Allan Sharpe is regarded as a hero by customers at his Gwent pharmacy, where he ignores the pounds 5.25 NHS prescription charge if the real cost of medicines is lower.
He has earned support from Labour and Liberal politicians. His neighbours in the former mining village of Newbridge have idolised him since he introduced cheaper charges during the miners' strike. But his fellow chemists are fuming.
Mr Sharpe will face a disciplinary hearing before the Gwent Health Commission in August,which could change the way pharmacists charge for drugs.
The commission argues that by treating NHS prescriptions as private prescriptions where the cost of drugs is less than the pounds 5.25 NHS flat rate, he is breaking his NHS contract.
At the moment, chemists are supposed to charge the flat rate regardless of the medicine's cost. Most medicines cost less than the prescription charge, leaving a balance which is fed into NHS coffers to subsidise the 80 per cent of prescriptions that are free to the elderly and unemployed.
But 12 years ago, during the miners' strike, Mr Sharpe began to treat low-cost NHS prescriptions as if they had been prescribed privately, and he has continued to do so ever since.
"Where the item can be bought for less than pounds 5.25, I treat it as a private prescription," he said. "If it costs more than pounds 5.25 then it is dispensed as an NHS prescription.
"The simple fact is that many people can't afford to pay, and they simply tear up their prescriptions and go without the medication they need. We know this happens; it is a fact of life. The end result is that because they do not take their medication, they often require expensive hospital treatment."
Seven months ago, the parliamentary health committee appeared to agree with Mr Sharpe when, in one of the conclusions of a report on NHS drug budgets, it said: "We ... recommend that the Government introduce a system whereby the pharmacist may dispense the item privately if the cost of the product prescribed is less than the NHS prescription charge."
Until Mr Sharpe's hearing in August, the position of pharmacists will remain unclear, but customers such as Julie Giles, one of his regulars, said she could not afford to pay for her weekly prescriptions if he charged the NHS rate. "We think it is disgraceful that Mr Sharpe is facing this sort of action only because he tried to help sick people," she said
But Gordon Geddes, assistant secretary of the Pharmaceutical Services Negotiating Committee, which represents community pharmacists, said private dispensing would benefit large chemists who could buy in bulk, forcing out smaller pharmacies.
"Lower prices might benefit customers in the short term, but in the long term they might find that their local chemist, who can't compete, has to close down," he said.
"Then, if more pharmacists prescribe on a private basis, the NHS prescription charge would have to rise again, resulting in more medicines falling below the flate rate, which would result in more private prescribing and so on. The loss to the NHS could be enormous."
The dispute has highlighted the confusion over drug-pricing. More than 50 per cent of all prescribed items cost the NHS less than the prescription price. Diazepam tablets, for instance, which are available only on prescription, cost less than 20p for 50, while Warfarin tablets retail at 44p for100.
The Department of Health has suggested that GPs should dispense cheaper drugs using private prescriptions, but the British Medical Association's advice to GPs is that this could be against their contracts.
"Our problem is a contractual one," a BMA spokeswoman said. "Our legal advice is that doctors cannot issue a private prescription to an NHS patient."Reuse content