North Uist Medical Practice under threat from pharmacy move. This analysis is from the Dispensing Doctors Association.

Hebridean Isles face first pharmacy threat

Public consultation runs until September

By Ailsa Colquhoun

Public consultation has started on an application to open the first pharmacy in the Outer Hebridean islands of Benbecula and North Uist.

The total neighbourhood targeted by the new pharmacy is thought to comprise around 2,700 patients.  The application has been lodged by a company registered as Local Pharmacies Limited, in January 2012, in Montrose, Angus.  Local Pharmacies is listed as having one director and two Glasgow pharmacist founders: Mohammed Yousaf Kashif Rahman Ahmad, and Mohammed Khalil Jamil.

In August, 2012, Mr Jamil received a warning from the pharmacy regulator’s fitness to practice committee. This requires Mr Jamil to “maintain proper professional boundaries in relationships with colleagues, patients, the public and other individuals”.

The new pharmacy proposes operating from premises in Balivanich on Benebecula and is the Health  Board’s first formal pharmacy application to affect a dispensing practice. Dr Kate Dawson from the Benbecula Medical Practice says there have been three previous enquiries from pharmacy businesses, but none have progressed to a formal application, “partly because of the high costs and marginal sustainability”, she says. Consultation events will be taking place in the affected neighbourhood during August, and will end on 29th September.

Doctors from two separate dispensing practices affected by the application say the new pharmacy could have a devastating effect on local GP services. If successful, the application will remove dispensing rights from all 1,400 patients of the North Uist Medical Practice and a substantial proportion of those receiving the service from the Benbecula Medical Practice.

Dr Gerry Wheeler from North Uist said:  “Patients, many of them elderly, could now face return trips of 60 miles to pick up prescriptions, and we face losing three members of staff, including one GP. This will have a devastating impact on the practice team and our ability to provide appointments and services.

“The changes are actually as disruptive as it is possible to be… they will leave Benbecula with a rump of dispensing patients in a decreasingly viable business with its fixed costs, and make the whole viability of the North Uist practice questionable in the long term.”

Western Islands MSP Alasdair Allan says he has already been contacted by well over a hundred constituents about this issue and he says: “To put this in perspective, the adult population of Benbecula and North Uist combined is only a couple of thousand, and this is more correspondence than I have received on a single subject for some time.”

He says he has submitted comments to the Health Board, reflecting constituents’ overwhelming concern for the viability of aspects of existing practices in these two islands if they lose the pharmacy side of their business, with implications for the staffing of the local hospital.

He told DDA Online: “It is difficult to overstate this point – there is nowhere else for people to go for medical services in these islands.  Most people already have to travel a good few miles (and there is virtually no public transport for many of them) to get to a doctor. There is no choice or competition which would be created for the public if the viability of some of the existing medical services locally were to be threatened.”

On top of its GMS provision, Benbecula Medical Practice currently provides medical services to the community hospital, including anaesthetic cover, dermatology and surgical clinics, surgical cover, and out of hours cover for the hospital as well as to patients registered with the Benbecula and North Uist practices. Dr Kate Dawson from Benbecula has told patients: “Benbecula GPs currently invest the money from dispensing services to support the provision of extended medical services to the whole island chain.”

She told DDA Online: “If [the pharmacy] opens, and it is not viable, we will have lost services and staff, and it would be difficult to reinstate these. It has taken us over 20 years to build up the current level of service. ”

To inform the public consultation period, the North Uist Medical Practice has developed a comprehensive set of patient information materials, which can be downloaded from the practice website, and can be easily adapted to suit other localities. The information materials point out to patients that loss of GPs will mean a loss of the overall medical service provision.

The suite of materials includes template letters for local MSPs, the local Western Isles Health Board and for the Scottish health secretary, as well as a copy of the DDA’s recent MSP briefing paper.

The Benbecula practice has also drawn up patient information materials, which can be adapted for local use:

• A point-by-point breakdown of current GP services and the corresponding proposed pharmacy services.
• A patient briefing document which contains information on the following areas:

1. What is a dispensing chemist/pharmacy?
2. Public right of access to a pharmacist
3. Current arrangements and how they are funded
4. Consequences of a pharmacy and chemist opening locally
5. Will the pharmacy be viable?
6. Application process
7. Current application
8. Future applications
9. Can Benbecula medical practice open a pharmacy?
10. What has happened elsewhere?
11. What can [patients] do to protect local medical services?
12. When should the public make their views known?

There is also a Facebook campaign set up for links and comments to be posted concerning the pharmacy application.  In the Western Isles there are 10 GP practices, of which eight are fully dispensing.