Taki Kyriacos is packing it in. After 26 years as the only pharmacist in the small Eastern Cape farming community of Stutterheim, Kyriacos says he can no longer make a living. He primarily blames Government moves  to  hand out dispensing licences to any doctor or health practitioner who applies for one for the situation that now challenges his very existence.

Entrepreneurial spirit has been the lifeblood of the Kyriacos family for generations. Kyriacos’ father arrived in South Africa 84 years ago, exchanging his life in Nafplion on the southern coast of the Greek mainland for a fresh vegetable and grocery store in Main Road, Kenilworth (Cape Town).

In 1978, After meeting his Stuttereheim wife, the young Kyriacos, fresh from graduating as a pharmacist at Rhodes University, moved to the farming town where he bought a share in Colletts Pharmacy. He  became the sole owner  a few years later.  

“I am not crying wolf. I do not rely on only dispensing income. I diversified my business long ago and sell many other goods over and above medicine, but I cannot survive with six doctors within 500m of my pharmacy dispensing medicine,” says the burly pharmacist, who has been voted ‘Community Pharmacist of the Year’ in the past and prides himself on his involvement with the 45 000 strong population – rich and poor.

Kyriacos says that he has implemented the new regulations “to the T” and charges an administration fee of between R2,50 and R7,50 (capped at R50), but that the dispensing doctors have been the final nail in the coffin for his pharmacy.

Kyriacos’ pharmacy  employs 14 workers, runs the dispensary at the public hospital, dispenses medicine to indigent patients, has a wellness clinic and operates an outreach clinic to local factories.

“My gross profit has fallen by 9% in one month, I can’t survive,” he says.

Kyriacos has appealed against the dispensing  applications of seven doctors  in Stutterheim and claims that a senior Department of Health official told him his objection was not worth the paper it was written on.

A dispensing license, issued by the Department of Health, allows a doctor, nurse, occupational practitioner  or veterinarian to dispense medicine from their practices. The license is valid for three years after which the person has to re-apply.

According to the Department of Health, the key aim of the licensing process  is to ensure that practitioners operate according to specific standards and guidelines. It also ensures that these practitioners have the required knowledge to dispense medicine as they complete an exam during the application period.

Inspectors from the Department of Health will do spot checks at premises to ensure that medicine is stored correctly and that the licensee is dispensing the medication as opposed to the receptionist or another employee.

Gary Black of the Pharmaceutical Society of South Africa concurs with Kyriacos about the lack of response to appeals: “None of our members who appealed against the granting of licences has been successful. In fact many of them did not even receive a letter acknowledging their appeal.”

Black said the one appeal that was heard was unsuccessful.

Health department deputy-director Mandisa Hela confirmed that 8 061 applications for dispensing licences had been received and that a total of 4 212 licences has been granted. No applications were refused. She said pharmacists had objected to one third of applications.

Earlier this year Health minister Dr Manto Tshabalala-Msimang remarked that many doctors had failed the dispensing license examination but Hela declined to confirm this.

She also failed to answer questions about whether the bulk of applications had been received from rural or urban areas, or the criteria used in the decision to grant a license.

She was also unable to explain why no hearings had been held on any of the applications and failed to acknowledge Kyriacos’ specific case.

Debbie Pearmain, chief legal advisor in the health department said the legislation was aimed at granting better access to affordable medicines for poor, aged or young people. Pharmacies could not necessarily do this, she said, because of set business hours, higher costs and their distance from people’€™s homes.

She claims that in most cases people would have been denied access to medicine if applications for dispensing licences had been declined.

Pearmain said it would be unconstitutional to reject a license on the basis that the doctor’€™s premises were within walking distance of a pharmacy.

“A number of factors are taken into account when deciding on a license, not only its proximity to a pharmacy, but also the demographics of a community in terms of being able to access medicine and being able to afford it.’€

She confirmed that there had been objections from pharmacists, but that these had all been purely on the basis of proximity.

“What do you say to the person who cannot go to a pharmacy during working hours or who cannot get off from work?” she asked.

Pearmain said there had also been applications from occupational health practitioners and nurses and it is hoped that these would serve people who cannot afford to go to pharmacies or doctors.

Dr Norman Mabasa, chairperson of the National Convention on Dispensing (NCD) said the organisation would continue its legal action against the Department of Health.

The NCD will next week (Nov 11) ask the Constitutional Court to lodge an appeal against a June Pretoria High Court ruling which dismissed, with costs, an application challenging the constitutionality of the dispensing regulations.  

Mabasa said that even though all doctors were being issued with licences, the Director General still had the power to withdraw such permission after three years and make decisions arbitrarily.

He said that those pharmacists who were trying to blame the dispensing doctors for their woes were “barking up the wrong tree”.

“The problem is not the dispensing doctors, but the pricing structure of medicine. Pharmacists should look at the option of charging a professional fee as we do, rather than viewing us as a threat,” said Mabasa.

On the one hand  it is clear that Government is planning to certify all those applying for dispensing licenses, no matter how much pharmacists protest.

Government is not  not prepared to even consider individual cases such as that of Kyriacos, leaving him, he says,  with no other option but to close shop.  Nobody is disputing that people need access to dispensing practitioners, but the process has to be transparent and fair.

On the other hand, there is no doubt that  the confusion created by court challenges, new legislation, regulations, petitions and mud slinging between affected parties is playing into the pockets of unscrupulous businesspeople. Consumers should demand an explanation when additional amounts over and above the dispensing fees, are charged.   They should also ask why a single exit price is not printed on medication and if their questions are not answered satisfactorily, vote with their feet.

An observer summed it up: “We almost need a Treatment Action Campaign to fight for the consumer.”

Ends.