Surgeries will close under white paper reforms, say dispensing doctors

Dispensing doctors are claiming rural surgeries will have to close as part of a Westminster campaign against the pharmacy white paper.   What has this government got against country dwellers?  Post offices, schools, transport now surgeries.  What next?

Following this letter and others directly to MPs, warnings about closures of dispensing surgeries are being taken seriously by the Conservatives and Liberal Democrats. Opponents claim measures to stop surgeries dispensing if they are too close to a pharmacy will damage rural healthcare.

In a letter to constituents who raised the issue, shadow health secretary Andrew Lansley said: "I am supportive of an expanded role for community pharmacists in providing services.  However, this white paper potentially also spells the end for many dispensing doctors, who for many years have provided a vital service in rural communities where a community pharmacy is unviable."

The Conservatives believe that instead of distance restrictions, PCTs should be able to commission services tailored to local needs. Ultimately it would be for the patient to decide which was the most appropriate and suitable dispensing channel, not central government, under the Tories' plan.   

No doubt the vast majority of dispensing doctors will agree with the sentiments of the Conservative party

Liberal Democrat MP Alan Beith also raised the issue. In a written Commons question he called for a review of the procedure for pharmacy applications within the areas of dispensing GP practices.   However, in common with most Lib Dems pronouncements it demonstrated a wish by them not to upset either side.  Consequently they continue to sit on the fence.

But members of the all-party pharmacy group, revealing stunning unimpartiality, reacted with caution, saying talks had to be held between the dispensing doctors and the pharmacy leaders, with the Department of Health acting as a broker to avoid progress on the white paper being side-tracked.   Dr Howard Stoate, GP, Labour MP and pharmacy supporter member of the group has not, on this occasion not been quoted as saying anything.

Health minister Ben Bradshaw admitted: "Dispensing doctors have expressed some concerns about aspects of our proposals." He said there would be "full consultation later this summer".  And continued, under his breath "and a fat lot of good that will do them"

A spokesperson for the DH said: "We are proposing changes to dispensing doctors' arrangements on which there will be full discussions with the awful BMA and our dear friends at the PSNC later this year.  You won't need much imagination to guess the outcome.  Unless, of course, Gordon falls on his arse, sorry, sword first"

 Dr Richard West, (who?) chairman of the Dispensing Doctors' Association Ltd, in an example of masterly understatements, said some dispensing doctors had raised concerns over the proposed changes to entry regulations for dispensing doctors with their MPs.   Well, at least he's got his finger on the pulse, then.

The experience of your editor, who these days travels the country widely, attempting to play the chemists at their own game, is that not "some" but "EVERY" dispensing doctor, like Dr O'Callaghan above, is extremely angry and very gloomy for the future of their patients and practices.

Let there be no doubt about it, the instantaneous and total loss of all the dispensing income of all practices who have the misfortune to have a chemist operating anywhere within their practice area, will mortally injure those practices and the service they provide to rural patients.  An estimate is that some 1,300 practices will be killed off.

I ask any level headed reader, who is more important to a rural community - or any community, come to that - the chemist who simply peddles the pills or the doctor who makes the diagnosis and prescribes the pills?  The answer is, to quote a phrase, a no-brainer.

This measure is another example of back-of-the envelope musings by Dawn Primarolo and will benefit only the chemists to whom she will give the dispensing doctor's income.  The fact that three of her Health Minister predecessors found profitable employment in health-related businesses after leaving office may not have escaped her.  We have not been told whether Alliance Boots, Lloydspharmacy and other multiples have been approached - for their opinion, of course.  Mind you, pensions are so welcome.

David Roberts (17/5/08)

On Monday, 19 May Mr Tony Baldry MP (Conservative) called an Adjournment Debate in Parliament on dispensing and the Pharmacy White Paper.   He put several questions to the Junior Minister, Ivan Lewis MP, and presented his speech to the minister in advance of the debate..  Amongst the questions was an enquiry about the future of dispensing by doctors.  

The Minister replied, keeping up the dismal standard of truthfulness of Labour ministers, by saying he hadn't had time to read the speech.  It took your editor three minutes to do so, so one has to look up for flying porkies.  In particular, in a longish reply Lewis failed to give any reassurance at all.  Indeed, he mentioned the hoary old mantra about "Doctors prescribe, chemists dispense" - as if he had never heard of prescribing chemists.

The lack of a reply speaks volumes.

Dispensing by doctors is to be sacrificed by a spiteful government for no good reason.  At least, no good reason was written into the White Paper.

For the full debate see:  http://www.theyworkforyou.com/debates/?id=2008-05-19a.133.0

(21/5/08)