The NHS, a monument to British 1948 idealism, remains a testament to compassion’s power. Yet, within that grand edifice, a curious crumbling exists. The pharmacy, a cornerstone of community healthcare, often finds itself relegated to a secondary position, a cramped cog in the intricate machinery of the system, rather than a vital, central component.
This predicament begs the question: how can a profession so deeply intertwined with human health, with the power to prevent suffering and improve lives, become so undervalued?
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To understand this conundrum, we must delve into healthcare’s historical and psychosocial underpinnings. Recall the ancient healers: shamans and their successors, the apothecaries, chemists and druggists and early 20th-century pharmacists. They were trusted advisors, confidantes and pillars of their communities.
Fast forward to the modern era, and we witness a fragmentation of healthcare. Specialisation, the normal trajectory for industrial societies, now reigns supreme. The UK boasts a plethora of health professionals with legally restricted titles. Examples are: biomedical scientists, clinical psychologists, speech and language therapists, dentists, dietitians, hearing aid dispensers, medical practitioners, midwives, music therapists, nurses, operating department practitioners, orthoptists, paramedics, podiatrists, optometrists—and pharmacists.
Each boasts impressive specialist expertise such as pharmacists on medicines. A podiatrist might identify gait issues and subsequently prescribe, dispense and fit orthotics (arch supports). However, I repeat, healthcare has become fragmented. Occupations found themselves jostling for dominance and prestige within their territory. Put bluntly: turf wars.
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One factor affecting pharmacy’s position is that in 2024, there were about six medical practitioners to every pharmacist. Another factor is the reluctance of pharmacists to engage in industrial action, potentially impacting their perceived influence and bargaining power.
Furthermore, the debate around NHS funding often centres on the allocation of resources. Some argue for reduced spending on the NHS (including pharmacists), substituting increased investment in social care, support services and education. This perspective highlights the broader societal factors that influence health outcomes.
It is crucial to acknowledge the inherent biases within any profession. As the adage goes, just as a child given a hammer will tend to pound everything, health professionals, deeply immersed in their respective disciplines, tend towards solutions aligned with their training. This “professional lens” can sometimes overshadow a more holistic view of patient needs. Ultimately, decisions regarding healthcare spending should be made collectively by a whole society through democratic processes, rather than by individual occupational groups.
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Human well-being is multifaceted. It includes not only physical health but also mental, emotional, and social well-being. This can be achieved without health professionals. Means include cultivating meaningful relationships, massage therapy, a personal trainer, spiritual guidance, practising mindfulness, engaging with nature or simply enjoying the simple pleasures of life. Just breathe, bathe in sunshine and feel joy grow.
For the fortunate few, new potatoes, forced rhubarb or raspberries, relished within an hour of growing in the soil, offer a taste of untainted paradise. Living alone can be isolating: a pet, usually a cat or dog, may immensely cheer. If you, using diplomatic discretion, feel that a patient would benefit from any of those, name it.
As a fellow pharmacist, although now retired, dare I suggest that practising pharmacists need to up their game? Project more confidence. Lobby more for your rightful place within the healthcare system. Embrace innovation. This includes staying abreast of cutting-edge technologies, such as personalised medicine and gene-based therapies. Remain vigilant in pursuing and adapting to the latest advancements in healthcare.
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Keep your eyes on the ball! For example, blood tests can detect early signs of some cancers. Vaccines are being developed to prevent or treat specific cancers, including personalised vaccines for individual patients. Pharmacists should be at the forefront of these advancements, ensuring their expertise is integral to the development and delivery of innovative treatments. That includes pharmacists dispensing personalised vaccines as they do today for (generalised) COVID-19 and influenza.
The pharmacy profession faces significant threats but also possesses immense opportunities. Signposting some patients to other health professionals with more specialist expertise should be just routine collegiate behaviour. By embracing a proactive and collaborative approach, advocating their rightful place within the healthcare system and embracing innovation, pharmacists can once again be esteemed figures.
Dr Malcolm E. Brown is a retired community, hospital and industrial pharmacist, and is a sociologist and honorary careers mentor at the University of East Anglia.