E-drug: Siting policies for retail pharmacies (cont'd)
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In UK there are minor differences with regard to policy Scotland
and the rest of UK, and one major difference with regard to the
dispensing by Doctors. Broadly there is no planning in terms of
determination of need by the Health Authorities and the subse-
quent siting of the pharmacy. However there is a system by
which a retail pharmacy must apply to the Authority for an NHS
dispensing contract, effectively a must for economic survival,
and this is determined on the basis of need. Other pharmacies in
the vicinity have the opportunity to object and hearings can be
held by the health authority to determine the case. Assistance is
given to outliers through an 'essential small pharmacy' scheme,
but, of course, the pharmacy owners claim that this is
insufficient! Areas of need, over-population of urban areas, and
development of the services is largely achieved through behind
the scenes encouragement and true British compromise. In
practice the health needs of the population are determined by
the siting of medical practices, which are determined by need.
The source of income for pharmacies is prescriptions and they
tend to follow the practices.
In Scotland, but not in rest of UK, doctors may not dispense
except where there is no pharmacy service and then the health
board may request/demand that the practice also dispenses the
medicine. If a pharmacy does open this dispensing must then
stop. Also in Scotland, but not in rest of UK, the pharmacy must
be owned by a pharmacist, or if a partnership, at least one of the
partners must be pharmacist. Makes a huge difference when
discussing health needs of the population and the ways to
provide for them, because when all said and done the
pharmacist practitioners went into pharmacy because they are
interested in health care.
In Pakistan, which is where I am based now, there seems to be
little in the way of control over the opening of pharmacies or the
qualifications of the pharmacist or the products that they supply
or they manner or circumstances in which they are supplied. The
Pakistan Pharmacy Association is working hard to correct this,
but it is difficult for the Health Authorities to grasp the full import
of the points they are making.
Tim Dodd
Director of Pharmacy
Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
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