What C+D didn’t quite mention this weekend about pharmacy’s differing direction in Scotland



Who will you be voting for on Thursday?

Chemist and Druggist magazine issued their much anticipated election special this weekend which I had an opportunity to glance over during my lunch break yesterday. It was an intriguing read, because it allowed a range of people from across the pharmacy profession to get their own perspectives on the record regarding the forthcoming United Kingdom election this Thursday. There is clearly no uniform view amongst the whole profession about how to take things forward in terms of advancing pharmacy’s cause across these islands, yet universally there is an acceptance that pharmacists must surely have a greater role to play in the provision of healthcare to patients, especially at a time when the NHS is under greater pressure than ever before.

It has been highlighted that the Greens and Liberal Democrats are the only two political parties who have mentioned the profession in some way or another within their own manifestos. Yet what the magazine failed to fully mention was that the Scottish National Party run Scottish Government, who hold responsibility over health matters, have already planned to set about on their own course in radically changing the landscape for pharmacists in terms of how they deliver healthcare services to patients in Scotland through Prescription For Excellence – it’s bold, it’s radical and it’s long overdue and will only finally and really kick start a substantial increase in pharmacist’s level of job satisfaction if reforms made are substantially backed up with a healthy level of investment and support. 

But as I have pointed out in a previous blog article, there are potential pitfalls that need to be avoided if Prescription For Excellence is going to be a true success. Now I totally acknowledge that this forthcoming Westminster election does not cover health in Scotland, but it would have been wise for C+D to briefly spell out what the current situation is regarding the other nations of the United Kingdom (Wales and Northern Ireland as well as Scotland). The focus was mainly on pharmacy in England, which I guess is understandable to a certain degree, because voters south of the border will be voting on health matters as well as other areas of concern this Thursday. But there is a lot at stake for the other nations of the UK as far as the health budget is concerned. 

A myth flew around before last year’s Scottish independence referendum about how the Scottish Government could spend whatever the hell it liked on the NHS if Scotland rejected independence. Any challenge to this claim by those on the Yes side was condemned to the hilt and regrettably so. The fact that prospective SNP MP’s are now ready to vote on budget matters regarding health spending in England in the next session of Westminster Parliament just goes to show how much is at stake for the NHS in Scotland – it is a pragmatic move and certainly not a move that represents an abandonment of any held set of principles. Scotland is not totally immune to any decision made at Westminster on health and how the NHS is funded. And more importantly, the block grant received by Scotland on how much it could spend on public services is being placed under intense pressure year by year. When less money becomes available to spend, it means cuts and less resources which is no welcoming news to patients and staff across all NHS services. And if there are less resources available then that is bad news for pharmacy in Scotland. In my opinion, this is where Full Fiscal Autonomy (FFA) is more beneficial than receiving a grant which is vulnerable to cuts year on year. Having real control over your budget makes the difference rather than being reduced to receiving a pot of money per annum where you have little control over how much cash is available to spend. And I certainly think that the absurd myth that Scotland would see another £7.6 billion in cuts if FFA was implemented is nothing other than that – it’s a deficit. Nearly every Western nation is running a deficit, but it isn’t the same as an automatic cut in spending. The UK’s deficit is nearly ten times as much as the projected £7.6bn figure for Scotland!

To be succinct, pharmacy in Scotland is more than likely to be more distinctive and more different than ever before in comparison with the profession everywhere else. And that is something I like to unapologetically shout about, because the country had led the world due to the increased level of professional autonomy given to pharmacists since devolution. But any new reforms to the delivery of pharmaceutical care in Scotland can’t truly happen unless other factors come into play and change favourably. Before we can move forward, we have to move Scotland forward in the way that it is governed generally and how public spending is managed. More autonomy for Scotland is great news for pharmacy in Scotland. And you probably will not find it difficult to predict where my cross will go on the ballot paper that I receive in the polling station this Thursday.

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