With Joni Mitchell playing in the background, I hear the lyrics:
Don’t it always seem to go
That you don’t know what you’ve got
Till it’s gone
I add to this the comments from journalists, MPs and Ministers talking about community pharmacy and I am sure that they don’t understand what they have and its potential.
We all know that community pharmacy dispensed medicines. The more important aspect of that is managing an ever more fragile supply system, ensuring patient safety and offering advice. They think that this can be done electronically at a distance, through the post and at a lower cost. They may be right, although there is precious little evidence to show that this is the case.
The difficulty is looking into two futures.
- Firstly when a third of community pharmacies have closed down their unprofitable front end to fight a commoditised world of dispensing in bulk. Or;
- Secondly when community pharmacy builds a network that delivers enhanced services that reduce the pressure in General Practice, urgent and emergency care.
The choice depends on NHS performance. Most performance indicators have slipped, many services have been decommissioned, General Practice is struggling and urgent and emergency care is swamped. It is clear that the Government has no intention of paying their way out of this problem until the NHS collapses or the next election beckons. I am confused as to how fewer community pharmacies, with less staff, offering fewer services in shorter opening hours helps?
How will you, the Government, encourage pharmacy owners to invest in their premises and staff, manage the move to bulk dispensing systems and seriously reduce demand in the over-stretched? I can see that money becomes the lever. However a lever without a vision, a route map and directed support is hopeless.
It is about time that there was some explanation of what the Government wants Community Pharmacy to become and how they are going to facilitate that change. Perhaps they really won’t know what communities have until they are gone.