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Features
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7/14/2011
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The Big Interview: Bharat Patel
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In his first interview since becoming chairman of the National Pharmacy Association, Bharat Patel tells Neil Trainis of his desire to drive community pharmacy forward by breaking free from the shackles of the past...
I'm not a power freak but I like things being done,” Bharat Patel says, leaning forward with a glint in his eye. The gregarious new chairman of the National Pharmacy Association is not averse to expressing a few home truths. He cuts through the waffle like a hot knife through butter and appears the perfect panacea for an industry caught in limbo and procrastination as revolutionary health legislation loom into view. “My style of chairmanship is distinctly different from other chairs we've had,” he proposes. “I like to chair a meeting and hear the views of all my board members and come to a consensus on how we go forward. That's not to undermine anyone else, I just like doing it my way. I'm not in it to be rude. That's not to say I dont believe your views. If you have a point of view, let's discuss it and come to an amicable solution as to how we go forward.”
As he begins restoring the faith of pharmacists in his organisation, many of whom have started to wonder what the NPA offers them at a time of great uncertainty, he cares little about what people think of him and more about how they perceive his function. “As you go through the routines of being a board member, you get more voice skills and become loud and people say I've got a bit of a mouth anyway, so there's not too much of a problem there,” he says self-effacingly. “I get very frustrated at things not being done. I can't get things done by the back-benches so sometimes you've to take the reins and say 'this is the way forward.'”
Having been an NPA board member since 2006, Bharat has a valuable insight on the weaknesses that have inflicted the body in recent years. “There are more challenges in the marketplace and I welcome the challenges,” he suggests. “I believe that when you get those challenges, you raise your own standards. The NPA has been unfortunate in the recent past of not having the stability we needed. We've got that stability now and we can go forward and bring back the NPA's reputation to where it should be.”
Part of the restoration process, he insists, simply involves making pharmacists more aware of what the NPA can offer them after 90 years of service. But he does not mince his words. “It does concern me and that's a challenge I'm up to and we will market ourselves in a way that everybody undertands what our role is. But we do an awful lot. Apart from insurance, there's full representation which they take for granted,” he says. “The amount of work that goes on behind the scenes in promoting that role is second to none. Another service they take for granted is our information service, which again is absolutely from the top drawer. We need to remind people about that every now and then. There are some really good things going on at the NPA and maybe we need to shout a bit louder.”
Passion
His intense desire for challenges is matched by a near repulsion of being dragged back to the past. An unadulterated passion for pharmacy has cultivated a driven, forward-looking entrepreneurialism within him which is not solely characterised by his energetic persona. The healthcare business he runs, accomodating two pharmacies, not to mention a nearby nursing home in Benfleet, are monuments to his dedication and predilection for the future. He sees no value, for instance, in dwelling on the length of time it took the NHS Future Forum to appoint the pharmacist Ash Soni. “We tend to make a song and dance about it,” Bharat suggests. “We need to concentrate on the positives and the fact he's there. The route we took to get him there is another matter and that's water under the bridge. Let's rejoice that we have someone as articulate, intelligent and passionate about community pharmacy as Ash.”
Living in the present involves winning back the hearts and minds of pharmacists. “(It is) important for my constituents to understand how the NPA protects them in their day-to-day job,” he says. “Whether that's insurance indemnity or giving them right advice and the right training material to cope with the new services that are about to come. So it's a three, four-pronged approach.” Bharat's vivacious approach to life translates into a determination to fight his corner. He scoffs at remarks made by Sultan Sid Dajani, the vice-chairman of the English Pharmacy Board at the Royal Pharmaceutical Society, during the Avicenna conference in Turkey in which he denounced Pharmacy Voice as 'Corporate Voice.' The insinuation was that Pharmacy Voice, of which the NPA play a prominent role, does not have the community pharmacist at its heart. “When you're on a conference, and I've been to many of these, sometimes you say things you regret. And sometimes Sid didn't think through one or two issues, like in previous occasions as well,” he muses. “Maybe this is something for Sid to reflect on because I'm firmly of my opinion that Pharmacy Voice is the inclusive body that takes care of pharmacy's independent electorate as well as corporate electorate.” Pushed on where this criticism of Pharmacy Voice has emanated from, Bharat admits: “I've heard this myself. I've got my beliefs on that. For whatever reason, people are being mischievous and whether they are being mischievous for commercial gain or whatever, that is for them to do their own soul-searching. As chair of the NPA, I need to dispel the myth that we don't represent independents. We do and I can't say that strongly enough.” Who are these mischief-makers? “They know what they're doing. It's not for me to say. I don't want to name names. Those people doing those kind of things, we know who they are. They know who they are. I think they are doing it for commercial gain rather than for true independents.”
Bharat soon launches into another impassioned defence of Pharmacy Voice. “Pharmacy Voice has gone a long way to address (a perceived lack of unity in pharmacy). Everybody has signed up to that, the NPA, CCA and AIMp. That takes care of all sectors. Pharmacy Voice represents a unified way of knocking on the Department of Health's (door) or any other listener with that one voice,” he says. “There will be disagreements but we'll have to move forward. But you cannot have one model fits all any more. We need to do it with an element of compromise and with the safety and well-being of the patient down the line.”
Pharmacists remain apprehensive about what awaits them in a reformed NHS and the concern persists that pockets of them lack the appetite to engage with GPs and adapt to change. “They're very comfortable with the way their business model is working with the number of items they're doing and all the rest of it. Perhaps there isnt the incentive or the notion of change in their working practices is just a step too far,” Bharat ponders. “I see it in my remit to facilitate that change because I have no doubt that the supply function is the bear minimum now and the services route is the way forward. More and more people are tuned into that way of thinking rather than 'I'm locked up in my dispensary all day long, I'm going to do prescriptions all day long.' Well, that view might not be sustainable in the future.”
Frankness
Contrary to a natural tendancy for frankness, Bharat, somewhat surprisingly, side-steps the question of whether Andrew Lansley should be jettisoned from his position as Health Secretary but admits that “he's probably been slightly naïve in thinking doctors can handle the £80 billion.” Smiling, he adds: “That's my personal view. He's seen elements (of what pharmacy can offer) through (Pharmacy Minister) Earl Howe, who's been singing our praises, hence the new prescription service later this year. There's little bits of positivity in all of this. Whatever the circumstances of (how) Andrew Lansley came to where he is, it's there and we've got to deal with that now.”
Bharat is unflustered that pharmacy's inclusion on Health and Well-Being Boards remain open to conjecture. “It's not worrying. I'm very confident locally that we're going to achieve something because we've got excellent dialogue with all the powers that be at the County Council and directors of public health,” he asserts. “It has to be driven locally. It's the local connections that'll determine whether pharmacy will be on the Well-Being Boards. We will encourage and facilitate that. We in Essex are making great progress. I had a meeting with one of the PCT's pharmacists and we talked about pharmacy representation on GP consortia. That's about to occur in this area. We've come up with a sensible dialogue of leaving the LPCs and having a nomination process, so it's not necessarily a local pharmacist who's going to win but someone who will look after the local interests of all the community pharmacists on their patch. I'm confident about that local element now.”
Barely breaking stride, Bharat is emphatic when asked how important it is for the NHS to move from GP-led commissioning structures and towards a more holistic health commissioning mechansim that, of course, involves pharmacy. “The whole ethos is moving towards services and away from the supply route, although that's a core part of our business at the moment. We need to come up with new ways of working, new ways of skill mixing, to enable the pharmacist to deliver high calibre clinical services that we're blatantly qualified for,” he says. “I say that without doubt and I qualified 31 years ago. I would love to put to shame what some of the youngsters are doing but I really admire them. We need to use their expertise and get on with it. We have pre-regs in our pharmacy every year and, by golly, do I learn from them.”
Bharat's hectic schedule allows him scant time to do anything else but work, yet this is a man who makes you believe that anything can be achieved. He “chills out” with a dose of heavy rock music and insists that “if you go into (my) iTunes, you'll find about 10,000 songs, all of heavy rock. I'm an avid follower of U2, Rolling Stones. I quite frequently fly off to Vegas on a Thursday night and come back on a Sunday night having seen somebody at the NPA on a Saturday night.”
His heavy metal reminiscences are a pleasant distraction from talk of NHS reforms and pharmacy mischief-makers. “I followed (Pink) Floyd when they were touring all over the world. I introduced my brother at the age of 30 to Knebworth when he saw Genesis for the first time,” he recounts. “When I'm depressed, there's nothing better than a dose of rock music! When I'm in my car and I'm coming back from the NPA or some very robust meeting we've had, I'll have rock music blasting out all day long.” He used to be a season ticket holder at Essex Cricket Club and, as a West Ham supporter, has endured a miserable season. “Everything good comes from something bad,” he simply says with a positivity that encapsulates his very being.
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