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Pharmacy competition - Pharmacy applications update

Progress has been made on the petition to the Scottish parliament, writes Alan Kennedy.

Scottish ministers have decided that there is a case to answer and will respond in late April 2009
Scottish ministers have decided that there is a case to answer and will respond in late April 2009

In October 2008, following the application for a commercial pharmacy in the Leuchars and Balmullo area of East Fife (later refused but now under appeal), I submitted Petition 1220 (GP, 20 February).

This called for the Scottish government to review all relevant legislation to ensure the continuance of GP dispensing services in instances where commercial pharmaceutical practices apply to operate in the same area.

The Scottish Parliamentary Petitions committee discussed this petition on 16 December and decided to call for views from a wide range of interested bodies. Responders included BMA Scotland, the Remote Practitioners’ Association of Scotland (RPAS), the RCGP, the Royal Pharmaceutical Society of Great Britain (RPSGB), NHS boards in Fife and Grampian, Community Pharmacy Scotland and the Scottish government.

Predictable response
The responses followed a fairly predictable line. The BMA, RCGP and RPAS argued strong cases for a level playing field for applications, where both patients and GPs are allowed to represent their views direct to the regional NHS boards which decide pharmacy applications.  This is not currently allowed.

It was also argued that dispensing surgeries are often better placed to provide community services and tend to be less expensive to operate under current public funding. The unanimous view from these organisations was that there must be a fair and open process that demonstrably ascertains the views of all parties – particularly local GPs and affected communities.

By contrast, the health boards were of the opinion that all necessary public consultation was in place. The RPSGB’s response was particularly interesting.

It clearly believed that the current pharmacy application rules were satisfactory but went on to admit that the processes to determine NHS pharmaceutical care services contracts may not be perfect ‘as they were based on largely subjective criteria’.

Community Pharmacy Scotland stated categorically that local people are involved in deciding entry to the NHS
Pharmaceutical List.

I am sure my fellow citizens of Balmullo and Leuchars would like to know how this was achieved in their case, other than by their own initiatives.

The Scottish government sought to justify the current legislation contained within NHS (Pharmaceutical Services) Scotland Regulations 1995.

The government’s case is that it believes local arrangements within NHS boards to deliver consistency and fairness to applicants and other interested parties, have developed sufficiently to make further advice on this subject unnecessary.

A case to answer
In essence, ministers believe that fairness is already being applied and that existing legislation allows NHS boards to decide whether dispensing surgeries may remain when a commercial pharmacy is opened.

In addition, it states that NHS boards may allow recommencement of GP dispensing services should a pharmacy close or move away.

On 3 March, the parliamentary committee, having reviewed all the submissions, decided my petition presented a case to be answered. Accordingly, the Scottish government was asked to respond to the following questions by 17 April 2009.

  • Whether it will revise the NHS (Pharmaceutical Services) (Scotland) Regulations 1995, to allow dispensing GPs to make direct representations to pharmaceutical committees when an application to open a pharmacy is made?
  • Whether the lack of any requirement to consult with all affected parties, including dispensing GPs and the public, is not at odds with the duty placed on NHS boards to consult and encourage public involvement as conferred by the NHS Reform (Scotland) Act 2004? What steps will the government take to rectify this anomaly?’

I expect to submit a written response to the government’s reply in late April. The Committee meets again on 2 June to
further consider this petition.

Progress has demonstrably been made in establishing a fair procedure for all interested parties concerning pharmacy applications. I look forward to a positive response from the Scottish government that ensures this happens without further delay.

  • Alan Kennedy is a patient at the Leuchars and Balmullo Village Surgeries in East Fife

Resources
The Scottish Parliament
Pharmacy competition – Fighting a pharmacy application

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