REPORTED TO GMC

In March this year a young chemist, who shall be nameless but who may well recognise himself, made an official complaint to the GMC about some articles I penned on this site.  Incidentally, they are mostly to be found in the “Dispensing” section.  

The GMC has given its decision that the items are “of a general nature, and although they are undoubtedly controversial and critical of pharmacists, they are not personal or offensive and are essentially political in nature”.

The gentleman in question seemed to naively believe in the universal goodness of his pharmacy representative organisations, that my articles disagreeing with that belief were “unprofessional” and that my “behaviour falls seriously short of what would be expected from a doctor”.   Looking at his registration date he is far too young to know much dispensing history, so I hope this will put him right and let other young pharmacists know why, after over 20 years in dispensing politics, I consider pharmacists to be “the opposition” – a word he vigorously complained about.  

I have to say that some of his colleagues may not like what I have to say.

I quote from my very extensive files.

Let us start back in the 1980s when PSNC, under Steve Axon, published a document entitled “The facts about Dispensing Services in Rural Areas”.  That official screed was very interesting in that it told the world, without quoting a shred of evidence, that dispensing doctors “mislead patients and resort to extremely unpleasant intimidatory tactics against pharmacists locally”.  Other tactics mentioned “include criminal damage and threatening behaviour”.   Hardly temperate, professional language, methinks.

Oh, and for good measure it states without reservation that “the interests of patients are best served when the GPs provide medical services (diagnosing and prescribing) and pharmacists provide pharmaceutical services (dispensing and related services).”     

I wonder if they regret that in today’s atmosphere of PSNC “arrogance” (another word to which he objected) whilst demanding diagnosis and prescribing from a full pharmacopoeia?

Let us move forward a year or two to when the late Tim Astill of the NPA wrote to David Coleman FRPharmS:  “far from warning a pharmacist not to attempt to establish a practice in a village with a population of 2,500, we would give him every encouragement to do so”.    

These, of course, are doctor dispensing areas and surprise, surprise, any incited applicant chemists are “the opposition”.

Around the same time the original DDA, of which I was foundation chairman, were attempting to set up a course for their dispensing assistants.  I asked the Society of Apothecaries for their help, only to receive a copy of a letter from their senior examiner to the Cornwall LMC Secretary.

Amongst other things it said:  “The (Apothecaries’) Society has been advised that if it offered facilities to assess and certificate doctors’ dispensers, support for the Society’s examination would be withdrawn by the main pharmaceutical organisations concerned.  Without this support the Society’s examination for dispensing technicians would not be viable”.

In short, they were unable to help, having been threatened by pharmacy. 

Was that a threat designed to help patients?  Even if you dislike dispensing doctors it is surely preferable to have their staff trained rather than not.   Even today the Society continues with that attitude and specifically ignores doctors’ dispensing staff qualifications by refusing to allow them to work in pharmacies.

But, let’s get a bit more up-to-date and talk about the Clothier “loophole” about which I used rather spectacular language in 1994.   

The loophole was an inadvertent error in the regulations and far from behaving professionally and accepting that peace could best be restored by its immediate closure, PSNC incited colleagues to get in there fast. 

Readers of Chemist & Druggist of 10 September 1994 will have seen Mr King, then PSNC Assistant Secretary, quoted as saying:  Any contractors considering an application in a rural area are advised to take advantage of the provision (the loophole) “quickly” as, says Mr King “the Department changing the regulations is always a possibility”. 

The article, on p. 380, continues: “Because the existence of the loophole has been kept quiet – partly due to ignorance and partly due to the wish not to alert “enemy camps” – dispensing doctors have been slow to react”.  That seems to have been said by Mr Newton, Humberside LPC Secretary.

So doctors are called the “enemy” by chemists, then?   On the other hand, I am “unprofessional.”

Even more recently, 1995, Stephen Axon was Secretary of Working Group II of the Federation Internationale Pharmaceutique (FIP) whose remit was to enquire about world-wide dispensing by doctors and to mount a “four-pronged attack” against doctor dispensing.    

So much for not being the opposition, then.

The Report runs to over 40 detailed pages and it’s conclusion is that the four-pronged attack should consist of  persuading governments that doctor dispensing increases the nation’s drug bill (Not in this country, it doesn’t.  Dispensing by doctors saved £500million last year) and is “against the patients’ best interests”.  

A second prong was to persuade the courts that dispensing laws “are being flouted, manipulated or ignored” by dispensing doctors.    No evidence is, apparently, needed for this libel. 

A third prong sits very sadly with pharmacy today.   FIP is to “persuade patients or third party payers that it is not cost-effective to allow the same person to both decide the medication which should be provided and to profit from its supply”.   Forgetting OTCs, I hope for their sake, your lot weren’t too successful with that one!  On the other hand, patients would be better served if medically unqualified chemists don’t attempt diagnoses or prescribing.

The final prong was “to demonstrate to all agencies that unless steps are taken to prevent further encroachment by community doctors into dispensing activities the medico pharmaceutical infrastructure could be irreparably damaged”.

To ensure that all registered pharmacists knew all about all this a very informative article was published in PJ (Vol 255, 9.9.95 p. 328-9.) entitled “Dispensing doctors – the greatest obstacle to success”.  The article reported a speech by one Stephen Axon in which he gave his theory of the routes to defeat dispensing doctors: “the legislative, the professional, the financial routes and public opinion and competition”

Following this, the RPSGB gets into the act with “Pharmacy in a New Age – the new horizon” which, on page 6, paragraph 5, states that it will “Press government and purchasers to restrict dispensing to areas where pharmacy services cannot reasonably be provided”.

So, the Society believes that doctor dispensing is alright unless it hits the chemist’s pocket, then?

The document continues that the Society’s Council will “oppose inappropriate applications by GPs for dispensing rights on a case by case basis”.    Thereby, of course, becoming the self-confessed “opposition”.

How well it has succeeded here by out-witting the silly DDA Ltd and the GPC into agreeing to the prevention of all new dispensing by doctors!   But do you see the influence of FIP here?

So, for as long as I have been in medical politics – over 20 years – pharmacy has been attacking and attempting to eradicate doctor dispensing but my files go back to the 1920’s.  Those who are interested will find a full history in my book The Complete Dispenser (CIG).

Far from being unprofessional, as my pharmacist complainant insists, I believe I have been pissing into the wind, with very little help from my friends, against the might and unscrupulous self-interest of pharmacy organisations.

Nevertheless, I have strong kidneys and a full bladder.  The pissing shall continue.  In the meantime I hope the above enlightens one or two impartial chemists out there.

Pharmacy is not “whiter than white”.

Far from it.  It is a very murky shade of grey and, with the help of my defence body, it was my intention to subpoena the President and Secretary of the Pharmaceutical Society, the Chairman of the NPA and any other relevant past or present member of their political groups.

It is most fortunate for them that the GMC denied me the opportunity to expose the sorry facade which is pharmacy.

(1/9/05)