GPs lose right to dispense drugs in shake-up of rural health services

Up to three million NHS patients could lose the right to obtain prescription drugs from their GP under proposals to boost the development of rural pharmacies in Britain.

The plan, contained in a White Paper published last month, is part of a radical overhaul of the pharmacy service under which chemists will prescribe drugs and administer tests for minor ailments such as coughs, colds and backache to take the pressure off GPs.

Up to 57 million consultations a year are expected to switch from GPs to pharmacists with savings of £400m a year by 2011. But in a move that has angered doctors' leaders, ministers are also proposing to change the rules which determine where patients living in rural areas obtain their drugs.

At present, patients who live more than 1.6 kilometres (1 mile) from the nearest chemist are entitled to get their drugs from their GP. Under the new rules, patients would have the right to receive their drugs from their GP only if the surgery is at least 1.6km from the nearest chemist. As most GP surgeries are located in towns or villages, the number of dispensing doctors in England is expected to fall dramatically, cutting access for their patients.

In England there are currently some 1,100 practices with 5,500 GPs who have the right to dispense drugs to 3.5 million patients. Richard West, chairman of the Dispensing Doctors Association and a GP in Suffolk, said: "We expect a majority of dispensing practices to lose their right to dispense."

Dispensing doctors earn £127,000 a year compared with £107,000 for other GPs. But Dr West said that dispensing work contributed £40,000 on average, so GPs who lost their dispensing rights could see their income drop to £87,000.

"Many dispensing doctors use their income from dispensing to support other services for patients, such as branch surgeries. Now, with uncertainty about the future, they are delaying appointing new partners or taking on extra staff. The result is that patients could end up with fewer doctors, fewer appointments and fewer services," he said.

Paul Cregor, a GP in a dispensing practice in Lincolnshire, said many doctors suspected the move was part of the Government's plan to involve private companies in running the NHS. "If new dispensing licences are restricted it will give an opportunity for the major chemist chains to get a monopoly," he said.

A spokesperson for the Department of Health said: "We are proposing changes to dispensing doctors arrangements on which there will be full discussions with the BMA andthe Pharmaceutical Services Negotiating Committee ... later this year."