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‘The hand of the Treasury’ – Interview


15 Feb 2016

Liberal Democrat peer Baroness Joan Walmsley sees “the hand of the Treasury” behind the 6% cuts to community pharmacy that could prompt the closure of 3,000 premises.

On the day Jeremy Hunt announced he would impose a new contract on junior doctors, we caught up with the House of Lords health spokesperson and were heartened to find the cuts were very much still on her agenda.

From the “eye-wateringly tight” schedule to her fears that closures will be simply “arbitrary”, Baroness Walmsley explained why she is demanding the government assess the impact of the £170m budget reduction.

I wanted to speak to you about the community pharmacy cuts that, I fear, are fading into the background a little today.

It isn’t fading into the background as far as I’m concerned; I think it’s crucial, a crucial issue.

Perhaps you can start by telling me if you plan to challenge the cuts and if so, why?

Well we don’t actually know yet what the whole plan is.

We do know that the government is determined to impose the 6% cut but we don’t know how exactly that will work and which areas of the service are going to be cut and whether any are going to be protected.

Our main concern is to protect community pharmacies and to ensure that everybody has reasonable access to a pharmacy, especially older people, vulnerable people and poor people who don’t necessarily have access to a car to go a long distance to their local pharmacy.

I have to say so far we haven’t seen a proper plan and it sounds to me as if it could be really arbitrary as to which pharmacies close and which remain open.

It sounds to me as if it is going to be the survival of the fittest really, those that can withstand the cuts in fees and grants will remain, and it is likely to benefit the big chains.

We haven’t had any kind of impact assessment from the government about how this plan will work and what the effects will be and that is what we will be demanding.

Do you foresee that the extra burden of work from pharmacy closures would go to pharmacies, or could it land at the feet of other healthcare providers?

If the GP practices have got pharmacists then some of it will go there.

One of the big advantages of high street pharmacies is they take some of the pressure off GPs.

So the worry is more people will go to the GP that could have been seen by a local pharmacist. And of course in urgent situations I suppose people may go to A&E and that is not desirable either.

What are your thoughts on the government’s plans for hub-and-spoke dispensing?

Joined-up working on the whole tends to be a good thing but what worries me is that there may not be the local stocks of medicines that people might need very urgently and it might take time to get them from the hub, which could be hundreds of miles away.

And if they are not available locally what are people going to do? Are they going to go to A&E in the hope that the hospital pharmacy will have what they need? I just don’t know – it is a worry for me.

Turning to the financial aspect, the cuts equate to a £170m reduction in real terms but the government have said they will plough £20m into a Pharmacy Integration Fund. There are easily other cost implications if they are going to roll out hub-and-spoke dispensing. Do you think this makes good economic sense?

That is for the Treasury to decide because I see the hand of the Treasury here.

This is not being done in order to provide a better service for the patient necessarily but to save money for the Treasury.

Yes, there certainly could be savings I think but on the other hand shouldn’t we be looking to provide a better service first and then if there are savings that come from that then wonderful, we can invest that money into further services and treatments for patients.

Do you have any further words of support for community pharmacists at this turbulent time?

I have a great deal of sympathy with all of those people who feel that their whole position is being destabilised at the moment but I think they just have to be a little bit patient, find out what the detail is, and I hope their negotiators will negotiate very carefully and vigorously with the government.

I would also say that I do think it is quite an exciting time for pharmacists really because of the various opportunities that are opening up to them to really use the learning they get at university when they do their course and in their pre-registration year.

I think some pharmacists in the past have been a bit frustrated that actually they haven’t been able to really use their knowledge of medicines and the effects they have on the body.

So I do think it is exciting but it has all got to be done carefully with a proper plan in order to protect the most vulnerable patients.

Can community pharmacists rely on the support of the Liberal Democrats when challenging the government on the cuts?

Absolutely. They are really important and especially given so many people now are on a whole package of medicines.

I think the regular medicine reviews that are being done by community pharmacists are really important because people carry on taking whatever they have taken for years and years and years, and I am afraid some GPs just keep on prescribing them.

So savings can be made if patients don’t need some medication anymore and pharmacists can recommend to the doctors a change in their prescription package if necessary.

I just wait with baited breath to hear how the negotiations go because we have this enormously short time to produce firm proposals, it is eye-wateringly tight.


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