Following the statement made by the GPhC on 19th March 2020, accusing Pharmacists of profiteering during the Covid-19 outbreak, TPC wrote to the GPhC Chief Executive Duncan Rudkin to express, in the clearest way, our concerns and apprehension at the GPhC’s approach to the claims. The Pharmacist Cooperative do not, in any way accept the way in which the GPhC have publicly attacked pharmacists based on information from multi-national conglomerates. See our letter, and the GPhC reply below. We’d love to know your thoughts on this.
Dear Mr Rudkin and Mr Clarke,
In the midst of the a worldwide healthcare crisis not seen for a generation, Pharmacists across the UK are putting their own lives at risk on the front line for their patients. As regulator of pharmacists, pharmacy technicians and pharmacies it falls upon the GPhC to manage the risk posed to patients when pharmacies are closed or when there is an absence of a responsible pharmacist. The Covid-19 pandemic is an unprecedented emergency which has lead to large conglomerates which operate pharmacy stores, threatening to report pharmacists to the GPhC for negotiating their locum rates. We have also recently seen the GPhC support these conglomerates and accuse pharmacists of profiteering. There are a few reasons why this particular issue is far outside the remit of the GPhC, and why the GPhC should remain impartial, which we outline below:
1. The GPhC regulates pharmacists and pharmacy premises. It is not in the GPhC’s remit to dictate wages or resolve employment disputes. The GPhC website clarifies: “Our role is to protect the public and give them assurance that they will receive safe and effective care when using pharmacy services… We seek assurance that pharmacy professionals and pharmacies continue to meet our standards, including by inspecting pharmacies.” As per the Jenkins case in 1920, the RPSGB did not have the power to regulate pharmacists’ pay, service conditions or to provide legal or insurance services and this holds true with the GPhC. By commenting on the situation, and allowing companies to bully pharmacists and damage their earning potential, the GPhC is, infact bringing the entire profession into disrepute, and risking legal action from its registrants.
2. Unless a pharmacist has breached the Standards for Pharmacy Professionals, as published by the GPhC, it is outside the remit of the GPhC to effectively dictate how a pharmacist chooses to practice.
3. Self employed locums having their wages dictated by their customer is absurd and illogical. Even if payments and wages were within the remit of the GPhC, the rates colleagues are requesting are fair and reflective of the market.
It is, however, well within the GPhC’s remit to discipline the large conglomerates that operate pharmacy stores across the country for many reasons, outlines below:
1. We have seen (increasingly through the Covid-19 pandemic) that companies are choosing to stay closed rather than pay a pharmacist what the company deems to be an ‘enhanced rate’. By keeping the pharmacy closed, the company is endangering public health and further straining the NHS by not allowing patients access to a pharmacist. The GPhC should be tackling this malpractice head on.
2. Companies have, in the recent past, asked responsible pharmacists to stay signed in to the pharmacy for two hours after they go home, so dispensers can catch up on work. This shows a clear disregard and abuse of the very rules set out by the GPhC. The GPhC should be tackling this malpractice head on.
3. Since the onset of the Covid-19 pandemic, some companies have been threatening to reprimand pharmacists for choosing to wear personal protective equipment (PPE), despite these pharmacists being on the front line and at great risk. The GPhC should be ensuring patients are protected, but without pharmacists wearing the PPE, both the patients and pharmacists are at great risk. The GPhC should be tackling this malpractice head on.
4. Following the recent statement issued by the GPhC where it was said that a responsible pharmacist may need to leave part way through the day and so medication may need to be handed out to patients in the absence of a responsible pharmacist, some companies have taken this a step further and have already implemented this as standard practice. They have even suggested that pharmacists can work remotely. This is in direct contravention of GPhC rules and greatly endangers patients. The GPhC should be tackling this malpractice head on.
The Covid-19 outbreak has brought into sharp focus the innumerable offences made by companies that operate pharmacies within the UK, and has also shown the GPhC is unclear on its roles and responsibilities. It is incumbent upon the GPhC to withdraw any statements made in support of pharmacies and tackle these as a matter of urgency instead of attacking pharmacists for following the very code of ethics put forward by the GPhC. We are making the patient out primary concern by agreeing to open the pharmacy at huge risk to our own health.
This letter has been sent both by E-Mail to the aforementioned E-Mail addresses and by post to General Pharmaceutical Council, 25 Canada Square, London E14 5LQ.
We look forward to hearing from you soon.
Tohidul Islam MRPharmS
The Pharmacist Cooperative
Mr Duncan Rudkin responded with the following:
Dear Mr Islam
Thank you for your recent email.
We understand the important role that locum pharmacists are playing by helping to keep pharmacies open to provide safe and effective care for patients, and we are very grateful for their contribution.
In response to your concerns about our recent statement on profiteering, we were in no way trying to suggest that all locums are taking advantage of the current emergency to negotiate higher rates or that locums cannot individually negotiate rates with their clients. However, we have received reports of both unjustified price inflation on some products by some pharmacy businesses, and concerns raised about concerted action by some locums asking for significantly higher rates than normal. Some of these reports have come from within the profession itself.
We also realise that locums will not necessarily receive sick pay in the way that permanently employed staff do if they become unwell or have to isolate for other reasons and they should be paid fairly and appropriately for the important work that they are doing.
However, we were concerned to hear reports that there was some co-ordination among a small minority of locum pharmacists to significantly inflate their hourly rate. Neither pharmacy owners nor locums should be looking to profit from this situation by involving themselves in anti-competitive action. We will continue to take a balanced and even-handed approach to issues raised about some pharmacy owners and some members of the profession, whilst applauding the great work that the majority on all sides are doing to support the public. The requirement to behave professionally at all times remains in place and at this time of national crisis it is more important than ever that everyone’s first concern is for patients and the public
Whilst we have a legitimate interest in upholding professional standards (and we have written to a number of registered pharmacies to remind them about the requirements to meet our Standards in this context), the Competition and Markets Authority remains the appropriate agency for investigating breaches of competition law. Notably, the CMA has released new guidance on their approach to business co-operation in response to Covid-19. This highlights how the current situation may trigger the need for companies to cooperate in order to ensure the supply and far distribution of scarce products and/or services affected by the crisis to all consumers. However, this also includes guidance on conduct which opportunistically seeks to exploit the crisis as a ‘cover’ for non-essential collusion and the situations when the CMA will take enforcement action to prevent any harm or detriment to consumers.
In relation to your broader concerns, particularly the issues relating to the role of responsible pharmacists, we were also concerned to hear reports that some pharmacies are going beyond the advice in the statement and standardising these arrangements. In response, we wrote to the key trade associations and published a letter to make clear that, even during the COVID-19 emergency, it is unacceptable to normalise operating a pharmacy without a responsible pharmacist (except as provided for in the current Regulations). This stated that employers should continue to act responsibly, and in line with the general legislation. You can find a copy of the letter here. Any concerns relating to pharmacies being operated without a responsible pharmacist or responsible pharmacists being pressured to remotely supervise a pharmacy should be raised with us via our online concerns form.
As to the points you raise about pharmacies being closed for periods during the COVID-19 emergency, we have issued a statement in relation to pharmacy closures. In this statement, we recognise that some pharmacies may need to adjust their opening hours or close for periods during the day to ensure that prescriptions are dispensed safely and that all staff can take necessary breaks. We make clear that if an NHS pharmacy decides that it needs to close for a period of time, they need to follow local NHS reporting and notification procedures and make clear to the public how long they’ll be closed for and where the nearest other pharmacy is. You can read the full statement here.
We have also issued a separate statement about the importance of social distancing calls on all pharmacy settings to consider how social distancing (at least two metres) can be achieved, to protect pharmacy staff and patients and the public. The letter says that the implementation of social distancing measures does not negate the need for all pharmacy teams to have access to appropriate PPE for specific instances where it is a necessary addition to social distancing measures, for example when working in small dispensaries. You can read the joint statement here.Although we are focusing on how to support pharmacy at this time, we are also continuing to use our regulatory powers where there is a risk to patient safety, which includes taking action against pharmacy owners, where appropriate.
I hope this has been helpful to clarify our position.