France has over 20,000 pharmacies – nearly 8,000 more than the UK. Even though France is bigger in land mass, its population is not double that of the UK. Hence more people have access to a pharmacy in France compared to us.
Matt Hancock’s French dream is just that – a dream. I could imagine a scenario where he visited a French pharmacy on a whim, found they were very well staffed and had lots of time. He may then have compared it to one of the usual pharmacies here with flustered skeleton staff and thought, “Hmm, I am going to make them work even harder with even less pay”.
As usual, the people in high NHS posts in the government seem to me to have no clue about what happens at ground level. Simply praising pharmacists and giving them more to do is not going to solve the issues. Pharmacists have always wanted to provide more clinical services, but we can’t, as we are at breaking point already. Mr Hancock also needs to understand that dispensing a prescription safely is a clinical service!
In my opinion, he has completely ignored the fact that the French healthcare system works differently from ours. Their rules are far stricter: medicines are not sold anywhere other than pharmacies, so they generate more income. Here we are competing with bargain shops and supermarkets. From what I have seen, they are also fans of natural remedies such as homeopathy, something that is mostly scoffed at in the UK. This, again generates more profit.
Another difference between France and the UK is that no chains own pharmacies in France, as they are all independents. They have no concept of hub-and-spoke dispensing. Every prescription is dispensed by adequately staffed chemists, and a proportion of the medicine cost is paid by the patient or their insurance.
I believe the government's push to increase the use of this dispensing model will only benefit the multiples, which are able to absorb costs through economies of sale. They can set up hubs and decrease workload on frontline staff, freeing them up for services – which all seem to be at the pilot stages currently.
Mr Hancock's French vision of asking pharmacists to “do more” could shut down many independents. Perhaps some of us will weather the storm, who knows? I can’t imagine there will be many, though, and this whole French obsession may leave the healthcare system more broken than it is already. As they say in France, ‘Qui vivra verra’!
The Contractor is an independent pharmacy owner in England
Listen to C+D's podcast from June on the French pharmacy model – and why Mr Hancock is such a fan: