Scripts freedom dying
From Dr David Roberts, Hitchin, Herts
There will shortly be howls of anger from dispensing doctors as their new dispensing contract gradually leaks out following the recent NHS roadshows.
Briefly, the contract disposes of 'on-cost', which reasonably fairly uprated income in line with drug inflation, and has replaced it with an all-in dispensing fee that will cover 'on-cost', 10 per cent of the container allowance and the old dispensing fee.
A calculation has been made for the 2004/5 costs and we were told an uprating has been made to bring it to 2005/6 levels and there it will stick. The actual fee/item will be on a sliding scale around £2.30.
There will be winners and losers. Some will lose £50,000 a year, the average will be between £10,000-£20,000, they say.
The PCTs will be presented with a fixed sum for dispensing of £143 million and if this is overdrawn then dispensing doctors will be paid less the following year.
Dispensing doctors will have to register for VAT. There is no way out because if they don't then nobody will reimburse them for the VAT expended on drugs.
The sum of £71 million, which the PCTs previously redistributed for VAT, will be divided between all PCTs and all doctors, dispensing or otherwise.
Part of the dispensing income will come following the jumping of every QOF hoop placed in front of the practice.
It is an all or none fee and the hoops are many. The fee amounts to £2.58 per dispensing patient per year.
Finally, there is the compulsion for all doctors to prescribe only from a locally approved list. A nationally approved list of drugs is sure to follow. Prescribing freedom is dead.