The somewhat lack-lustre Blair babe, Dawn Primarolo, who has somehow reached the dizzy heights of Secretary of State for Public Health,  has set her "mind" to destroying the rural health service, lock, stock and barrel.

For those who are unaware of what I talk, rural patients are, by and large, served by small practices who also provide their medicines.  Over all these dispensing doctors provide a convenient dispensing service in their surgery premises.   It is certain that that service is safe and welcomed by patients.   What is also certain is that chemists are no longer interested in their dispensing role and are searching for roles as barefoot, unqualified doctors  roaming the community.  God help our patients.

To allow themselves to fill these roles they leave the dispensing of medicines in the hands of qualified dispensers - staff with the same qualifications as those employed in dispensing practice.   Indeed, today's pharmacist is so eager to do this that he is even prepared to  give up his supervisory role.

In short, there is not a cigarette paper of difference between dispensing practice and pharmacy except that dispensing practice is probably safer and certainly more convenient.

Yet what has Miss Primarolo proposed in her White paper but measures which will largely eradicate dispensing by doctors - and, of course, hang the opinion of patients, especially those who live in the environs of large villages and market towns where there may be chemists.

Until Primarolo's interference chemists dispensed to patients within a mile of their shop and the outlying patients were efficiently served by the general practice.  Patients within the mile often complained that their doctor was not allowed to dispense to them, too and it was, logically difficult to understand.

However, the proposals are that where there is a chemist within a village or market town the doctor should be compelled to cease dispensing and, more to the point, the patients both in the town and the outlying patients must do as they are told and go to that chemist.   The Primarolo's breathtaking logic is that to get to the surgery patients must pass the chemists therefore they must use it.

And, to hell with the medical practice which uses the additional income to supplement its medical services but how nice for the chemist who will get fatter and greasier on this generous gift of the Minister as her measures destroy around 1,300 rural medical practices because there will be no compensation from any source.  Just a diktat.

One has to wonder, as I said earlier, at the intelligence of this government which sets out to destroy so many perfectly working and greatly appreciated dispensing practices.

Why did she do it?  Was it to satisfy the loudly shouting pharmacy lobby as she was wined and dined by them or was it, one certainly has to ask this with three past New Labour Health Ministers now working in the private health field, or was it a question of preparing for later employment?  One never knows who is paying who or who is promising to pay who in this the sleaziest of sleazy governments.

What is for sure.  She did not make these proposals to improve the service for patients.  If she had she would have canvassed their opinion first and she would have found enormous support for dispensing by doctors.  But she didn't.

What is also for sure is that corporate pharmacy, the Lloyds and Alliance Boots of this country, will grow fat on her proposals.

Now, two and two does not always make four but, one has to wonder about motives.    Of course, until proven otherwise, even Miss Primarolo is as white as the driven snow.  Isn't she?

If she is pure then the only alternative is where we came in, she is incapable of thinking beyond the back of the  fag packet where this idea presumably began life.    After all, one has to ask, which is the more important, the increasing size of the corporate chemist's bottom line or the preservation of rural medical practice as we know it?

It's a no-brainer, really.

(5/4/08)