INFORMATION

Leuchars and Balmullo Pharmacy Application. The History to Date.

Leuchars and Balmullo are two small communities in North East Fife.  They are served by a single medical practice with dispensing surgeries in both locations.

The practice also has patients from the nearby and much smaller Guardbridge and St Michaels areas.  Over the past twenty years the medical practice has grown out of initial operation from a wooden shed to two purpose built surgeries which house the normal NHS GP services and also the two dispensaries as well as giving accommodation to midwife and other community –based nursing services. Patients after seeing their doctor can usually leave with any prescription they need in their hands without the need to journey further to a pharmacy outlet.  Needless to say this facility is hugely appreciated by those patients, numbering around 3,500 in total.  The excellent services now provided have only been possible thanks to the doctors in the medical practice  reinvesting income from the NHS funded dispensaries back into the practice to provide  modern and extremely fit for purpose premises. Without such income the premises would not have been built.

Out of the blue in September, 2008, the  practice doctors learned, from a third party  no less, that an application had been made by a pharmaceutical firm from the West of Scotland to open a commercial pharmacy in the Leuchars Post Office.  Under current Scottish NHS regulations this would, if approved, mean the compulsory cessation of dispensing services in both surgeries. 

The news that the application had been made was greeted with anger and disbelief by patients.  There was major concern that the Post Office was far too small to contain a pharmacy, however compact the planned layout and access to the pharmacy in terms of nearby parking, disabled access and privacy once inside was either totally lacking or extremely unsatisfactory.  In addition, since direct public transport is non-existent between Leuchars and Balmullo without a detour be via St Michaels or Guardbridge, patients in Balmullo would also be even further disadvantaged

In due course a series of public meetings were held to discuss the application which was due to be decided by the Pharmacy Practices Committee of Fife NHS.  There was unanimous support for the application to be refused and the applicants were conspicuous by their absence, although invited to attend.  In addition hundreds of protest letters were sent to Fife NHS.  Patients and others in the two areas also submitted a 2000 signature petition against the application.

 The upshot to all this was that the Pharmacy Practice Committee decided that ’existing services were perfectly adequate as demonstrated by the support for them - and that the proposed premises were unsuitable’.  This decision was upheld on appeal. 

That should have been the end of the matter but, hard on the heels of that decision in June this year a second application was made with the same applicant address but under a different name.  This was virtually identical to the first application, a fact which was acknowledged by all parties.  To the dismay of the practice and its patients the same Pharmacy Practices Committee decided to grant the application.  To this day no one can understand why and attempts to find out have been met with a response from Fife NHS at all levels that as the medical practice has launched an appeal no comment can yet be made.   Questions everyone locally wants to know are:-

1.  What was different in the second application, virtually identical to the first, that could have allowed it to be allowed to be processed at all and should the Fife NHS board not have exercised common sense to rule it inadmissible?  They certainly should have had enough grounds to defend that decision were it to be legally challenged.

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3. What on earth was the Pharmacy Practices Committee’s justification for doing a complete U-turn on their original decision on the first application?  In doing so without explanation in the minutes or in any other form they have lost any confidence the public might have had in their ability to make decisions for the good of patients’ welfare in this area.

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6. What is to prevent the pharmacy applicants submitting further identical applications if the appeal against the pharmacy opening is upheld?  The applicants have said publicly that they will do just that.  The Scottish Executive need to take steps to prevent this happening- but will they?  No sign of that yet.

Yet again the two communities find themselves fighting to preserve an existing NHS service which many declare as excellent.  Yet again protest letters and petitions have been raised by patients. The communities’ doctors have to spend their valuable time and money defending what their patients want.  Patients views were forcefully illustrated by the two packed-to-overflowing meetings held recently, involving hundreds of people who wished unanimously to publicly declare their opposition to the pharmacy approval.  As someone said, “We have nothing against the post office seeking to supplement its income to exist –but if it comes to a choice between a dispensing surgery or a post office it is no contest.”  Needless to say the pharmacy applicants again refused an invitation to present their case.  NHS Fife was also not represented.  Again not one single voice was raised at either meeting in support of a pharmacy at that location. 

 MSPs and MPs have lent their support to the communities and are currently trying to make sure our voice is heard. What really angers  so many people is that the doctors, having clearly laid open their surgery accounts to show how the two practices could not exist without  dispensing income have no direct say in the outcome of such applications and are not, under existing Regulations, considered as ‘interested parties ‘.  However if their appeal fails the current level  of service provide by  three practice doctors will certainly reduce and one  surgery location , probably in Leuchars, may close or go part-time.  This is not scaremongering as the pharmacy applicants have said.  It is fact and they had, but chose to ignore,   a chance to challenge this before the public in general.

Closure of all or part of the local surgery services in either location may well be the most chilling result and demonstrate the totally unfair nature of the current Pharmacy Regulations.

The progress so far of the  Scottish Parliamentary E-petition 1220, submitted by a Balmullo resident in October 2008 has brought the introduction of a new requirement, in that from the 1^st July ,2009, all area health boards must ‘take all reasonable steps to ascertain public opinion’ when a pharmacy application is made which may affect a dispensing practice. It still remains the case that the current Pharmacy (Scotland) 1995 Regulations are woefully inadequate in many other respects.

• They are heavily weighted both in content and application in favour of pharmaceutical interests against any other counterbalancing factors, such as submission of existing services data  by any dispensing practice which may be affected and the overall effects on the community  if an application is approved.

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• They do not demand fit-for-purpose minimum standards in respect of the premises to which they will be applied regarding space standards, privacy in consultation and preparation and sales areas.

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• The same point also applies to the provision of disabled access since the provision within planning laws is weak in respect of   existing buildings.  However one would suppose that where there is an obvious need for access by the disabled very particular attention would be paid to this point.

  Meanwhile we await a date for the Practice’s appeal to be heard.  We will continue to lobby the Fife NHS Board, politicians at all levels, the media and appropriate civil servants throughout the NHS for a fairer and more democratic rewrite of the regulations which are presently able to bring about so much harm to patients under the NHS.  We know that just such a review is under way but we do not know exactly who is involved in submitting evidence for it.

  Pharmacies have an important part to play in the health affairs of all patients.  That public role should not be compromised or belittled by applications seeking to cancel out for commercial gain, existing services, which patients both enjoy and often vitally need in relation to dispensing surgeries.  As the matter progresses we will keep you informed on this website.  There is much work still to be done to bring both commonsense and respect for these ongoing services which are threatened by the wholly inadequate regulations we now have to endure.   Our final word is ‘SODS!