‘One after the other in doleful tones they poured forth a tale of woe,’ wrote Emile Zola in Germinal, that seminal exploration of the nuances, motivations and repercussions of strikes.

No, community pharmacy doesn’t have it as bad as the downtrodden protagonists in Zola’s sociological balefest, and it's not exactly striking either. But there are plenty of tales of woe going around. So why shouldn’t pharmacists raise a fist?

A metaphorical one anyway. Are the crippling conditions affecting community pharmacists not enough to warrant as tough a stance as they can muster?

Yes, of course they are. And for the purposes of this National Pharmacist's Association (NPA) ballot, that toughened up stance involves only working contracted hours, suspending free deliveries and free blister packs, and ceasing to share data with the NHS.

Read more: Saturday shutdown: Pharmacy protest ballot could see weekend closures

Where do you stand? It’s a fair question. Tell us here. The NPA are calling for unity, for pharmacy to speak with one voice, and there is near universal agreement that unity would be preferable to the status quo. But there are many reasons why collective action won’t appeal to many.

It will be - at least - unhelpful to patients. There may be moral, ethical and practical objections around withholding care for them, many of whom couldn’t care less about NHS budgets, they just want their omeprazole. Let’s hope they just want their omeprazole. Other stronger medications are also available. And not all patients are blessed with patience.

Read more: Patients ‘aggressive’ and ‘spitting at staff’ over drug shortages, says new report

With long-delayed core funding stuck in limbo, is it reasonable to expect pharmacies to continue to offer these services gratis? Yes, patients and the NHS have come to rely on them, but it's precisely that reliance which offers pharmacy much needed leverage. 

It’s not mysterious – these 'free' services eat time and resource, so inevitably they impact on profitability. And community pharmacy has been driving efficiencies for so long it’s already pared to the bone. It can’t cut any deeper, is what those supporting the ballot say. There is no more fat to trim. And with appropriate funding still failing to materialise six months after the due date, they have, glumly, reached this last resort.

All these reasons (and more) make this is a complex decision, but they also serve to emphasise why a pharmacy is such a vital part of every big and small community in the UK.

Infamously underrated by all, it’s a crucial cog in society-at-large. So I don’t imagine this issue will sit lightly on Wes Streeting’s desk. It will sit there red and angry, oozing pus and throbbing, especially if (or when) complaints from patients and GPs start coming through. Who knows, perhaps it will make the healthcare secretary so uncomfortable he will head straight to Number 11 to lance the angry boil that collective action produces.

Painful

If community pharmacy votes to work to rule there will be painful moments. The pensioner you close a door on while temporarily working to rule will not be happy, but they will be even unhappier when their local community pharmacy has shut for good. Online pharmacy dispenses medicines in a very different way to community pharmacy. It may be super-efficient, but it doesn’t care.

The ballot is expected to end in around six weeks. Of course there is always the chance CPE will come roaring through with some good news before then. But until it does, the NPA is increasing the available leverage it has to put pressure on the government as hard as it can. Evidently it feels it has no other hand left to play.

Which leaves the question: What do you think?