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Responding to the White Paper

Dispensing doctors must ensure their voices are heard in the consultation, writes Dr Richard West.

I doubt any dispensing practice can be unaware of the Pharmacy White Paper, Pharmacy in England, Building the Future, published in April this year, which suggests changes to the regulations governing dispensing doctors. At worst, these could lead to the end of dispensing by doctors in all but the most isolated and rural practices.

Dr Richard West: the decision is not a forgone conclusion

Patients' interests
After the initial shock of finding somewhat more in the White Paper than we were expecting, the Dispensing Doctors' Association (DDA) consulted other stakeholders and its public affairs advisers before starting on the task of convincing decision-makers that patients' interests would be best served by maintaining the status quo.

We met with the GPC, the Pharmaceutical Services Negotiating Committee (PSNC) and the DoH and, through a series of email broadcasts, meetings across the country, and articles in trade and national press, our membership was galvanised into action.

The threat being as real and imminent as it appeared to be, there was little galvanising needed. Local MPs have been contacted on dispensing issues as never before and, for the first time in living memory, there have been two debates in Westminster on the topic.

Another first was the joint statement by the DDA and PSNC calling for collaboration and co-operation between doctors and pharmacists, and for the current system to be retained.

Further consultation
The promised further consultation on the 'structural enablers and levers' foreshadowed in the White Paper, was published on 27 August, together with its impact assessments.

Four options are given in the section on dispensing doctors including 'no change'. It is slightly heartening to note that the government states in the consultation that it is not convinced that there is any need for change, and stresses that no decision has yet been made.

Since the publication of the consultation, the DDA has been busy speaking to a large number of the key stakeholders, including MPs. We have attended all three main party conferences and spoken to many politicians.

There has been a remarkable degree of consensus across the three parties that 'no change' is the best all-round option. A common phrase used by parliamentarians has been, 'If it ain't broke, why fix it?' while others have commented that 'this is a fight we do not need to have'.

Despite the degree of cross-party agreement, it is vitally important that our argument continues to be made. This is best achieved through as many dispensing doctors as possible engaging with the consultation process and responding formally, both to the consultation and to their MP.

Co-ordinated response
This is a public consultation and it would be appropriate for as many interested parties as possible to respond to it so that the DoH has a comprehensive view of people's feelings.

The DDA has a number of resources available on its website to help with any campaign you wish to run.

The DoH is very interested in the effect that any changes would have on individual surgeries or individuals themselves. Therefore, it is important to write letters to explain the potential effect on patient services, for example, reduction in patient choice.

A DDA survey of 100 randomly selected practices showed 95 per cent of dispensing patients would find it difficult or inconvenient if their doctor was unable to dispense for them. There will inevitably be a disproportionate impact on the disabled and elderly in rural areas where transportation is a significant issue.

There would also be a loss of integrated medical and pharmaceutical services which seems a shame when the rest of the White Paper is looking to increase integration between medical and pharmaceutical services. And there would be a loss of services and possible branch surgery closures in rural areas.

Another major concern is the large number of jobs that would be put at risk by the changes: not only dispensers' posts but those of doctors, nurses and practice managers.

The DDA is happy to continue working in partnership with the pharmacy profession and is broadly supportive of the rest of the White Paper but we are deeply concerned by the potential consequences of the loss of dispensing and would encourage you to respond to the consultation.

The decision is not a foregone conclusion, this is a genuine consultation. If you do not respond, how will government know what you, and your patients, think?

  • Dr Richard West is chairman of the Dispensing Doctors' Association

Responding to the Consultation

  • Respond as a practice
  • Encourage patients to respond individually
  • Be pro-dispensing doctor, not anti-pharmacist
  • Be accurate


  • Exaggerate
  • Organise patient petitions
  • Use standard letters



The DDA is the only organisation that ensures the views of dispensing practices are heard by the government and key negotiating bodies. We also provide telephone advice to members and essential updated information via our website, and email alerts. To find out more call Jeff Lee on (01751) 430835 or visit www.dispensingdoctor.org

The DDA does not necessarily support or endorse the opinions or information contained on this page.

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