Health

LORD GRADE makes a passionate plea to save independent pharmacies

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Down by the quayside at Yarmouth on the Isle of Wight, where my wife and I are living under lockdown, there stands a stalwart of the community, a sweetly old-fashioned local chemist.

The pharmacist’s wooden windowfront sits on a narrow street between the local newsagent and the King’s Head pub. To the casual passer-by, it reflects a Britain staying quietly resilient in the face of Covid and all our other trials.

But if you live in the area, you can’t help but notice that the chemist’s lights stay on from dawn until late into the night. The owner, pharmacist Tim Gibbs, seems always to be working in there.

Thanks to a government funding crisis that is bankrupting the nation’s independent chemists, Tim is, indeed, having to work from dawn to 10pm, seven days a week. 

Even so, his financial losses have proved so great he’s been forced to let go of three of his staff in the past year.

To the casual passer-by, it reflects a Britain staying quietly resilient in the face of Covid and all our other trials. But if you live in the area, you can¿t help but notice that the chemist¿s lights stay on from dawn until late into the night, writes Lord Grade, pictured in front of the pharmacy

To the casual passer-by, it reflects a Britain staying quietly resilient in the face of Covid and all our other trials. But if you live in the area, you can’t help but notice that the chemist’s lights stay on from dawn until late into the night, writes Lord Grade, pictured in front of the pharmacy

Now he must do the work of four people. The shop cannot lawfully open unless he, as the qualified pharmacist, is physically inside. Tim cannot afford to pay a locum pharmacist to cover for him.

At night, he personally delivers all the prescriptions to housebound and shielding people who simply could not get their essential medications otherwise. He performs this vital service free of charge.

My wife, Francesca, and I are in and out of the shop all of the time, so I couldn’t help but notice Tim’s plight. He’s had no family holidays in the past few years, and took only one day off last year, on Christmas Day. He looks exhausted. I honestly don’t know how he is still standing.

Then I discovered that Tim is far from alone in being squeezed out of business. His dire situation is typical of this country’s independent single- unit pharmacies.

Tim, at least, has some security in that he bought his own premises years ago, so is not constantly in fear of landlords’ rent rises, as are so many other pharmacies. That is the reason why he has been able to keep going thus far. But he can’t get a penny out of the business for himself.

Now, he says, he is at crisis point, if not beyond. Tim fears that he will be forced to close within 12 months unless funding from the NHS improves.

He is hardly alone. Across the UK, some three-quarters of independent, often family-owned, pharmacy businesses are either closing or under threat of closure, according to a study by Ernst & Young last year.

The shop cannot lawfully open unless he, as the qualified pharmacist, is physically inside. Tim cannot afford to pay a locum pharmacist to cover for him [File photo]

The shop cannot lawfully open unless he, as the qualified pharmacist, is physically inside. Tim cannot afford to pay a locum pharmacist to cover for him [File photo]

The shop cannot lawfully open unless he, as the qualified pharmacist, is physically inside. Tim cannot afford to pay a locum pharmacist to cover for him [File photo]

The report concluded that, without intervention from NHS England, many community pharmacies will be unable to survive. In many areas, this will severely limit people’s access to health services.

Last year, nearly four pharmacies per week closed, with deprived areas hit worst, an analysis by The Pharmaceutical Journal reported last month.

Overall, the UK lost 202 pharmacies in 2020 — the highest number in five years. Some 11,000 remain battling on, prescribing more than one billion items a year in England alone.

And all this at a time when local pharmacies have proved a lifeline for so many people unable to see their GPs because of Covid-19.

But beyond the pandemic, independent chemists are a hugely important part of British life. Entire communities rely on them — as their sole local pharmacy — for their continued health and wellbeing. And for people living alone, it can also be a vital point of simple human contact.

Seeing Tim’s battling community spirit — and knowing what a vital role these chemists play — inspired me to campaign on their behalf in Parliament, where I am a Conservative life peer.

I quickly learnt how independent pharmacies are having to be run in a way that effectively subsidises the NHS to the tune of millions of pounds a year.

Tim is out of pocket by 73p every time he performs the vital job of providing people with a medicine vital to their health. He is paid £1.27 for every NHS prescription that he dispenses — but dispensing each prescription actually costs him £2 in overheads such as insurance, business tax, staff costs and specialised computer systems. What’s more, his overheads are rising by 5 per cent a year.

For two hours every day, Tim is on the phone chasing wholesalers to supply him with vital medicines.

Yet because he is not part of a chain, he does not get the discounts that the wholesalers enjoy. The wholesalers are owned by big pharmacy groups that don’t share their discounts equitably with the independents.

Overall, the UK lost 202 pharmacies in 2020 ¿ the highest number in five years. Some 11,000 remain battling on, prescribing more than one billion items a year in England alone [File photo]

Overall, the UK lost 202 pharmacies in 2020 ¿ the highest number in five years. Some 11,000 remain battling on, prescribing more than one billion items a year in England alone [File photo]

Overall, the UK lost 202 pharmacies in 2020 — the highest number in five years. Some 11,000 remain battling on, prescribing more than one billion items a year in England alone [File photo]

The Government deems, however, that independent pharmacies do fully receive discounted rates and effectively deducts the difference from them.

This lost Tim £52,000 last year. It only pushes him and his fellow independents deeper into crisis.Tim’s plight is shown starkly by this comparison. In 2016, he filled 81,900 prescriptions and received £95,270 from the Government. In 2019, he filled 89,700 prescriptions and received only £79,350 from the Government.

Furthermore, the NHS contract has frozen funding for community pharmacies until 2024. This follows a series of swingeing funding reductions, with £113 million being cut in 2016, and a further £95 million axed in 2017.

Nevertheless, the Government also expects pharmacies to do more and more. It is currently trying to recruit them into a new scheme called the NHS Community Pharmacist Consultation Service.

This lets GP surgeries and the NHS 111 phone line divert people to local pharmacies for help and advice, instead of using their own services. The pharmacists are then expected to give these people advice and treatment for a range of minor illnesses.

Research shows that in the UK, pharmacies already, of their own volition, perform more than 600,000 such consultations with customers every week on average.

If they weren’t doing this work, it would add some 500,000 extra appointments to the workload of our GP surgeries. The doctors simply wouldn’t be able to cope.

Patients often consult chemists as their first point of contact. Typically, the problem is something with which qualified pharmacists can indeed help, by giving advice or recommending over-the-counter remedies. If the patient’s needs are beyond their scope, then pharmacists know to advise them to see their family doctor.

Each independent pharmacy also now administers, on average, 850 flu jabs a year for the NHS.

They are excellent gatekeepers for GPs and A&E, and throughout the coronavirus pandemic they have worked as the heroic front line of these services.

Indeed, an analysis of government figures shows that the use of community pharmacies soared during the pandemic, with a third more prescriptions dispensed at the height of the first lockdown in March 2020, and a third of patients reporting that they visited a pharmacy instead of their GP.

When a community loses an independent pharmacy, the answer isn’t simply to travel farther. In places such as Yarmouth, there is a significant proportion of elderly people who don’t drive, and so cannot visit chemists elsewhere. And they certainly can’t rely on the sparse local bus service.

Of course, the big pharmacy chains are not interested in opening branches in small towns such as Yarmouth because the profits aren’t there.

People go up in arms about post offices closing, but this is much more serious.

Pharmacies are already seriously underfunded and now, thanks to Covid-19, the situation has become even worse, forcing the independents to take on even more costs, with the need to provide partition screens, protective equipment and regular deep cleaning.

The NHS community pharmacies’ representatives, the Pharmaceutical Services Negotiating Committee (PSNC), has asked the Department of Health for additional funding, not only to cover the costs associated with the coronavirus, but also to keep pharmacists from going bust before 2024. However, the only government support has come in the form of loans. The sums on offer are woefully insufficient and only worsen the pharmacists’ problem in the long term.

Some £370 million has been given out in loans. Not only is this not enough to support independent pharmacies adequately, as I pointed out in the House of Lords, the loans will also need to be paid back. Many independents simply will never be able to afford this and will be forced to close.

Such a deal is plainly ridiculous. The Government must instead write off these debts. It must transform these loans instead into investments in the future of UK independent pharmacies.

Earlier this month, I set up a 30-minute Zoom call with Jo Churchill, the junior health minister, so that she could talk with Tim and a fellow pharmacist from Huntingdon, Cambridgeshire, to hear of their plight.

The minister seemed very sympathetic, but at the time she made no commitment to action.

Screen time

This week: Scary films protect against mental health problems during the pandemic

People who enjoy horror films may have greater psychological resilience to the coronavirus pandemic, according to research from Penn State University in the U.S. working together with Danish scientists.

The findings were based on an online survey involving 310 people who were asked questions designed to evaluate their resilience levels, as well their viewing habits before the start of the pandemic.

Those people who watched horror, psychological thrillers and apocalyptic films experienced reduced psychological distress during the current crisis, wrote the researchers in the journal Personality and Individual Differences.

The scientists suggest their findings show that stories from films, books and even video games may help us imagine and prepare for future challenges.

Now, though, we have a ray of hope. Last week, at a press briefing, Boris Johnson answered a journalist’s question about the community pharmacists’ crisis by pledging that they should be reimbursed for their additional costs during the pandemic ‘as soon as possible’.

The Prime Minister said: ‘I don’t want to see any pharmacies close. I think community pharmacies provide an absolutely outstanding resource for our country.’

Problem solved? Sadly, it’s not that simple. As the PSNC’s chief executive Simon Dukes said in response to Boris Johnson’s pledge: ‘Negotiations on Covid-19 costs are ongoing. At their heart is the question of how great those costs are.

‘This is the difficult discussion that we are having with the Treasury and the Department of Health. The very positive words of politicians must now lead to the funding outcomes that we need.’

The Prime Minister’s words must urgently be transformed into real action. Otherwise Tim’s pharmacy and untold numbers of others will undoubtedly go out of business, severing millions of people’s vital link to the NHS.

And when our independent pharmacists fold, the tragedy is that they will not be replaced.

The Government needs to understand how serious the loss of community pharmacies will hit our national life. If you rely on your local pharmacist, I would urge you to write to your MP calling for their lobbying support.

Millions of us now depend on local heroes such as Tim. We all need to campaign for their survival — and not least for our own sakes.

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bourbiza

Bourbiza Mohamed. Writer and Political Discourse Analysis.

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