An Unhealthy Decision for Us All

An innovative and worthwhile healthcare service has been suspended because of a dispute between the Department of Health and around 500 community pharmacists in Northern Ireland. It is a dispute which appears to be of the Department’s own making and which has left the public bemused. For just over two years, the pharmacists have been providing a minor ailments service, treating common conditions such as hayfever, coughs and colds.

The need, and indeed desire, for the service is amply illustrated by the numbers of people who have availed of it during that period. It is estimated that the pharmacists have conducted 350,000 consultations. These are people who would otherwise have gone to their GP for advice and treatment, or else suffered on until their condition improved. The service ended when the Department planned to extend the number of minor ailments in the scheme to eight, but, at the same time, cap the number of paid consultations carried out by the pharmacists. Any extra consultations provided would not be paid for by the NHS. Pharmacists, who are asking for extra money for the service as part of protracted contract negotiations with the Department, not unnaturally refused to agree to the new criteria.

It is a puzzling row, even if viewed simply from an economic point of view. The cost of each consultation with a pharmacist is under Pounds 7, compared to more than Pounds 40 for a consultation with a GP. The pharmacists reckon they have saved the NHS more than Pounds 12m in the two years that the scheme has been going, based on the number of people they have seen. At a time when the Department of Health is seeking to cut its spending as part of the government- wide review, it seems to be a nonsense to jeopardise a cost- effective healthcare system.

While it has to be admitted that the pharmacists are seeking more money for their services, it would still be less costly than allowing all these patients to see their GP. The type of ailments covered can be adequately dealt with by pharmacists, so there is no diminution of the care on offer. Pharmacists are expert in drug treatments and also know when to refer patients to other medical specialists if the condition is outside their field of expertise.

The minor ailments service also had another tremendous advantage. It is becoming increasingly difficult to get an appointment to see a GP. Many patients have to wait several days or even a week before visiting their doctor, unless in an emergency. Having an alternative healthcare expert available on a drop-in basis means that people can be seen, assessed, treated or referred to their doctor much more quickly. The minor ailments service meant that hard-pressed family doctors were able to concentrate on potentially more serious health queries.

The service was both cost-efficient and effective. It treated thousands of patients and freed up valuable GP time. It is up to the Department to find a way of resolving its dispute with the pharmacists and to get the service running again.

In the meantime, the real losers are the patients who used the service and who now have to wait much longer for assessment and treatment.

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