The NPA, according to the following extract from the chemists' web-site "dotpharmacy.com" thinks their colleagues should be allowed to prescribe for any condition from any formulary.  I kid you not.  

Here is the posting:

"Support for pharmacist prescribing of all drugs

Pharmacists should be able to prescribe for any condition from a full formulary, say pharmacy organisations in response to a Government consultation on independent prescribing.

The National Pharmaceutical Association believes the benefits of competency-led prescribing far outweigh the risks. Pharmacists would be taught to prescribe only within their area of competence and would refer to a GP when necessary, so there would be no concerns over safety and quality. Restricted formularies would miss important products and it would be difficult to get medicines added or keep pace with constantly changing clinical guidelines.

Limited formularies could also result in pharmacists being able to prescribe for some of a patient’s conditions but not others when carrying out medication use reviews."

What on earth the NPA means by "competency-led prescribing" this author cannot begin to imagine.  Unless the chemist has spent several years at medical school he is, by definition, incompetent to practice medicine.  What arrogance.  What conceit to actually believe so strongly that they are competent as to put themselves seriously forward as such to a government enquiry.

I have little doubt that this government will be taken in by their submission as it values the input of the shopkeepers more than that of qualified doctors whom it has belittled, one way or another, since the lack-lustre days of Alan Milburn.   Thank God he's returned to spend more time with his family again.

Apart from that, the government has made medicine as a profession so unpopular with home grown doctors that it must trawl the third world for recruits.

However, to return to the chemist, the level of the synapse-free thought processes of the NPA official who thought up this wheeze (for it surely must be a wheeze), may be deduced from the final paragraph of the extract above.

My driving licence only allows me to drive cars but I don't believe I should be allowed to drive aircraft.  Mind you, i don't believe the High Street chemist should have any licence to prescribe anything from any sort of formulary, let alone a full one.

Just think of it, as the bodies mount up in Mr Blogg's shop.  "Have a bit of this, Mrs Jones, it'll have you better in no time.  I don't know what's wrong with you, mind, but the NPA says I can try anything on you".

But apart from opening up a massive potential for killing patients, this NPA idiocy is also rank hypocrisy.

As Chairman of the original Dispensing Doctors Association for 13 years I was constantly told by chemists that "Doctors should prescribe and chemists dispense.  Each to their own sphere of competency".  That was when they were defending their shops against applicant dispensing doctors.

Now the NPA and others have duped the DDA Ltd (not my DDA) into banning all new dispensing practices, they can safely drop that hoary old, but one-time useful adage, and claim that their shopkeeping colleagues may prescribe.  What affrontery.  What hypocrisy.

The only chemist who should be permitted to prescribe (which implies making a prior diagnosis) is one who has been medically educated.  And there aren't many of them in the High Street.

It's a pity that a few patient-deaths will be needed to stamp this stupidity on the head.  But since when did this government value patients' lives?

Let us hope that the High Street chemist himself recognises the folly of this suggestion before it is implemented and before patients are harmed.  A salutary lesson should have been drawn from recent research, by pharmacists, that there was a 30% increase in hospital admissions of the elderly after a chemist intervened in their homes to "rationalise" the old person's repeat drug list.   And that was without any attempt at a new diagnosis.

Hippocrates would weep.

(24/5/05)