Pharmacy expansion threatens rural GPs

Pharmacies are threatening the livelihood of small Scottish practices that rely on dispensing income to stay afloat, the GPC has warned.

Pharmacies are opening in small communities without public consultation, according to the GPC. Dr Dean Marshall, chairman of GPC Scotland, said such pharmacies were threatening the viability of practices.

'Isolated GPs in Scotland are in a peculiar position,' he said. 'In some areas, dispensing GPs are able to earn a lot but, in island communities and remote parts of the country, it is a matter of sink or swim.

'They need the money to be able to hire other staff and subsidise the work that they do.'

Many practices in remote areas are dispensing GPs, relying on their pharmaceutical work to bolster lower pay from small lists. But changes to the Scottish pharmacy contract have made setting up shop in small communities a much more attractive proposition.

GPC Scotland argues that this represents a significant change to service provision, as allowing the pharmacies to open is unlawful under the NHS Reform (Scotland) Act 2004 unless there is public consultation.

Dr Andrew Buist, deputy chairman of GPC Scotland, has been at the forefront in several battles to stave off pharmacies. He said patients forget that GPs often hire other staff, such as nurses and health visitors, which pharmacies are unable to supply, and that the loss of a GP is a poor trade-off for slightly more convenient access to medicines.

'Residents may welcome the new pharmacies but, if they were made aware of the impact this could have on their ability to access a wider range of healthcare services from their GP practice, they would not be so enthusiastic,' he said.

Dr Susan Taylor, a GP from the Morvern Medical Centre in the isle of Oban and chairwoman of the Rural Practitioners Association of Scotland, said the lifeblood of small practices was under threat.

'The new pharmacy contract gives them access to a kind of quality and outcomes revenue stream that is simply not open to us, which means it is a good incentive for them to open in remote communities. But it isn't a level playing field. Potentially some areas could be left with a pharmacy but no GP - it's that serious,' she said.

The Pharmaceutical Services Negotiating Committee was unavailable for comment.

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