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I'm tired of people who have never risked anything in their lives telling me how to run my business. It's time we held this civil service bureaucracy to account...

I'VE SPENT the last few weeks getting annoyed about the hypocrisy of unelected and unaccountable civil servants. They lecture me about the need to be efficient and to look for new models of service. Well, it's time we held them to account, starting with England's chief pharmaceutical officer (CPO).

Take the Pharmacy Call to Action. This began with a wave of enthusiasm from pharmacy bodies with an interest in how the community pharmacy contract develops, but when I saw the questions I was less enthusiastic. Was this an excuse to wield the axe?

The CPO says there are some areas where there are too many pharmacies. In part I share his view, but I wasn't the person in post at the DH in the aftermath of the disastrous relaxation of market entry rules, which let many new pharmacies in through the back door in places they weren't actually needed or even wanted.

He says that his view €can be quite disturbing to people who have invested a lot of time, energy and money into their business€. Well, we can certainly agree on that.

The problem is, the DH and NHSE seem to want us to move towards a hub-and-spoke model, where prescription 'factories' ship finished prescriptions out to those pesky community collection points.

Great news if you happen to be a wholesaler or a large chain that can quickly move towards this new world, where economies of scale and efficiencies exist. Not such good news for small businesses.

The Government should care about small pharmacy businesses because they perform a unique public duty with respect to their competitive purchasing of medicines on behalf of the NHS. You see, it is in wholesalers' interests to keep prices high, because this keeps their owners happy. It is only because independents drive the market price down through competitive purchasing that the taxpayer reaps the benefit through category M clawbacks.

Reduce the number of independents (and therefore competition) and you sustain fewer independent wholesalers, leading to less competition on price. The ultimate result is higher medicine costs.

Dr Ridge is playing with long-term economic fire

Governments cannot perform this function efficiently, but the market can. Dr Ridge is playing with long-term economic fire if he thinks otherwise.

It is really easy for civil servants who are paid every month, regardless of performance, with the prospect of a nice pension at the end, to lecture us about the need for efficiencies. And just as easy to gamble with the sector's future when you don't have a direct stake in it.

Savings before safety

With regard to technology, it appears as though the bureaucrats have made their mind up that they want wider use of technology, almost certainly because they think it will save them money, not because it is necessarily safer or better for patients.

A great example of the hypocrisy of Government is its stance on the Falsified Medicines Directive, an EU diktat which says that the public needs to be safeguarded from fake medicines. This could be done in pharmacies and tied in with software to remove the danger of most dispensing errors. But the Government's stance is, we're reasonably happy for it to happen €“ we just don't want to pay for it.

A bad deal

A final example of out-of-touch bureaucrats meddling with no thought for the long-term consequences is the Modernising Pharmacy Careers programme, which would present a huge windfall for universities as it would largely give them total control of pharmacist training up to registration, and the money to go with it.

The trade-off was supposed to be a cap on student numbers to make the profession sustainable, but that does not seem to be coming any time soon. Make no mistake, this is an historic and irrevocably bad deal for employers, students and for pharmacy.

So, returning to the Call to Action, those bureaucrats who have already demonstrated a naive and reckless attitude towards market entry, technology and training will be able to cherry pick from the 800 responses... or decide to do exactly what they wanted to do in the first place, hiding behind a thin veneer of legitimacy.

The world must look very different from those Whitehall ivory towers, but officials must be honest €“ are they trying to make the pharmacy service cheaper or better?