A case of bad medicine: Peter Victor on a war between doctors and a chemist

MONEY and medicine make a volatile mixture. It has fermented into a bitter battle in a quiet Wiltshire village as two GPs and a chemist fight over lucrative drug-dispensing rights. The dispute, punctuated by threats and subterfuge, has left patients frightened and medical authorities apparently powerless.

Edwards Chemist opened in Wiltshire's largest village, Durrington, last January. Until then the village's two surgeries, the Avon Valley Practice, run by Dr Anthony Davis, and Dr Bill Grummitt's, made up prescriptions from their own dispensaries. Doctors with dispensing rights receive 80p for each prescription they make up, but under NHS rules rural doctors are not allowed to dispense prescriptions if there is a chemist in their area. So the two surgeries began using Boots in Salisbury.

Dr Davis and Dr Grummitt had organised petitions of local residents against the new pharmacy, claiming that medical services would be reduced and patients might 'have to travel as far as Salisbury for out-of- hours medicines'. Nevertheless, the Department of Health gave Edwards Chemist permission to open.

However, once its pharmacist, Sultan Dajani, arrived in the village, the doctors began a war of attrition. Patients were asked to complete forms nominating their doctors to collect prescriptions for them. Elderly patients were deputed to collect prescriptions from Boots 12 miles away in Salisbury.

Rumours circulated in the village: the new chemist sent its prescriptions to Boots anyway; John Nash-Steer, its owner and Mr Dajani's employer, had already opened a pharmacy in Durrington and gone bankrupt; staff at the new pharmacy were ignorant and not qualified to 'play with medicines'.

Mr Dajani says that some of the rumours were laughable but others were deeply damaging to a business that serves a population of 12,000 from neighbouring villages and an Army barracks.

'We should be doing 3,000 prescriptions a month. We get around 400. We get a grant from the Government so we could keep on like this forever. But I don't want to take taxpayers' money that way. I want to work and provide a service.'

He attempted to win over the doctors, inviting them to visit his dispensary. He says Dr Davis declined and banned him from his surgery. Dr Grummitt visited the surgery on 2 February and later wrote a letter to Mr Dajani advising him to: '1) Stop selling sugary sweets. 2) Be careful of John N-S. He admits that greed is his motivation. If you have money of your own, be more than careful. 3) Keep in touch with the job market: I believe your stay in Durrington will be temporary.'

Mr Nash-Steer, who owns a pharmacy in a neighbouring village, called in private detectives. Their report said Avon Valley staff asked new patients to sign a pink form authorising the surgery to provide medications. 'The procedure was given as if this was the only method to collect prescriptions,' said the report.

At Dr Grummitt's surgery, a receptionist said all new patients had to sign the pink forms, adding that a new chemist had started trading 'which we do not like to use'.

The report said that villagers felt the new chemist was being victimised. Last week, one of the patients making prescription runs to Boots in Salisbury agreed, although he did not want to be identified. He said the driving had become onerous, with both surgeries needing collection runs. Nor did he receive petrol money for his trouble. 'I did it at first because I thought I was helping elderly people, but the truth turned out to be different.'

The Salisbury branch of Boots has been reported by Mr Dajani and Mr Nash-Steer to the Royal Pharmaceutical Society for its part in the arrangement.

A Boots spokesman said: 'There are discussions between our pharmacy supervisor and the society. I cannot comment on those discussions.'

Several patients, who did not wish to be named, said they now felt unhappy with the doctors' hard-line attitudes. One has complained to the Family Health Service Authority that Avon Valley Practice prescribed a drug that had been discontinued. She has since changed doctors.

Another has written to the FHSA saying she is sure doctors in the village are trying to close the chemist. One local resident has written saying he is 'appalled to learn that the doctors at the Avon Valley Practice are going to great lengths to prevent their prescriptions being dispensed at the newly opened chemist there'.

Another patient wrote: 'I signed the petition at the Avon Valley surgery against the opening of the pharmacy . . . because I felt pressured into it and scared . . . I am writing this now because I feel disgusted . . . how the doctors and Boots are treating the pharmacy, which we have needed here for years.'

Last week Dr Grummitt said the new chemist was costing him pounds 1,500 a month in lost dispensing fees: 'This (surgery) building cost me pounds 310,000. That is a lifetime's commitment. My income has suddenly dropped. Nash-Steer is doing this to turn one shop into a chain so he can retire on the fat profit. I am happy he is finding life difficult.'

Dr Davis denied forcing patients to sign forms: 'My patients are not frightened of me. They organised themselves. I was approached by a group of patients who said they wanted to take their prescriptions to Boots in Salisbury. Frankly, an intellectual contest between myself and Mr Dajani would be most unfair.'

But Mr Dajani said he would not give in. 'I trained for four years to do this. I'm getting paid to do it - I'm damn well going to do it.'

(Photograph omitted)