At last year's Dispensing Doctors' Association (DDA) conference, dispensing doctors were faced with very real threats posed by the Pharmacy White Paper. We won our fight for survival, but there are other issues that could make it difficult for us to continue providing the first-class service patients expect.
Presaged by the Pharmacy White Paper, the Health Bill will, in all probability, have become an Act by the time the DDA meets for its 2009 event in Chester, on 13-15 November, so this year's event has a stronger-than-usual political slant.
Last December, we were overjoyed by the announcement by health minister Phil Hope, that there would be no change in the regulatory position on dispensing by doctors, a message that has since been repeated by departmental officials.
However, the reassurances given do not prevent the membership from worrying that some PCTs will interpret pharmaceutical needs assessments as 'pharmacy' needs assessments rather than looking, as they should, at all their suppliers, including dispensing practices.
Our guests include Baroness Gibson of Market Rasen, who has agreed to become our patron; she has long been a supporter of dispensing by doctors and was able to open doors for us at various stages in our lobbying campaigns.
Recently, she called for amendments to the Health Bill, to ensure that current arrangements for dispensing would be upheld.
We have also invited Lincoln MP Gillian Merron, the minister of health with responsibility for rural matters, but as GP went to press we had yet to receive confirmation of her attendance. If she attends, it will be the first time a serving minister has addressed a DDA conference.
The DDA was promised that it would be involved fully in the development of the regulations that arise from the new Health Act. It is therefore very pleased to be part of the GPC team on the DoH's Pharmacy Regulatory Advisory Group. Paul Burns, chairman of the advisory group (and former chief officer at the NHS Litigation Authority), will provide delegates witha brief update on the group's progress and take questions.
The current threats that face dispensing practice do not, on the whole, come from pharmacy or even from legislation, but from changes to the business and financial environment in which we work.
Changes to the pharmaceutical supply chain imposed by manufacturers, and the consequent reductions in discount rates, have hit dispensing practices hard in the past year, taking some small practices to the limit of financial viability.
Although the widespread moves by drug manufacturers to change the supply chain configuration through direct to purchaser (DtP) and restricted wholesaler schemes are not entirely to blame for the current shortages of many branded medicines.
However, they make sourcing supplies more difficult and time-consuming than in the days of the true full-line wholesaler. Andy Carr, formerly of Astra Zeneca and the man who steered through its DtP scheme, will talk us through pharmaceutical manufacturers' rationale behind their introduction.
Discount reductions are only part of the equation threatening dispensing practices, and would not matter too much if clawback (discount abatement) kept pace with the reductions. It is not a viable business proposition to continue supplying patients with medicines at a loss.
To explain the current negotiating position, we will welcome David Bailey, chairman of GPC Wales and the GPC negotiator with responsibility for dispensing, as our key medico-political speaker.
A general election must be called within the next nine months, so on Sunday morning we continue the strong political theme with an address from Norman Lamb MP, Liberal Democrat shadow health secretary.
Mr Lamb is the MP for North Norfolk and, this time last year, his constituents support for our White Paper campaign, gave him the largest postbag he had ever received. His interventions, both in and outside the House, were very helpful to our cause.
In addition, we shall welcome back our past chairman, Malcolm Ward, in his current role as chairman of the RCGP Rural Forum, with which the DDA works closely.
Closing conference will be Dr Dorian Dugmore whose specialism is 'wellness'. He has served on the National Coronary Prevention Group panel for cardiac rehabilitation in the UK; helped form the British and European Associations of Cardiovascular Rehabilitation; and played and coached soccer at the highest level.
He is now leading a research project on the cardiovascular health of football league managers and helping to pioneer the first MSc in Wellness and Preventative Medicine; his ultimate dream is to see the development of specialist centres around the world for disease prevention and rehabilitation.
- Dr David Baker is chief executive of the DDA
- Andrew Lockhart-Mirams, an acknowledged expert on pharmaceutical regulations and practice contractual issues, will talk on medico-legal problems and dispensing.
- The Buttercups Training team talking on dispenser issues, including information on the new course due to start September 2010.
- A glimpse into the world of automation in the dispensary from a member practice in Caythorpe, Lincolnshire.
- Phil Stephens from the DoH on the provision of disability living aids.
- The association AGM and your chance to grill the DDA board.
- A sold-out exhibition and full social programme.
- Book your place online at www.dispensingdoctor.org