BMA(NI) initial response to Appleby Report

Aug 31 2005

Following publication yesterday of Professor John Appleby's report on Health & Social Care Services in Northern Ireland, BMA(NI) Chairman, Dr Brian Patterson, in an initial response said: "The BMA met with Professor Appleby as part of this independent review and early indications are that much of his report appears to be consistent with the evidence provided by the Association."

The report will now be examined in detail by the BMA's NI Council when it meets in October but commenting briefly on aspects of the report in today's media, Dr Patterson said: "The issue of generic prescribing is one which needs to be resolved by the DHSSPS.

"Comparing Northern Ireland with other countries in the UK is not comparing like with like. For example, in NI a generic prescription is only recorded if the pharmacist dispenses a generic product; in England a generic prescription is recorded irrespective of whether or not it is dispensed by the pharmacist.

"There is also a lack of confidence by patients in the cheaper generic drugs because the colour of the medication, plus the colour and language of its packaging, frequently changes. This is dependent on the manufacturer and the country of origin. On the other hand, the brand drug generally remains the same and inspires confidence in patients who are using the medication regularly. This needs to be sorted out by the DHSSPS."

On the issue of Professor Appleby's recommendation that an assessment be carried out on the implementation of the new GMS contract, particularly relating to improvements in the quality of patient care and its cost effectiveness, Dr Patterson said that a planned review of the contract was in fact already taking place. "This was something built in to the contract during negotiations", he said. "The contract made provision for a review during its third year and this is currently underway."

BMA(NI) is pleased to see that Professor Appleby has recognised the absence of a fully integrated primary health care system. Dr Patterson said: "The lack of such a system is very frustrating for GPs and is largely due to not enough Allied Health Professionals being in place. There is also an impediment to the integration of the nursing profession within primary care, caused by independent management structures within their employing Trusts.

"We are keen to work with the Health Minister and his team on these issues, and many others, but although we requested to meet with him some time ago, no date has yet been arranged. Hopefully the publication of this report will move matters along with a degree of haste."