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  • 100 hour and DDs

    The local surgery's application has been approved. Concerns were raised by local chemists but each was dismissed in turn by NM of Blisworth using loopholes in the acts.

    One of the points raised was regarding position of Superintendent Pharmacist.
    NM's reply was that he would be SP until permanent one appointed. He quoted a test case at Hughenden Valley as establishing this.

    It apperas to me that it is possible that a new multiple made up of DDs with NM as SP could be in the process. The local health authority says that as received assurances re services and 100 hours with no more than 40 hours by any pharmacist, they have had to concede the contract and no appeal is possible.

    Very worrying situation especially in view if carterfeira's posts in another forum re recent successes of DDs applications.

    The White Paper has enabled the DDs to present their case and gain allies in all parties.

    Meanwhile pharmacy just rolls over. As Oscar said "For evil to prevail it is sufficient for good men to do nothing"

    In the public's eyes, the DDs are knights in shining armour.

    johnep

  • #2
    Re: 100 hour and DDs

    Yes, NM seems to have made himself a nice little earner out of this. Quite a complicated situation isn't it.
    As I understand it, the RPSGB is very unhappy with the PSNC's position, but of course PSNC has always insisted that contractual matters are for it and it alone, and the RPSGB has got it's fingers badly burned when it tried!. Now, of course, PSNC is totally dominated by the companies, which also own wholesalers, so as far as the bottom line is concerned, it doesn't matter to them too much!

    As one who has ben concerned with "The Rural Question" one way and another for most of his professional life, I would say that the concept of a surgery and a pharmacy close together, especially in the same building is one which I would support, but the pharmacist must have professional independence. As far as NM is concerned, while he is correct that one can be a Superintendent for a while, resign and another be appointed, one can only be Superintendent for one company at a time!

    As far as the political campaign is concerned no-one seems (yet) to have pointed out that dispensing income is included when calculating doctors pensions! Or that a dispensing doctor writes a cheque to himself, which the Government will honour, with almost no checks on whether what is being done is what is alleged to be done. But, as I said at the beginning the PSNC doesn't want to get involved, and doesn't want (is frightened of?) others doing so!

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    • #3
      Re: 100 hour and DDs

      Who is nm? I assume he/she is a pharmacist?

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      • #4
        Re: 100 hour and DDs

        Originally posted by GAZ View Post
        Who is nm? I assume he/she is a pharmacist?

        Nigel Morley, who has been running various schemes on behalf of dispensing doctors for several years. Started off, if memory serves with a training scheme for dispensers. And yes, he is a pharmacist.
        Last edited by the old merlin; 25, November 2008, 02:54 PM. Reason: grammar

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        • #5
          Re: 100 hour and DDs

          Working in same area today and told that all local practices are dispensing. They are all clustered around town centre.

          Possibility of the 100 hour sgy becoming a consortium of local Drs and probability of direction of scripts, or am I just being cynical?.
          johnep

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          • #6
            Re: 100 hour and DDs

            The trouble is, John that, as you know, unless the doctors keep their "right" to dispense for all the patients, then bankruptcy at best is inevitable. Could well be that their children will have to leave school and seek employment where they may, (coal mines or fruit-picking) their wives will have to go on the streets and, as the doctors will be moonlighting as taxi-drivers, there will be no out-of-hours calls!

            The fact that no-one, doctor or other member of staff, has ever been made redundant from a practice in these circumstances is, of course, irrelevant.

            ChopperT, if you are reading this, you should know that those of us who have experience of your colleagues applications have, as you'll now appreciate, a VERY cynical view of the claims routinely made.

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            • #7
              Re: 100 hour and DDs

              Interesting discussion and no surprises really. I think there are various reasons for DDs seeking to open pharmacies, some will be doing it to try to increase profits whilst the majority of us are doing it to maintain profits. Opening a 100hr pharmacy is a big gamble. Pharmacists cost a fortune to employ by the time wages/pensions/benefits and national insurance is paid for such long hours. The financial benefit of selling OTC drugs seems small when there are other pharmacies around and supermarkets open until late. The white paper and challenges on rurality by large pharmacy companies has scared DDs into finding more secure ways of protecting their incomes. DDs currently have relatively low overheads by not needing to employ pharmacists or pay for overheads such as IT/shop fitting so most DDs are only taking on the risk of these overheads out of desparation. I would happily maintain the status quo however government bodies have caused a significant shift in thinking already simply by threatening a change. We currently face a challenge to our dispensing list by pharmacy companies trying to open pharmacies in the villages we cover. This is not the purely one sided problem of dispensing gps trying to take the profits of pharmacies -it is happening both ways.
              Irrelevant to the arguments that will be made about medical services that will be lost if dispensing income goes and the fact that GPs incomes will fall is the sad truth that dispensing staff may face redundancy unless DDs are proactive and seek solutions like 100 hour pharmacies to protect themselves and their staff. The prospect of making loyal, hardworking and caring staff redundant is one that I do not wish to face in just the same way that I'm sure most small pharmacies feel about their staff. These are sad times that did not need to be forced upon either side.

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              • #8
                Re: 100 hour and DDs

                I have to agree re staff.

                However, the original driving force was the provision of services in small rural communities, often by single handed GPs. With the formation of group practices, it was more convenient to site the surgery centrally for the various combining practices and this usually meant the local town.

                I remember prior to the introduction of the NHS when virtually all Drs dispensed, especially for their 'panel' pts. They were very happy to be rid of this on inception of the health service. Many Drs were single handed in the sense of no staff, ie no receptionist etc. As a rep, I would be first in a surgery and last out for my final call. No appts, health centres or dragon receptionists in those days and I could easily see 8 Drs in a morning. Most Drs welcomed a visit and often did not see a rep from one month to another.
                johnep

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                • #9
                  Re: 100 hour and DDs

                  Originally posted by ChopperT View Post
                  pharmacies around and supermarkets open until late. The white paper and challenges on rurality by large pharmacy companies
                  Glad you made the distinction between pharmacists and large pharmacy companies and supermarkets. As with medicine for a lot of us being a pharmacist is a vocation, yes we want to make a good living but the drive is different.
                  47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                  2018 AD : Modern Man : I shopped, I clicked, I collected.
                  How times change.

                  If you find you have read something that has upset or offended you an anyway please unread it at once.

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                  • #10
                    Re: 100 hour and DDs

                    Hi,

                    A quick question, how does the 'dispensing' sevice within a dispensing practice operate practically i.e. professional, legal, accuracy, and legal checks etc?

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                    • #11
                      Re: 100 hour and DDs

                      GP supposed to supervise, but no inspectors to worry about.
                      johnep

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                      • #12
                        Re: 100 hour and DDs

                        Pharmacy chiefs united with dispensing GPs over white paper plans
                        Pharmacy chiefs united with dispensing GPs over white paper plans - Chemist + Druggist

                        CAN SOMEONE EXPLAIN TO ME WHY WOULD PHARMACISTS UNITE WITH DD??? i might be missing something but feel free to enlighten me, after all are not the Drs who always complain of business and putting a lot of barriers between them and patients reasoning how busy they are...etc it take some patients days to book an appointment and see their GPs.

                        the survey is just a joke! i doubt it was randomised, yet it was aimed on those benefiting from the service.



                        [COLOR=Olive]xxxx They tried to break my back, but i survived. whatever doesn't kill you, will only makes you stronger xxxx
                        [/COLOR]

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                        • #13
                          Re: 100 hour and DDs

                          The PSNC is so far of the mark on this one.

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                          • #14
                            Re: 100 hour and DDs

                            If the profession was merely a dispensing service, then fine doctors - dispense! But the new contract, expanding role, prescribing, etc..... Surely on a clinical level a pharmacy gives a geat deal more than a dispensary in a surgery?

                            With regards to the patient survery, well thats expected, especially when the questions are put to the patients in such a way that the public believe the introduction of a pharmacy in their village will lead to closure of the surgery or loss of staff.

                            The justification of a dispensing doctors surgery should be dictated by health reasons, and them alone (not sentiment).

                            "Without change, there is no innovation, creativity, or incentive for improvement, those who initiate change will have a better opportunity to manage the change that is innevitable."

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                            • #15
                              Re: 100 hour and DDs

                              Interesting post by Dr Chopper. I would agree that DD's have a variety of reasons for their actions; humans generally do for any action. There are a number of points which, I think, would bear further examination:

                              He writes: "government bodies have caused a significant shift in thinking already simply by threatening a change." I submit that the change proposed is a logical one, and one which brings England & Wales into line with Scotland. Those who have studied this contentious issue know that, whereas, as another contributor pointed out, once doctors who dispensed were single handed in villages, economics and professional support have now pushed them into town, so that patients have to travel into the surgery, passing the pharmacy, which is often close to the surgery. I know of villages where although the pharmacy provides a regular delivery service to patients within the "mile limit" the dispensing doctors do not to those outside! However, I have also seen cases where pharmacist have opened considerable distances from the surgery and I cannot see that as beneficial.

                              I would say that, as one who once ran a Health Centre pharmacy that the idea of close contact between the two professions is close to my heart; I have no problem with the concept; when I was in a position to do so I pushed it and I wish that the various organisations concerned had the vision to encourage practitioners to get together. I would here commend to Dr Chopper the Devon dispensing practice where the pharmacist is a partner; given goodwill by all concerned there is no reason why any regulations, professional or contractual, making it difficult cannot be bent appropriately!

                              He also writes "Pharmacists cost a fortune to employ by the time wages/pensions/benefits and national insurance is paid for such long hours." It's called the going rate! Might it, I suggest, indicate why DD's seem to be on a Good Thing!

                              Pharmaceutical organisations are moving into such areas as his primarily because those are the only ones open to them. I have to admit surprise if it's the LARGE companies which are doing so, since they control the PSNC which has recently agreed a statement with the DDA! There are though, I think, one or two smaller organisations which have such a policy and I repeat my regret that they are not approaching such people as Dr Chopper with a view to joint development.

                              I agree that no-one likes the thought of the possibility! of making someone redundant, but in 20+ years involvement (admittedly to a lesser degree as time has gone on) with this issue I have never come across dispensary staff who have been made redundant! I'm prepared to believe that it's happened, and I've sought evidence of it happening but I've never had a actual case quoted. And I've been personally involved with several openings by pharmacies in dispensing doctor areas and have colleagues who've been involved in many more!

                              I noted his other post about finding a temporary superintendent. No reason why he should not advertise for such a person in the Pharmaceutical Journal, or approach an agency. One name has already been quoted on this thread. In spite of the attitude I appear to take I would not, in principle, be averse myself, subject to a careful review of the current arrangements in his locality, since as I said, a properly structured joint practice would be in the interests of the patients. However as I'm on the non-practising register I'll have to rule myself out!
                              Last edited by the old merlin; 28, November 2008, 04:45 PM. Reason: grammar

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