This blog by me was published in Chemist+Druggist on 31 August 2018:
Last week, the Court of Appeal handed down its much anticipated Judgment declining to quash the 2015/16 decision to impose unprecedented funding cuts on the community pharmacy sector.
C+D has asked me to write a blog, not about the legal arguments, but about my personal experience of working on this case which has been of such interest to many.
The one sentence answer is that it has been an absolute pleasure and tremendous professional experience, despite the final outcome. I will always recall the lightning bolt moment of going through DH’s disclosure documents and coming across Philip Hammond and Jeremy Hunt’s letters to Theresa May which a) gave her completely incorrect information about the cost of dispensing medicines and b) wrongly described community pharmacy as “inefficient and over-subsidised”. The day we discovered the “industry insider” notes was another shocker!
From a few days before Christmas 2015, when the Department of Health delivered its unexpected letter starkly announcing an imminent £170m cut to community pharmacy funding, I have seen the NPA work tirelessly to do everything possible to help its members and the patients they serve.
One thing which has consistently impressed me (and I don’t think many NPA members know) is how hard NPA Board members and senior staff have worked. For a core group, there has been no such thing as an uninterrupted evening, weekend or holiday over the past 2.5 years. Although senior staff might be expected to go above and beyond in this manner, the NPA Board members who volunteer their time alongside running their own pharmacies have been quite amazing.
From the legal perspective, I am proud of what has been achieved since 2015. Working within a tightly controlled budget, we have successfully:
- Challenged the introduction of inter-group hub and spoke, which was originally intended to commence from Autumn 2016;
- Discovered much about the sometimes wrong-headed thinking on community pharmacy within government (powerful knowledge which has since been used to better inform and negotiate);
- Created circumstances whereby the further cuts initially indicated to senior NPA staff – on top of the original £170m – have not come to pass;
- Clarified the correct interpretation of s.1C NHS Act (legal duty to reduce health inequalities).
So was the NPA right to challenge DH?
The NPA team have always known the prospects of overall success – statistically, 92% of applications for judicial review are refused. The most difficult of all judicial reviews are those seeking to challenge high-level government policy decisions.
However, I think the NPA did exactly the right thing in not rolling over. I believe community pharmacy would be in a significantly worse position now if the NPA had not ‘fought the good fight’.
The Court of Appeal Judgment marks a line in the sand and opportunity to move on from what everyone sensible must regard as a very unfortunate period in community pharmacy/DH relations. Going forward, I look forward to seeing both the NPA and PSNC progress with constructive dialogue. The will to do so is clear on both sides and I was greatly encouraged to hear Matt Hancock use his very first speech to promise “to make the investment in primary care and community pharmacies”. I wish him the best of luck.