Threat to rural GPs who dispense medicine as fees cut

Rural GP surgeries are under threat as fees paid to them for dispensing medicines are being cut leading to fears some may be forced to cut back services, stop providing drugs or close.

GP practices which dispense medicines are almost entirely in rural areas and 3.5million patients, particularly the elderly, rely on them so they can see their doctor and collect their drugs in one trip.

However, the labour Government is now cutting the fee it pays to the surgery for each medicine it dispenses.

NHS Employers has announced that from October 1st the fee per medicine dispensed will drop from £2.14 to £1.95, leading to a drop in income of around £850 per month for the average dispensing practice.

Dr David Baker, chief executive of the Dispensing Doctors Association, said: “If something does not happen to protect surgeries there is a risk practices will struggle hugely and certainly some will have to cut services. If we cannot cover our costs there is a major problem.”

He said surgeries would try to continue dispensing because patients rely so heavily on the service but other things like branch surgeries or nurses would have to be cut.

There are around 1,500 dispensing practices in England and Wales out of around 8,500 in total.

It comes after plans announced by Andy Burnham, Health Secretary, to abolish GP catchment areas so people can visit surgeries near to their work, rather than their homes. There are fears this will lead to them losing their younger healthier patients to surgeries near where they work and leaving the older, sicker patients who are more expensive to care for.

Dr David Bailey, negotiator for the British Medical Association on behalf of dispensing doctors, said there was little choice but to accept the cut in fee and moves to correct the discounting problem will not be solved for some time, meaning dispensing doctors will suffer in the meantime.

He said: “It makes no sense to have a situation where it costs you money to privide a service to the NHS.

“In rural areas the dispensing side of the practice subsidises the GP surgery and if that subsidy is removed there is a diseconomy in running a rural practice. It will threaten small rural practices.”

An inquiry is due to be launched next year into the costs of GPs dispensing drugs which may lead to changes and doctors said it was unfortunate that the reduction in fees could not be put off until after that was concluded.

Officials have said the changes in the fee will mean the way funding for dispensing GPs is calculated will be brought into line with non-dispensing GPs.

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