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Dispensing practices' own-goals

Dr David Roberts sees a bleak future in the new rules on dispensing

With an astonishing lack of vision in these rapidly changing times, the custodians of dispensing practice have once again allowed themselves to be duped by the pharmacists, this time over the closure of the loophole in the Clothier dispensing regulations.

It would be bad enough if their incompetence affected only dispensing doctors, but it doesn't. It affects all GPs, especially those with a substantial number of patients in rural areas but for whom they do not yet dispense.

If any of these doctors were thinking about applying to dispense then, sorry, chaps, the Dispensing Doctors Association Ltd (DDA Ltd) and the GPC have slammed the door very firmly in your faces.

The Clothier regulations were enacted in the early 1980s, after decades of in-fighting by chemists and dispensing practices. They were an attempt to regulate who should provide drugs to patients and where. They had their drawbacks but dispensing practices did have a right to defend themselves against an applicant pharmacist.

This was thrown into turmoil in the mid-1990s when a pharmacist was told by the NHS Appeal Body that there really was no need for him to use Clothier in his application as he already had premises within his health authority area ­ and thus could open up without having to prove he didn't 'prejudice general medical services'.

Consequently, scores of chemists have savaged scores of GP practices and despite eventual formal legal proceedings by GPs and the GPC, the loophole remained, souring relations between the professions for the next 11 years. So, the chemists started the negotiations' penalty shoot-out with a lead of one goal to nil.

Eight years ago DDA Ltd was founded especially for the negotiations. It was prepared, if not determined, to give away the right of any other practice to apply to dispense anywhere. And that is exactly what has happened. Two-nil to the chemists.

However, chemists may still apply through Clothier's successor to invade dispensing 'controlled' areas of any size. Three-nil to the chemists.

But chemists will need to submit themselves to the 'prejudice' clause in future. Three-one.

Then come the clauses that subject dispensing practices to unprecedented inspections and the formal registration of all dispensing practices. Four-one to the chemists.

Then we come to the new dispensing clauses for doctors. 'Minor relocation' is introduced, practice amalgamations must satisfy 'prejudice', and the winding up period for dispensing practices has been reduced to three months after a chemist succeeds in his application. Five-one to the chemists.

GPs are still not recognised as providing 'pharmaceutical services', though God knows what else they do. This makes the chemist's application relatively easy.

This is becoming a rout, six-one, which is just about what should be expected when a non-league Conference side takes on one of the leading Premiership teams.

Admittedly the concept of 'reserved locations' has been introduced but these only protect the smallest of areas where, as the Government says in its guidance to PCOs, pharmacy would not be viable in any case.

To be fair to the GPC, they just wanted to get this long-running sore off their backs but there is no such defence for the DDA Ltd. It has spectacularly failed to protect its members while irresponsibly taking away the rights of other GPs ­ without any consultation.

Dr David Roberts is a GP

in Kettering

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