Letter: Pharmacists can help NHS drugs debate

Sir: Ian Bogle and Ian McKee (Letters, 16 March) are, of course, both correct: first, there is no simple answer to the control of the prescription drug bill, and, second, pharmacists do have a financial interest in the reduction of the total amounts of drugs prescribed. The Nuffield inquiry into pharmacy a number of years ago identified this financial interest in the cost of medicines as inhibiting the pharmaceutical profession from taking a more active role in reducing their inappropriate use.

Now, it seems, that in suggesting restricting the number of days' cover a normal prescription should give, the pharmacy is suspected of evil interest in seeking additional dispensing fees, which would occur only if Dr McKee and his colleagues continue to prescribe the same total amounts of drugs.

Dr McKee does not believe, I am sure, that the duration of a course of medication on a prescription has anything to do with controlling the frequency of visits to surgeries, although patient convenience must come into the equation. But polarised debates are sterile and if all sides continue to claim that 'they would say that wouldn't they', we will get nowhere.

An informed and urgent inquiry with the medical and pharmaceutical professions and those who invent and produce the drugs (the pharmaceutical industry which is not a 'medical' institution) as well as those who use them (patients) and those who pay for them (the taxpayers via their representatives in government) is overdue.

To exclude pharmacists, who are highly trained in matters which inform the industrial, clinical and therapeutic debate as well as understanding fully the issue of generic medicines, would be folly. New modes of payment of pharmacists (such as the Dutch method of capitation fees) would remove any doubt about the monetary interest and allow the true potential of pharmacists as independent arbiters of quality to be realised.

Yours faithfully,

ALEXANDER FLORENCE

Dean

School of Pharmacy

University of London

London, WC1

16 March