My least favourite lecture at university was always “ethics and practice”. With my head full of the wonders of microbiology and pharmacology, having to learn the law relating to “a person lawfully conducting a retail pharmacy business”, I felt like a child that had been given an Xbox and told to study the cellophane wrapper it came in. Of course, 12 months of pre-registration and years of reading fitness-to-practise reports did eventually focus the mind to a point where I would no more breach the Medicines Act than proverbially consider committing a murder or Morris dancing.
But maturity and experience eventually bring us understanding that there are consequences to inaction as well as to action, and so when presented with a script for metoprolol or one of the many forms of hormone replacement therapy, we must ask ourselves if it’s good enough to just say “no stock – try elsewhere”, as opposed to the time and effort involved in contacting the prescriber to advise an alternative.
Would that t’were so simple. On the one hand, we have a GP saying quite rightly that it is a waste of her time and an insult to our clinical proficiency to ask her to produce a replacement script for most stock problems, and on the other we have MPs anxious to tie it down in so much red tape we’d need hell to freeze over before we could supply Peptac in place of Gaviscon. I suppose this is a step forward from March, when MPs declared us insufficiently skilled to make such a judgement, presumably encouraged by the British Medical Association’s similarly disparaging assessment a month earlier.
Politicians, however, have demonstrated over the last couple of years that they’re experts in nothing and so are understandably ignorant that it is pharmacists who produce the clinical commissioning group drug formulary and pharmacists who tell the GPs when and how to prescribe those drugs. And it will have escaped their minds that it’s precisely 10 years ago we were making preparations for the swine flu epidemic, before when the idea of pharmacists being competent to hand out antivirals without a prescription, trusted to provide more than five days’ emergency supply, or able to administer flu vaccination would have caused apoplexy both in parliament and at the BMA.
But it’s surprising how quickly principles change when crisis looms and the zombie apocalypse comes crawling through the shopping mall. Recent elections show people are in the mood to give the government a good kicking, so imagine how this will escalate once patients, who trust pharmacists more than MPs and GPs, realise that sensible and rational access to their drugs is being hindered by MPs. And I imagine the BMA will also change its tune as a tide of angry patients storm GP surgeries demanding replacement prescriptions.
So hold tight my colleagues because, despite mutterings in parliament, I reckon it won’t be long before once again the bat signal is high in the sky and we’ll be called upon to be swapping Kliofem for Elleste Duet Conti with impunity.
A long-running C+D contributor, the identity of Xrayser remains a mystery, but his irreverent views are known by all. Tweet him @Xrayser