Colin D Gordon

The American actor Walter Matthau once remarked that, if he hadn’t been in films, he’d have liked to have been a pharmacist. Why? Because, in his youth, he’d admired the way his local pharmacist always dressed in a “nice white coat and looked very calm.” According to the journalist Nick Cohen, however, (in “The Observer” on 2^nd March), no child these days dreams of entering that particular profession. Pharmacists, he notes “are never the romantic leads or action heroes” in films or novels. Becoming a chemist, he suggests, is “to choose a comfortable (though perhaps somewhat boring) existence. He wasn’t surprised, either, that “almost a fifth of pharmacists in the UK are Asian” as (to him) it seems “ a good career for second generation immigrants”. Data provided by the career assessment website “Alec.Co.Uk” website indicates that there are “currently around 31,000 practising pharmacists in Britain” and that they work on average between 37-39 hours per week – though if they are based in a hospital or a “community pharmacy” their rota will include evenings and weekends. The “Office For National Statistics” (ONS) states on its “Publication Hub” that there are more than 10,000 pharmacies in England. These “dispense over 886 million prescriptions” as well as “providing a range of (other) services”. Furthermore, the NHS (National Health Service) spends “about £3.8 billion on medicines used in hospitals”.

So if Walter Matthau was a UK resident in 2014, would he still want to become a pharmacist? John Murphy, the Director of the “Pharmacists’ Defence Association” (PDA) might have some doubts about that. At the beginning of the 20^th century, he points out, 95% of pharmacists were also pharmacy owners. Today, that situation has been completely reversed: the figure is now just 5%. The “Multiples” (for example, the supermarkets, Boots, Lloyds, the Co-Op, Phoenix, Rowlands, Welbecks) have been “gobbling up the independents and the smaller chains”. These organisations (asserts Murphy) “always talk the right language about ‘patient protection and safety’, but profits are their priority”. They “consider themselves as retailers not healthcare outlets, have commercialised the sale of medicines, transformed molecules into almost a normal business item and have let the profession and the public down”. Boots, for instance, will sometimes sell Analgesics (painkillers) at a discount of three for the price of two. Murphy is especially scathing about Boots’ current policy on “E-cigarettes”. This powerful chain (which has 2,500 stores around the country) is (he declares) “in bed with a fully-owned subsidiary of Imperial Tobacco”. They “ban the smoking of e-cigarettes on their premises but want to sell them to the public on the grounds that it will help them stop smoking”. In reality, “e-cigarettes glamourize smoking: it’s a nicotine product”. Murphy recognises that Boots are “accomplished retailers, that they offer a lot of “goodies” and benefit hugely from the number of customers passing through their shops”. As part of the “Alliance Boots” international health and beauty group, it can manufacture, wholesale and retail its own brand medicines, which “obviously puts it in a very advantageous position”. At least (Murphy acknowledges) Boots has its roots in pharmacy – unlike competitors such as Tescos and Sainsbury’s, who regard providing a dispensing service as a useful “add-on” from which they can make a reasonable profit

The PDA was founded in 2003 as a “non-profit defence association and trade union for pharmacists”. It’s principal aim is “to support the needs of individual pharmacists by representing their interests and, when necessary, defending their reputation”. This applies particularly to situations involving contracts or disputes with employers and when any of their 19,000 members have a claim for negligence brought against them. As one “indignant, disenchanted pharmacist” ( who from now on be referred to as “IDP”) has emphasised, if they make just one mistake ( such as preparing the wrong dose or drug) they can end up in court: “It’s amazing that so few do, considering that most pharmacies will be dispensing 150,000 prescriptions per annum”. Sometimes the error might not even have been the fault of the pharmacist: “The colour coding on some of the boxes can be confusing and is sometimes changed by the manufacturers of ‘generic drugs’ (those for which the original patent has expired)”. Pharmacists are not responsible for drugs which have had to be “recalled” (due to doubts about their content) unless they continue to dispense them.

The PDA’s John Murphy, meanwhile, depicts the “Company Chemists Association” as representing “the big guys, the big high street names which have massive lobbying funds and power” and are “calling the tune” in the sector to the detriment of the individual pharmacist. The PDA’s “rallying cry” is “Let’s grab our profession back off the employers”. They see themselves as battling to “stop the tide where commercialisation (selling medicines as though they are like cans of beans) is over-riding the pharmacists’ autonomy and what is best for the patient”. What’s gone wrong in pharmacy (declares Murphy) is that all Members of Parliament and Government Ministers believe that Boots, Lloyds, Phoenix and the other major outlets represent the profession. The PDA’s “Road Map” reflects their view that community pharmacists should be dealing with patients with long-term conditions, who may be on repeat prescriptions of 13-15 drugs per day: “A very high proportion of hospital admissions of elderly people is due to problems with the medication they are taking. Nobody is looking after that part of their welfare. This demographic group will get greater over the next 15-20 years”.

As Nick Cohen wrote in his “Observer” article on 2^nd March, the PDA has since 2012 been locked in a “protracted legal struggle” with Boots for recognition as a trade union. The conglomerate has refused to do so, preferring instead to deal with its own “staff association”, which PDA regards as “non-independent, with no bargaining power on working conditions”. Although, in February, a High Court judge ruled that – under English Law – Boots did not have to recognise the PDA, he also added that this “could well be incompatible with the European Convention” and invited (as Cohen reported) the union to go to another court to seek a “declaration of incompatibility”. Last year, the “Guardian” revealed that “Boots has 4,000 staff on controversial zero-hour contracts (whereby the employee never knows how many hours, at what times or on which days they will be required to work). Its disparaging attitude towards the PDA demonstrates (concludes Cohen) that it treats its chemists as “red revolutionaries just for wanting to negotiate with their employer as free men and women”.

The role of the National Pharmacy Association (NPA), the Royal Pharmaceutical Society  (RPS) and the General Pharmaceutical Council (GPhC) in this sector will be assessed – along with other key contentious issues – in Part Two of this analysis.

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