Letter: Complementary roles of the doctor and pharmacist

Sir: John-Paul Flintoff's report, based in part on extracts from a lengthy telephone conversation with me, gives a distorted picture of the long-running battle between doctors and pharmacists in rural areas.

Throughout Europe every rural town and village has its pharmacy. That is not so in England. Doctors can simply take over dispensing in rural areas so that when the surgery is closed people have to wait to have their prescriptions dispensed. Even when there is a pharmacy there, patients on a doctor's dispensing list are prevented from using it.

GPs are paid generous allowances towards the cost of premises and ancillary staff. They are also paid a profit on their dispensing so they are reimbursed twice. On average, a doctor is paid about pounds 1.50 per prescription; by contrast the pharmacist is paid about 12p. It is thus hardly surprising that 'dispensing doctors' write 17 per cent more prescriptions than do their non-dispensing colleagues.

Pharmacists dispense several billion pounds worth of drugs annually at the taxpayers' expense. The Government naturally checks dispensing on a random sample basis to ensure that the taxpayer is getting value for money. No such checks are applied to dispensing by doctors who are thus able to spend tens of millions of pounds worth of taxpayers' money without anyone knowing what, if anything, it has been spent on.

This problem does not exist in Scotland because there is no extra financial reward for dispensing by doctors there. Rural pharmacies are thus viable and able to thrive. Doctors get emergency supplies of medicines by writing a special NHS prescription for their own use, but this facility is not available in England and Wales. In Scotland there is harmony between the medical and pharmaceutical professions; they work together for the benefit of patients and that is the way it should be throughout the United Kingdom.

Yours faithfully

T. P. ASTILL

Director

National Pharmaceutical

Association

St Albans, Hertfordshire