A SLIGHT DEREGULATION OF MEDICINE IN BRITAIN


"Pharmacists in England and Wales could offer some health services currently provided by GPs, under a new deal agreed with the government. These would include supplying repeat prescriptions, offering basic health advice and blood pressure checks. Chemists would be paid by the NHS according to the range and quality of services they provided. Pharmacists now have to vote on whether to accept the new contract, which would come into force next April.

The document has been drawn up after two years of talks between the Department of Health and pharmacists' representatives. Speaking ahead of a meeting of the all-party parliamentary pharmacy group, health minister Rosie Winterton, said: "This new contract represents the beginning of a new era for pharmacy in the community, in which everyone will benefit... "Until now, pharmacists have been an untapped resource. I want to see them more integrated with the NHS family."

Under the new contract, patients will be able get up to a year's worth of prescriptions from their GP at a time. This will be dispensed at intervals agreed between the doctor and pharmacist. According to Ms Winterton, this will reduce GP workloads and relieve patients with chronic conditions from having to repeatedly visit their surgery.

The chairman of the Pharmaceutical Services Negotiating Committee, Barry Andrews, said: "I am pleased that we have been able to reach agreement with the government on proposals for a new pharmacy contract that will provide better services for patients, better use of the skills of pharmacists, and a more secure future for community pharmacy contractors."

Source

One of my medical readers comments:

This is just common sense. No one with chronic hypertension should have to go to a doctor just to get a prescription refill. And Wal Mart has BP machines - why not pharmacists?

Unfortunately, this is one more area where such a policy would probably be squeezed out in the USA by litigation - pharmacists may not want to be liable if a patient doesn't take his medicine reliably, takes cocaine (which could lead to a stroke, and then blame the pharmacist for not giving him the correct meds, etc..).

Also, a lot of other "baggage" goes along with hypertension - coronary artery disease, peripheral vascular disease, heart attacks, heart failute, obesity, diabetes, etc.. The pharmacist may be liable for not diagnosing such things etc.

In a rational society, patients would have the option to visit the pharmacist instead of the GP to have his BP checked etc.. But then the pharmacist would have to be immune from liability for not diagnosing diabetes etc. So add this to the list of reasons why American medicine is so expensive: Threat of litigation REDUCES COMPETITION.





AND IN AUSTRALIA THE DOCTORS STRIKE BACK

Doctors will seek authority to dispense prescription medicines to their patients after pharmacists asked the Federal Government to allow them to perform some of the basic functions of GPs.


The Pharmacy Guild of Australia yesterday revealed it was entering negotiations with the Government to extend the role of pharmacists so they could administer vaccines and help monitor conditions such as diabetes and high blood pressure. Pharmacy Guild president John Bronger said any proposal to take pressure off GPs at a time of doctor shortages should be seriously examined. Giving pharmacists the extra powers would amount to evolutionary rather than revolutionary change, he said. The Pharmacy Guild would not be asking for drug-prescribing powers.

However Australian Medical Association president Bill Glasson labelled the plan "mischievous and irresponsible", adding that it was an insult to general practitioners and an unnecessary threat to the nation's high standard of primary care.

More here





THE WYOMING CONSTITUTIONAL AMENDMENT

Payout caps are a poor substitute for reponsible judges but when judges think that they are Father Christmas (with other people's money) what choice is there?

Amendment D would give the Legislature the power to limit the amount of noneconomic damages in medical malpractice lawsuits. Noneconomic damages generally involve such things as pain and suffering or mental anguish. Economic damages, including loss of past and future pay, past and future medical costs, repair and replacement costs, would not be affected by the amendment. If voters approve the amendment, the Legislature would be charged with deciding a cap on the dollar amount that could be awarded for noneconomic damages.

A companion amendment, Amendment C, would allow lawmakers to establish a panel to review a medical malpractice case before it reaches the courts. The two amendments are among four that voters will decide on Nov. 2. For a constitutional amendment to pass in Wyoming it needs only a simple majority of votes cast in the general election.

Opponents of the amendments C and D, led by trial lawyers, argue Wyoming residents are being asked to surrender the right to collect all possible damages for injury or loss caused by medical negligence. They say Wyoming has not had any large malpractice damage awards to warrant such a drastic move.

Supporters, led by doctors, contend that unchecked malpractice awards are driving up insurance costs for doctors and driving them from the state, particularly its rural areas. They contend caps will help slow the rapid rise in premiums. A medical review panel would cut down on costly frivolous lawsuits, they say. Alarmed by news of doctors pulling up practices or retiring early, leaving some communities without medical care, the Legislature held a special session last summer where legislators overwhelmingly approved putting the constitutional amendments on the ballot. Gov. Dave Freudenthal, a lawyer, supported the amendments, saying it should be up to voters which direction the state should take.

Shauna Roberts, spokeswoman for Citizens for Real Insurance Reform, which opposes the amendments, contends capping damage awards is not going to help doctors. She noted that nine states that passed damage caps in 2003 all had subsequent premium increases. "The evidence is not at all conclusive that putting caps on noneconomic damages does anything for rates," Roberts said. She also contends that the argument doctors are leaving Wyoming is incorrect.

Citing numbers supplied by the state Legislative Service Office, Roberts said Wyoming had a total net increase of 238 direct patient care doctors since 1994. But Wendy Curran, executive director of the Wyoming Medical Society, which represents the state's physicians, contends the numbers don't mean much to a community with no obstetricians or surgeons. "What we do know is that if you live in Gillette, where there is only one surgeon and where they are having difficulty recruiting new surgeons, you might not think there's enough doctors in the state," Curran said.

More here.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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