As pharmacist, we know that a boil is frequently the sign of an underlying problem. It’s not difficult to figure out that if you treat the malaise you will solve the issue. Community pharmacy, collectively, have a very large underlying condition. Partially, it stems from being singled out in the health system as a group that has never had our FEMPI cuts reversed. Aside from the sheer inequity, it reflects the harsh reality that we have had, effectively a pay cut every year for the last 17 years. The only saving grace, if that’s what you want to call it, is that volumes of dispensing have increased. The mantra was always, we were being told, that we had to get more efficient to justify pay restoration. We have done that. Any of you that has read this column on any sort of a consistent basis will know that community pharmacy has become much more complex in the last few decades. The health system is groaning under the sheer volume of patients. Pharmacists, more than ever, are at the forefront of protecting patients’ health and, not  infrequently, their lives. We have often noted that, when a hospital prescription arrives with more than two items, there is at least one mistake or clarification needed. With multi-item prescriptions being almost the norm, it can often be an enormous challenge to decide the intention of the prescriber, not to mind what they wrote. Like many of you, I have long since given up trying to contact the local emergency department. They do not answer the phone. I have been told, by people working there, that it is because they’re so busy. If they answer that phone, they know they are going to lose a good 10 to 20 minutes of patient care trying to track down whatever issue has arisen. While understandable, it frequently puts pharmacists in a very difficult position. You are faced with making a decision, in relation to the prescription, that may harm or heal the patient. All that is keeping you from disaster is your training, your experience, and your professional judgement.

It is clear that while some people appreciate the level of professional input into prescriptions, most do not. We are in an extraordinary situation where a Minister has decided that our professional time is worth the price of an ice cream cone. The economics of pharmacy have changed enormously. Over the last decade many of our fixed costs have dramatically escalated. Wages have almost doubled. IT, insurance, and much more have all seen serious increases. Add into this mix the fact, which can be demonstrated in every pharmacy in the country, that our gross margins are decreasing. Additionally, if you need more evidence, look at the numbers of community pharmacies – last year saw a net decrease. In simple terms this means more pharmacies called it a day, because of unviability, than pharmacists taking a punt on a greenfield site. So, when ‘Liveline’ put out the call, looking for pharmacists on Easter week, it was obvious that something was up. Like Chamberlain coming back from Munich, we had a triumphant ‘peace in our menopause’ moment. The Minister exultantly rolled out a proposal that was clearly as unrealistic as any in 1938.

Our Union leadership have been remarkably consistent in briefing what we feel is a reasonable, fair and just resolution to our role in primary care. Never has there been a time where our skills and training have been more essential. This is our Munich. There is so much at stake. If we anchor our professional value at a loss-making rate, we are condemning the profession. I am a proud of the service that I, and my well-trained staff, deliver to the community. It is not unreasonable to ask that we have a sustainable financial model. Over the next while, many of us will be considering our options. The offer from the Minister is a ‘there will be jam tomorrow’, cynical ploy to drive a rift in the profession. There will we those, under financial pressure, that will feel enormous pressure to buckle. Yet, as we have seen from time immemorial, the quick and easy ‘fix’ is almost always the wrong one. This is an important moment for us. We need to secure our, and the profession’s, future. Let history be our teacher. Stand up for what is right.