BETWEEN the ages of 14 and 18, I worked in a chemist shop two evenings a week and some Saturdays. It was the usual first job responsibilities, restocking shelves, cleaning, greeting customers and patients who were not always well, for a variety of different reasons.
I loved it because there is never a dull moment in a pharmacy. I remember a frantic mother handing me dead nits taped to a piece of cardboard, and someone asking me to run a pregnancy test on a bottle of cough medicine before discreetly letting me know that it actually contained a urine sample rather than cough medicine!
But it was exactly what it said on the tin. It was a community pharmacy and the whole community would walk through those doors for advice, for medication and for reassurance. What I really saw – and understood – was the extent to which a lot of older people trusted their pharmacist more than any other clinical professional. That’s why community pharmacies matter and it’s why they work.
When the community pharmacy contractual framework was announced in October 2016, it sought to reduce the budget for pharmacies from £2.8bn in 2015-16 to £2.59bn by 2017-18. This represented a four per cent reduction in funding in 2016-17, and a further 3.4 per cent reduction in 2017-18.
When you factor in inflation and all the services that pharmacies were already offering for free, this was a near fatal blow to pharmacies across Yorkshire and across the country.
The Minister at the time told MPs that he expected between 1,000 and 3,000 pharmacies to close as they would no longer be viable in the face of the cuts. He was quite clear that multiples and pharmacy chains would be best placed to survive, leaving those long standing independent and more rural chemists at a disadvantage.
Three years on, whilst closures are not yet reaching the Minister’s anticipated number, many pharmacies are now operating at a loss, clinging to the hope that the funding arrangements will improve, but with a business model which just isn’t feasible.
When I worked in a pharmacy, delivering prescriptions to people’s homes and organising drugs into trays with dates and times for those who needed it was a big part of the team’s day, but are tasks which are no longer funded and for a pharmacy to absorb those costs following the cuts is just not possible.
Boots was the last of the big four chain pharmacies to start charging for delivery over the summer, with all patients having to pay £5 for delivery or £55 for a 12-month delivery subscription by the end of the year. There was a degree of social care being undertaken by pharmacies which in the financial climate has had to end. We can all see what the consequences of that will be: more costly and more clinical interventions.
In addition to the financial pressures facing pharmacies, the implications of drugs shortages are now becoming unbearably resource intensive across the NHS, with pharmacies having to spend hours sourcing drugs, or speaking to GPs about possible alternatives to prescribed medications.
Pharmacy Magazine is running a campaign which has seen posters go up in chemist shops and hospitals all over the country, saying; “Please don’t blame us for the NHS medicines shortages. It’s a nationwide problem. Please ask your local MP to help”.
The poster is largely why I have secured a debate in Parliament this week. As it stands, it would seem that the shortages are caused by a combination of different issues. The implications of Brexit are inevitably a factor which will play out over the coming weeks and months, however we know that the UK is potentially losing out to more profitable and attractive markets elsewhere. In addition to this, the stockpiling of certain drugs which are harder to source as a precaution, coupled with the deliberate and more alarming manipulation of the markets by some wholesalers to deliberately push prices up, are having a detrimental effect on their availability.
Naproxen is a commonly used anti-inflammatory used to treat conditions such as arthritis pain. However, earlier this year, one of my local pharmacies tell me that the cost of a box shot up from having been around 26p to around £15.
Whilst there are a number of complicated issues driving pharmacies into closure, the latest Government proposals do start to understand the potential of pharmacies in alleviating the pressures on GPs and hospitals. Yet I return to the very clear warning given by the then Minister back in 2016.
Between 1,000 and 3,000 of all pharmacies will not be viable and will be forced to close if the overall funding does not increase. For all the aspirations of delivering more services, sadly you can deliver diddly squat from a pharmacy which has been forced to close down.
Holly Lynch is the Labour MP for Halifax.