Pharmacy-of-your-choice vision (2)

The Oxford Dictionary defines "editorial" as a newspaper article written by, or under the responsibility of the editor - which puts into question the responsibility of The Times's editor when, in the editorial of August 13, he assumes responsibility for the statement that the pharmacy of your choice scheme... is inherently flawed in concept because... problems are certain to arise in an arrangement wherein two competing systems free and paying are run from the same premises.

The editor is unscientific in an approach that fails to qualify his assertions with appropriate references. European, United States and Australian models for the distribution of free or subsidised medicines all use community pharmacies as their distribution points, and they do this for very pertinent reasons which include:

• Patients' right to select their individual pharmacist;

• Patients' right to change the pharmacist with whom they are currently interacting, and in whom they may have lost confidence;

• Patients' ability to interact consistently with the same pharmacist who is au courant of their prescribed medication and who consequently counsels them against the background of this information;

• Pharmacists' understanding, from a business perspective, that the loss of a POYC patient for whatever reason is equitable with the loss of a paying customer. This completely negates the editor's assertion that the systems, paying and non-paying are in competition and reflects his lack of understanding of the POYC system which was designed in this way precisely to protect patients from poor professional service. This holds true especially for a business, such as a community pharmacy, which competes exclusively on service.

I am a community pharmacist practising in a pharmacy which offers the POYC scheme. Community pharmacy practice has been revolutionised with the introduction of this scheme. Pharmacists' workload has in-creased significantly.

So has their input into the primary health care system of this country. Pharmacists are the point of reference with respect to drug administration, and while these are put into sterling use clinically on the wards of our hospitals, they represent a completely untapped resource in the management of chronic conditions from a community standpoint - where they are most, and constantly accessible to patients. Community pharmacists are now involved in medication management of chronic conditions, relying often on the use of multiple drugs with complicated regimens.

That POYC requires fine tuning and improvement is only to be expected in a continuously evolving model.

The editor ignores the fact that pharmacists in government employ are doing their utmost to reduce out of stock situations through changes in the distribution system such that the stocks in the community at any one time are as low as possible consequently also ensuring that community pharmacies have to contend with lower stock volumes.

The editor's claims that abuse is heaped on pharmacists by patients in out of stock situations, is disrespectful to patients who make use of this scheme, and a gross extrapolation of reality. Patients understand the setting of ground rules and codes of behaviour in pharmacies. The editor, researching for this editorial, failed to acquire the results of the government questionnaire which sought to evaluate patient satisfaction with the scheme, and which showed that patients in their absolute majority were positive about its utility.