OFT pharmacy competition proposals
Hewitt indicates that the government will turn down OFT proposal.
UKHRA response to OFT competition proposals
To Peter Dunlevy, Department of Health (07/03/03)
Please forgive this
hurried response and I hope an email will suffice in lieu of a letter
Our modelling of HCV (at Imperial College) indicates that syringe distribution needs to expand significantly in order to have an impact on HCV incidence. A major concern must be that pharmacists relocated into supermarkets will restrict access. It is unlikely to be a priority in any business plan to increase the number of drug users using supermarket based pharmacists. Any reduction in local availability is likely to result in increased inconvenience to drug users which is unlikely to be offset by increased opening hours. Has OFT and DH considered the impact on needle exchange activity and public health in its exit scenario modelling? If the proposals are accepted, what provision can be made to preserve local supply and exchange of needles and syringes?
other substitution treatment
Will there be provision for all pharmacies including supermarkets to dispense all NHS prescriptions? Para 1.25 of the OFT report states "this would mean that all registered pharmacies with qualified staff may dispense NHS prescriptions." - it does not say that they 'shall' do so. We need to clarify whether or not this means that pharmacists will have a choice over which prescriptions they choose to dispense.
Currently under the NHS contract they have to dispense all NHS prescriptions. Supermarkets will not want to increase the number of drug users using their facilities solely to obtain prescriptions, often on a daily basis, and not purchasing other products within the shop. Given that the NTA target is to get 100% more drug users into treatment by 2008, this could mean a considerable increase numbers using these facilities. And what will happen with supervised consumption? Given that the NTA is pushing for increased use of supervised consumption the proposals may have a major impact on acceptability to drug users and their privacy.
It is hard to imagine
that supermarkets would be willing to allow supervised consumption. And
whilst the longer opening hours of supermarkets may make it easier for
some patients to collect methadone, there will for some be the problem
of access, particularly if a visit to a supermarket is only possible by
I could, given more
time. back up these points with more data on syringe distribution and
methadone - but you probably have this in any case from within DH and
Our HIV, HBV and
HCV prevention and our drug treatment strategies rely heavily on the participation
of community pharmacists. It has often taken local drug services many
years to establish good working relations with community pharmacies and
to persuade them to deliver services to drug users. It would be a pity
if much of that was destroyed for the sake of a notional saving to consumers
of about £30 million a year. Indeed, there might be considerable
costs to offset against this and borne by government in making alternative
arrangements for delivering the above mentioned parts of the drug strategy.
Prof Gerry Stimson