Pharmacists in sport - Royal Pharmaceutical Society

P O L I T I C A L V I E W
B U S I N E S S P R A C T I C E
Skirmishes, then
a long election
campaign
All the latest from the corridors of power, RPSGB
head of public affairs Charles Willis reports
THE START of 2010 saw
the beginning of a series
of political skirmishes
that will develop into one of
the longest election campaigns
in living memory. At this point
in the electoral cycle Downing
Street will have identified the
most opportune ‘windows’
in which to launch a general
election. This usually involves
plotting release dates for any
‘bad news’ announcements such
as rising unemployment figures,
indications of an ongoing
recession etc.
The Conservative Party has
been prepared for some time
now, awaiting the turn of the
year to launch a more concerted
attack on the Government. In
Westminster, the intensification
of political campaigning has
two major effects: the usual
passage of legislation becomes
hijacked for party benefit; the
Government develops a split
personality.
Traditionally, opposition
political parties embark upon a
process of gaining the maximum
advantage from parliamentary
activity by delaying bills,
gaining amendments, and even
stopping them altogether.
The Government has already
started to demonstrate its
split personality, with senior
politicians representing the
Government and also the Labour
Party – two very separate
guises. They have defended
Government positions and
record of delivery against
Behind all this frantic activity,
the parties are trying to find the
ultimate set of policies to win the
hearts and minds of the electorate
opposition criticisms across
almost every policy area. Now
it develops an offensive, party
political persona and attacks its
critics.
Behind all this frantic activity,
the parties are trying to find
the ultimate set of policies to
win the hearts and minds of the
electorate.
Healthcare is one of the
chosen battlegrounds on which
the parties will fight.
Pledges, claims and counterclaims
on party plans for health
will become more evident.
The public affairs team are
analysing every statement from
the parties, adding to what is
already known about what is
likely to happen to pharmacy
under the next government – of
whatever political persuasion.
This activity is a little like
knitting fog, but as the election
campaigns progress the policy
commitments become more
tangible.
Arguably the most likely
candidate for No.10 Downing
Street, David Cameron, was using
a recent TV interview to overturn
a pledge by the Shadow Secretary
of State for Health, Andrew
Lansley MP. He confirmed that
what appeared to be a manifesto
pledge to the country was, in fact,
a draft policy.
The Labour Party – in its
current guise as the Government
– and the Conservative Party
have both pledged to stop the
automatic criminalisation of
single dispensing errors. For us,
making sure they don’t go back
on these pledges is paramount.
It is quite clear that politicians
have the same ambition for
pharmacy as the profession has
for itself. The difficulty they
have is visualising that new role,
seeing how it fits in the new
healthcare landscape in which
we operate. This may be because
there are many competing
interests both within the
profession and amongst other
healthcare professions. During a
debate at a fringe meeting at last
year’s Labour Party conference,
an RPSGB representative
convinced a junior minister that
there must be more pharmacyled
healthcare services. At the
point of agreement, the room
erupted with other healthcare
professionals all demanding the
same recognition.
It is hoped that the current
joint Inquiry with the Royal
College of General Practitioners
will help to identify where
pharmacists should play a more
prominent role.
The Inquiry is well under
way, with analysis of the
many submissions almost
complete. The interim report
will be drafted in the next few
weeks and the results – your
opinions – will be used to lobby
key policymakers in the main
political parties.
The aim of the Final Report
is to identify what are the
worst blocks to more effective
inter-professional working and
provide answers to finding a
solution. From the submissions
so far, it is clear that there
is real innovation, drive and
a passion to deliver a better
standard of care for patients and
the public.
It is also clear that the
perceptions of pharmacy by
other healthcare professions
is changing but needs to be
brought up to date in line with
recent developments within our
own profession. n
l charles.willis@rpsgb.org
Relying on public finances
THE SIZE of the public
sector will feature largely
in this year’s general
election as political parties
compete to cut its cost. The state
accounts for an increasing part
of the UK economy, including
the £10bn of the National Health
Service budget that passes
through pharmacies’ tills.
We have witnessed not only
the state’s acquisition of Royal
Bank of Scotland, Northern Rock,
Bradford & Bingley’s mortgage
business and the biggest stake
in Lloyds with its Halifax and
Bank of Scotland subsidiaries, but
also the government’s rescue of
British Energy, renationalisation
of Railtrack, the East Coast rail
line’s return to state ownership
and the decision to keep the Post
Office public. Add in the £1bn
innovation fund created by Lord
Mandelson to pick private-sector
winners – plus long-held state
enterprises like the Tote, Channel
4 or National Savings – and such
a portfolio could suggest Britain
is no longer a capitalist country.
Yet before the 1980s
privatisation programme the UK
had a mixed economy whose
mix was much more biased
towards the state. Nationalised
steel companies used coal from
nationalised mines to supply
state-owned shipyards whose
vessels docked at publicly-owned
ports. Nationalised planemakers
supplied state-owned airlines
flying from public-sector airports.
Electricity, gas and water, like
the phone system, were public
bodies. The taxpayer owned
car firms – Jaguar, Rover and
Rolls-Royce – plus companies
putting petrol in their tanks,
including a large part of BP. The
Richard Northedge
Pharmacies in the front line
state not only made lorries but
also operated the biggest haulage
fleet, driving on state-owned
roads alongside public-sector
buses competing with the
government-owned railways.
Even broadcasting was for long a
state monopoly. Add in the town
halls, the military, education and
other public offices and the heavy
hand of the state had a finger in
most parts of everyday life.
Supply chain
Most of that nationalisation
happened immediately after the
Second World War when it was
a political philosophy rather
than, as recently, a financial
necessity. It was part of the
programme that created the
National Health Service, yet
while the NHS became the most
expensive sector of the welfare
state, government stopped short
of taking full control of the
supply chain. Hospitals were
put into the state portfolio while
general practitioners remain
self-employed but paid from
public funds; however, thoughts
of adding the pharmaceutical
companies to that long list of
nationalised industries never
materialised and it was not even
on the agenda for the state to own
the outlets dispensing the drugs.
Even the most ardent supporters
of public ownership conceded
that the distribution chain was
best left in private hands.
And history has proved
that decision correct. Instead
of becoming as dreary and
daunting as post offices – and
as unprofitable and possibly as
unreliable – retail pharmacies
have adapted and advanced,
adopting modern retail methods,
adding over-the-counter medical
products and diversifying into
other goods. Ownership has
changed over the decades with
consolidation creating national,
and even multinational, chains
to compete with independent
pharmacists while inefficient or
unsustainable outlets have closed
or found new entrepreneurs
prepared to provide a public
service and seek to produce
a profit. This final link in the
public health service – supplying
privately-produced drugs through
privately-owned outlets – has
worked well for government.
While repeated changes have
been made to other parts of the
NHS to produce private-sector
efficiencies and performancerelated
pay, retail pharmacies
continue to write their own
business plans.
But the cost of nationalising the
banks is a state-sector debt that
will result in public spending cuts
whichever party wins the general
election and which are likely
to impact on those independent
pharmacy operations. Despite
promises to ringfence health
spending and pledges that the
NHS is safe in their hands,
politicians will be under pressure
to seek savings and the temptation
will be for government to
protect its part of the service
at the expense of the private
suppliers and distributors. And
the consumer, besides the drug
companies and retail pharmacies,
could be squeezed.
Demand for health products is
not inelastic. Faced with higher
prescription costs, a proportion
of the population will prefer
to do without, to the detriment
of their own health but also to
the disadvantage of dispensing
pharmacies. Fewer visits to the
pharmacy mean less chance for
customers to buy non-prescription
items while those who do come
and pay the extra charge will have
less disposable income to spend
on those other items. The effect of
January’s increase in Vat on goods
liable for the tax may have been
disguised initially by bad weather
that both deterred discretionary
spenders and increased sales to
those suffering seasonal ailments,
but it adds to a pressure on the
public’s pockets that will rise
during 2010. Unemployment
is increasing and overtime and
bonuses are tempered, while
freezing tax thresholds ahead
of raising National Insurance
payments will reduce workers’
purchasing power. Add on the
prospect of rising inflation,
increases in interests rates and
the possible direct hit of a hike
in Vat rates above 17.5 per cent,
and prospects for retailing look
gloomy.
With private spending
squeezed, protecting the £10bn
contribution from the public
purse to pharmacies’ revenues is
thus even more important than
in past years. It is a cushion that
other shops on the high street
do not have, but it is one whose
provision lies with a single
decision-maker – the government
of the day. Pharmacies may be
loath to display political posters
on their premises, but an interest
in parliamentary processes has a
sudden importance for profits and
prospects. n
l Richard Northedge writes
for the Spectator, Wall Street
Journal, Independent on Sunday
and other publications.
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February 2010 | Pharmacy Professional
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