And so it has come to this – pharmacy will restrict the services it provides to patients unless adequate funding is forthcoming. What consequences will swirl up as a result?
Frustrated GPs? Patients arriving on a Saturday to find the pharmacy closed? How about something more serious?
How about a confused patient who no longer has her medication clearly delineated via a helpful MDS. Or an immobile patient used to their prescription dropping through the front door.
Use your imagination, but at the very least there will likely be a negative impact on patients, on some level. Anathematic for pharmacy, yet the decisive vote is clear that any negative impact on patients will worsen if the status quo continues. That is the point.
As National Pharmacy Association (NPA) chair Nick Kaye said in the aftermath of the result: “Pharmacy owners are not a radical bunch, we have never proposed action like this before, but after a decade of underfunding and record closures, something simply has got to give.”
Read more: NPA gives DH ‘time to digest’ results of 99% ‘Yes’
In a world filled with close votes, this ‘Yes’ vote was so decisive it demands respect. Critics say the ballot will not endear the sector to the new government. As if the last one was a sweetheart. Proponents believe this government, like the last one, will only cave once the negative issue in front of them is so well publicised it can’t be ignored any more, preferably splashed on the front pages.
It’s likely collective action won’t endear pharmacy to the government. But what will? So far this government views community pharmacy in much the same way the last one did. Labour – remarkably – still has some way to go before it plumbs the depths reached by the Conservatives. But it is trying.
The budget was an opportunity for the new government to show it understands the role community pharmacy is being asked to play in the nation’s healthcare and pay for it. It failed to do that. Instead, it pushed pharmacy harder into the financial predicament it is desperate to escape.
Weeks ago Labour was insisting investment without reform was pointless. Now it’s lobbed an amorphous £22bn at UK healthcare and Wes Streeting triumphantly tweeted it will ‘fix the foundations’ of the NHS. No it won’t. It won’t come close. And the risible claims about fixing foundations rankle, because the exaggeration swerves reality.
A 4% increase on annual spending is a little more than the 2-3% in recent budgets, so it’s just enough to keep propping up those horribly corroded NHS pillars. Pharmacy (and GPs) got clobbered by the changes to national insurance and the minimum wage.
Read more: NPA protest ballot: Government ‘committed to working with sector’
The Independent Pharmacy Association crunched some numbers and generated an additional bill of £12k a year per pharmacy, solely from the NI and NLW upticks. And help will not be forthcoming.
Asking the question brought a sharp reminder that this government views community pharmacies as private businesses. Uh-oh.
Private is a disingenuous definition that doesn’t reflect the reality of operating a community pharmacy business. It does reflect that this government is a lot more like the last one than it cares to admit.
In the vast majority of cases, the NHS is effectively a community pharmacy’s all-but-sole customer and paymaster, with the pharmacy bound up by a required NHS contract. It’s a hybrid business. Quasi-public, part-private-part-state, with emphasis on the latter, and to pretend otherwise shows no appetite for the reform Labour used to be so keen on.
Read more: Pharmacy First negotiations ‘were just horrendous’
I hope Community Pharmacy England’s thoughts are unprintable. So far, publicly at least, the CPE has maintained a good cop persona, publicly playing nice, cajoling things along. Now it knows where it stands.
Shorn of appropriate funding, community pharmacy has been branded a private sector by a Labour government that’s just made its intentions towards private enterprise clear. Not only is pharmacy being starved of funding, it’s also being hit with tax hikes. Weakening pharmacy further is a mistake for a government claiming to be fixing foundations.
Pharmacy, once again, finds itself caught up in a state of someone else’s confusion. But confusion reigns, apparently. Labour’s strategy for growth and productivity was developed by someone without a grasp of how growth and productivity work. That’s confusing.
The state, an obese cash-sucking cow, got a big feed, while private business, a relative cash and jobs generator, got hobbled. That’s also confusing. I haven’t seen a credible economist predict this relic of a budget will deliver sustained long-term growth for the UK, but plenty say it will do the opposite. They aren’t confused.
So what now? Collective action in January will put pharmacy back on the political agenda once everyone has tried to have a Merry Christmas. The movers and shakers of pharmacy can regroup and refocus on the New Year, with a unified effort, rather than a disjointed one, when Labour is expected to unveil details of its ten-year health plan.
You never know, there might be something for pharmacy, finally. We’d all like to see it sooner, but a new funding solution for pharmacy stretching out into the next decade that was reformational, comprehensive, thought-through and – whisper it – beneficial, could wash away a lot of industry stress overnight. Had it come sooner, it would have washed away the looming consequences of the ballot, too.
There is still time. What a Christmas present that would be.
