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Pharmageddon – new chemist could wreck local health service.

A few years ago I was interviewed by a medical journal about being a new GP on a remote island. I remember saying at the time that I really appreciated the kind of medicine I could practice here compared to how it works in other places, With a small list size and plenty of spare capacity I was finding that patients and their doctors here seemed to be generally happier and more satisfied with local health care than might be expected in ‘typical’ mainland surgeries. I want to stress this, because people need to be in no doubt that the proposed pharmacy for Benbecula could destroy this benign working model.

Basically – if the pharmacy opens it would close our dispensary. The inconvenience that this would create for patients getting prescriptions would be important – but this would be just one in a long line of issues, as it would also inevitably lead to a drastic reduction in the services that the practice will be able to provide.

Dr Dawson in Benbecula has created a fact sheet that you can see here. This has a lot of detail in it about how the new pharmacy application is progressing – but I will try to distil things down to a few key points – looking specifically at how North Uist could be affected.

1) I have been informally told that the pharmacy application is to serve from Berneray to Eriskay. If this is true – then a pharmacy on Benbecula will directly affect North Uist patients – not just those who live across the causeway potentially this one pharmacy will change beyond recognition all 3 medical practices on the islands.
2) North Uist medical practice isn’t really viable without dispensary rights. We only have 1400 patients – the money that such a small group attracts from the health board is not enough to fund the kind of practice we have at the moment.
3) If the practice is able to survive it will only be able to do so if it contracts quite severely. At the very least one doctor would be made redundant and possibly two reception / dispensing staff will have to go.
4) Life for those left behind will be considerably more difficult – it simply wouldn’t be possible to maintain current service levels. Decisions would need to be made nearer the time – but I would envisage that branch clinics would need to stop, and availability of GP appointments will be reduced significantly. From what I understand, when this happened in Millport on Cumbrae, locals found that they went from being able to see a doctor within 24-48 hours to needing to book at least a week ahead for routine appointments. The same would probably apply here.
5) If you come to see the doctor in North Uist in future you will need to then go all the way to Balivanich for your prescription. Repeat scripts will probably be OK as I presume there will be some sort of delivery service – but if you need something on the day then you potentially face quite a substantial round trip.
6) One selling point of pharmacies nowadays is the provision of pharmacist led care along the lines of smoking cessation, blood pressure checks, cholesterol and diabetic checks. These are already available from the practice however – so I don’t really see much benefit. it will basically be a similar service to what we already provide – but by less qualified personnel at a location that is less convenient. One way of looking at it is… there isn’t much point a pharmacist telling you that you have high blood pressure if you can’t see a doctor who is able to actually tell you what to do about it.

So in summary. Having a local chemist is usually a good thing – but when you live in a very remote location like ours you have to take the down sides as well as the benefits. In other communities where this has happened doctors surgeries have closed completely, in others services have been drastically reduced. Unfortunately, if a pharmacy opens, the local doctors surgeries aren’t allowed to compete with them, we are forced to close our dispensary – it’s the law. Follow these links to read about a couple of real life examples from the last couple of years,,,,, Scalloway, Millport.

As far as I can see, everyone loses – we lose jobs, we lose convenience, we end up with a less safe / less viable medical service that may not be sustainable at all going into the future.

Please come along to a public meeting of our patient participation group scheduled for 7:30pm on Wednesday the 3rd of July at Lochmaddy hall to ask questions / tell us what you think.

Dr Gerry Wheeler.