ANNIVERSARY
INDEPENDENTLY MINDED
changed the name of the business to Maguire Pharmacy as I knew that I needed to try to build up my own reputation because the previous owner had also had a very strong, personalised type of business and I neededto make my mark quickly.’My initial objectives were obvious. I needed to increase my prescription numbers andmy OTC business, but I also knew that I wanted to look at the delivery of new services.
ON 1 AUGUST, WEST BELFAST PATIENTS WILL BE ABLE TO JOIN IN THE CELEBRATIONS AT BEECHMOUNT’S MAGUIRE PHARMACY AS DR TERRY MAGUIRE MARKS 30 YEARS AS A CONTRACTOR. PIF CATCHES UP WITH ONE OF NI’S BEST-KNOWN
AND HIGH-PROFILE PHARMACISTS... In those heady first years as a contractor in West Belfast, Dr Terry Maguire often had to climb over burnt-out cars to get to his shop premises, but the enthusiasm that he demonstrated in those turbulent years has seen him pursue a career in which he has put medicines management and patient care at the heart of his business.
on, I took over as manager on 1 July
of that year, eventually becoming contractor on 1 August.
’I think I was very lucky that I became a pharmacy contractor at the time that I did,’ Terry told PiF. ‘I had been asked by the existing contractor to take over in June 1986 and, while the negotiations over the deal were going
30 - PHARMACY IN FOCUS
’When I became a contractor, the Limitation of Contract Act had just been introduced and everyone thought that the prices of contracts would increase dramatically. In fact, the prices didn’t actually shoot up until about two or three years later, making the costs of entering pharmacy as a contractor much more expensive. So I was lucky in that I got in at the right time.
’As a sole trader, I immediately
‘At that time, in addition to being a pharmacy contractor, I was also a lecturer at Queen’s University and I became involved in a cholesterol testing pilot in conjunction with James McElnay, now Professor McElnay. We sourced UK funding to use the shop as a type of ‘research lab’ for cholesterol testing, which was then in its infancy. The pilot turned out to be very successful because we identified patients whose cholesterol levels were raised. ‘It was the same with smoking cessation. As a socially deprived area, smoking levels in Beechmount were above the national average. Fortunately, smoking cessation had just begun to enter the public psyche at that time and Nicotine Replacement Therapy had just become available, so we had a product to base a service around.’
As a result of the work that pilot work we did in smoking cessation, the NPA in the UK formed the Pharmacists Action on Smoking (PAS) team. They developed the PASmodel, which was the forerunner of the current system that’s operating in the UK and all of this stemmed from the work that was done in the Beechmount pilot. To this day, I still get people stopping me in the street saying ‘you saved my life. I haven’t smoked a cigarette since I underwent the smoking cessation programme with you’. It’s very gratifying.
’What does Terry consider the main change that he has witnessed over the last 30 years?’Definitely polypharmacy,’ he says decidedly, ‘and not in a positive way. When I started out, it was rare to meet anyone on three or four medicines, but now it’s practically the norm. That, in my view, will be the challenge
for the future: how to reduce the number of medicines that people are taking. I believe that it is the ‘medicalisation’ of lifestyle that’s to blame. The vast majority of patients who live healthy lifestyles will not develop respiratory disease, cancer or cardiovascular disease. A lack of activity in prevention, however, will be resolved by the patient being ‘medicalised. It’s almost as if we’re saying to the patient, ‘don’t worry about getting ill, we have medicines for you’.
Does Terry, I wonder, have any regrets?
’Oh absolutely,’ he says, to my surprise. ‘I think, unfortunately, that community pharmacy has not developed as far as I would have liked. We’ve spent too long looking for a contract that would lift all of these services into day-to-day practice. We’ve seen through initiatives such as the Building the Community Pharmacy Partnership the value of the work that we can provide, yet we still haven’t managed to raise the level of those professional services that we can provide.
’I’m also sad to have witnessed the demise of the independent pharmacy. When I became a contractor in 1986, a ‘big multiple’ was maybe one who had four or five shops. Even Boots in N. Ireland at that time had only five or six. The rest were independents and it was rare for a contractor at that time to even have two shops. Look at the pharmacy landscape now. The multiples are a much bigger feature on the high street and they’re working to their own format of prescription management rather than medicines management. The rest are forced to follow.
’I always had a vision whereby the pharmacist would be the medicines expert: where the GP would provide the patient with a diagnosis and the pharmacist would make the decision with regard to the medicines. It was a dream 30 years ago and it’s still a
dream...it remains a challenge for all of us if we want to be professionally relevant in the future.’ •
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