Message from John D'Arcy
Marshall Glynn has asked me to express a view on the best way forward for adding weight to the campaign against the funding cuts proposed by the Department of Health in England. Pharmacy has mounted a very successful campaign which has featured a large amount of both national and regional activity, including a petition that now has over 2 million signatures from members of the public who are, rightly, concerned about the impact of the cuts on their local pharmacy service provision.
From a Numark perspective we have written to the Department of Health to express concern about the proposals and have commented widely on their impact. We also made a detailed submission on the hub and spoke consultation. However, we took the view that the organisation and implementation of a pan pharmacy campaign is best left to the representative bodies, including Pharmacy Voice, PSNC and NPA. Particular praise should be given to NPA, who have spearheaded a campaign which hits at a political and consumer level raising awareness of pharmacists’ concerns about the impact of the proposed cuts and half-baked government proposals.
It is clear that the campaign is having some resonance. It woke Alistair Burt from his sleep-walk and made him focus on pharmacy, and he participated on a number of pharmacy visits and meetings with pharmacy representatives to better understand what pharmacy does for local communities, and the concerns pharmacy has about the funding cuts and proposals. A risk with any politician is that they move on and so it is with Mr Burt. We now have to start afresh with a new Minister. But always bear in mind that the man at the top of the Department of Health, Jeremy Hunt, is still in post.
The consultation on the Department of Health letter and its “proposals” closed on 24th May and we now wait to hear what the Department of Heath intends to do. It looks like the 6% is here to stay. This seems to have been driven and agreed at a Treasury level. However, it is not clear what will happen in future years. There is no doubt in my mind that the campaign has made Government re-think some of the proposals. The original letter was piece-meal and poorly drafted. We have already seen one significant U-turn in respect of hub and spoke which has – for now at least – been kicked into the long grass. This is due entirely to the noise created by pharmacy about how ill-conceived and nonsensical the plans were, including the lack of any business plan behind the proposals. With a new PM and front bench team, there is at least an opportunity to give further and better thought to the proposals and to consider whether they are in the best interest of the health needs of local communities. And whilst the 6% may be gone, there may be an opportunity to negotiate in other ways as a means of minimising the impacts of the funding cuts.
The key factor in any campaign will be gaining the support of the public. Pharmacists may be forgiven at times for thinking they have no allies, given the recent onslaught from the Department of Health. However, politicians - at every level - will always listen to constituents as their political future depends on local support. So the existence of a petition with 2 million signatures on it conveys a powerful message to MPs of support for local pharmacy services and makes clear the concern local communities have about the impact of the funding cuts on local service provision. The fact is that consumers love pharmacy. The pharmacy is at the heart of their local community and, in many cases, the only viable healthcare provider in the community. A huge problem for the NHS is access to services and the community pharmacy network provides a ready-made solution to this problem. The community pharmacy network guarantees access for all within easy reach of virtually everyone from where they live or work or their doctor’s surgery. Why would the Department of Health want to put this at risk? In essence, the “proposals” appear to be playing fast and loose with a system that works well to meet the needs of local communities.
One of the debates throughout the campaign has been whether to show support through the signing of a single letter or through the preparation of a large number of individual letters. An individual letter approach is always the best because it indicates the writer has taken time to compose a letter in his or her own words and, where this is particularised to reflect local circumstances, it has a much greater impact. “Standardised” letters, on the other hand, are easy to copy and easy to sign and will always convey the impression that this is simply a campaign orchestrated centrally by one or more representative bodies. Individual letters from local contractors outlining particular issues for their local communities illustrate that the national campaigns are reflective of the view of members on the ground.
So where to next? The consultation has closed and we wait to see how the Department of Health responds. But it is clear that this is not the end of the process. The Department of Health wants change and is clearly frustrated by the pace of change within the community pharmacy sector. Pharmacy cannot resist change and must engage in dialogue with the Department. However, the change must come in a phased manner and in line with an agenda and timelines that have been agreed between pharmacy and the Department of Health. In the meantime, we need to keep up our lobbying efforts. At local level we need to impress upon local MPs and customers what pharmacy is all about and of the health benefits pharmacy brings to local communities. At a national level, Ministers need to be educated about the many ways pharmacy can and does contribute to local health improvement. Alongside this, negotiators need to make the case for investment – and not disinvestment – in local pharmacy services, which day in day out provide health gain and value for money wherever medicines are used.
The efficacy of any message is proportional to the level of engagement on the ground. So, I would urge all contractors, who have not already done so, to get involved in engaging their customers and political representatives so that they fully understand the potential implications of the funding cuts and other proposals on the viability of the pharmacy network and the extent of local service provision.
Full detail of the pharmacy campaign along with a wealth of support resource can be found on the NPA Website:
John D'Arcy - Numark