increase in funding on a like-for-like basis. On top of this, it has taken on a large number of highly successful additional roles – the most recent and important of which is the flu vaccination service.
The bit about the internet is over-stated. The reason that the use of the internet to access medicine supplies is relatively low is because, firstly, there is no price competition in NHS services and, secondly, because access to pharmacy services is superb either in terms of physical premises or as a consequence of collection and delivery services. These two factors render e-pharmacy (or mail order) relatively redundant. So where is the problem that the government seeks to fix?
A fundamental pissue for the government and the NHS is access. This does need a fix given ever-increasing demand for services and lack of health professionals on the ground. A key part of the solution is community pharmacy, which guarantees ready and easy access to services where patients live or work.
Rather than wasting time and effort on building up problems that need a fix, government would be best advised to invest resource into building on the strengths inherent in the pharmacy network – this would, in turn, improve the health and wellbeing of local communities.
John D’Arcy is managing director of Numark