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Gold, incentives and meh

Dispensing practices under threat

Almost 300 practices in Scotland are threatened by closure in the wake of the Government's push to replace dispensing doctors with community pharmacies, the BMA is warning.

The GPC said doctors who provide a crucial dispensing service in rural communities were under threat from the revamped national pharmacy contract.

The change, which opponents claim was not given full public consultation, gives pharmacists cash incentives to provide additional services such as a minor ailment surgery and non-prescription medication reviews – all routine, unpaid services already offered by dispensing doctors.

Dr Susan Taylor, chair of the Rural Practitioners Association and a dispensing GP in Oban, Argyll, said: ‘Politicians think doctors dispensing medicines is perverse, but I represent very rural doctors where there has never been any choice.'

The GPC last week joined the battle saying that Scottish GPs were a special case for consideration. Dr Laurence Buckman, GPC chair, said: ‘We often have this cliche about dispensing practices. The Scotland rural doctors do not fall into that group.

‘These are people who are low earners with small lists, so people sit back and say "well they don't do much work, they don't need to get much money", but actually, that's not fair – they are where they are because they are providing an essential service for people who live there.'

GPs in Scotland are required by law to dispense when there are not enough patients to support a pharmacy, but they must stop if a pharmacy opens.

Since 2006 the pharmacy contract has been having a creeping effect across Scotland, particularly in Ayrshire – without a full public consultation.

This contravenes arrangements set out in Scotland's

NHS Reform Act 2004, said Dr Andrew Buist, deputy chair of the Scottish GPC.

He said: ‘If residents were made aware of the impact that this could have on their ability to access a wider range of healthcare services from their local GP practice, then they may not be so enthusiastic.'

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