PHARMACY PRACTICES COMMITTEE MEETING Tuesday, 27 September 2011 at 11.30 am The Purple Room, Hilton Light House, 4 Tomatin Road, Inverness, IV2 4UA

Application by SANJAY MAJHU for the provision of general pharmaceutical services at Unit 1C, Milton of Leys Neighbourhood Centre, Milton of Leys, Inverness, IV2 6GP

PRESENT Bill Brackenridge (Chair) Maureen Thomson (Lay Member) Margaret D Thomson (Lay member) Sandy Cumming (Lay member) Alison MacRobbie (APC Non Contractor Nominate) Catriona Sinclair (APC Contractor Nominate) John McNulty (APC Contractor Nominate)

APOLOGIES Charles Tait, Boots (UK) Limited

In Attendance Mary Morton (Head of Community Pharmaceutical Services) Helen MacDonald (Community Pharmacy Business Manager)

Sanjay Majhu, Applicant Harminder Shergill, Applicant Support Jennifer Lumsden, Rowlands Lisa Gellatly, Tesco Emily Macintyre, Tesco Support Peter Mutton, Area Pharmaceutical Committee

1. The Chair welcomed everyone to Inverness. He asked all members to confirm that they had all received the papers for the hearing and had read and considered them. All members affirmed these points.

2. APPLICATION FOR INCLUSION IN THE BOARD’S PHARMACEUTICAL LIST

Case No: PPC - Milton of Leys_3 Mr Sanjay Majhu, 23 Crow Road, Glasgow, G11 7RT

The Chair asked each Committee member if there were any interests to declare in relation to the application being heard from Sanjay Majhu. No interests were declared.

It was noted that two Pharmacy Practices Committee members reside within the Applicant’s proposed neighbourhood.

3. The Committee was asked to consider the application submitted by Mr Sanjay Majhu to provide general pharmaceutical services from premises situated at Unit 1C, Milton of Leys Neighbourhood Centre, Milton of Leys, Inverness, IV2 6GP under Regulation 5(10) of the National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009, as amended.

The Committee had to determine whether the granting of the application was necessary or desirable to secure the adequate provision of pharmaceutical services in the neighbourhood in which the Applicant’s proposed premises were located.

P1 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Committee, having previously been circulated with all the papers regarding the application from Mr Sanjay Majhu, agreed that the application should be considered by oral hearing.

Prior to the hearing, the Committee had, as a group, visited the vicinity surrounding the Applicant’s proposed premises, the existing pharmacies and facilities in the immediate area and surrounding areas of: Culduthel, Slackbuie, Wester Inshes, Parks Farm and Milton of Leys. There were no GP surgeries in the vicinity.

Also prior to the hearing, the Committee carried out a site visit meeting with the Applicant, Applicant Support, Developer and Builder present and it was noted that the premises were not constructed and were subject to conditional contract, dependent on the Committee’s decision on the application.

The hearing was convened under paragraph 3(2) of Schedule 3 to the National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009 as amended (“the Regulations”). In terms of this paragraph, the Pharmacy Practices Committee “shall determine an application in such a manner as it thinks fit”. In terms of Regulation 5(10) of the Regulations, the question for the Pharmacy Practices Committee is whether “the provision of pharmaceutical services at the premises named in the application is necessary or desirable to secure adequate provision of pharmaceutical service in the neighbourhood in which the premises are located by persons whose names are included in the Pharmaceutical List.”

The Applicant, Support and Interested parties and Interested Party Support were invited into the meeting at around 11.40am

4. The Chair welcomed:-

The Applicant, Mr Sanjay Majhu, who represented himself and was assisted by Mr Harminder Shergill, the Interested Parties who had submitted written representations during the consultation period and who had chosen to attend the hearing, were Mrs Jennifer Lumsden, Rowlands Pharmacy; Ms Lisa Gellatly, Tesco Pharmacy assisted by Miss Emily Macintyre, Tesco Pharmacy and Mr Peter Mutton, Area Pharmaceutical Committee, (“the Interested parties”). The Chair then invited the Committee members to introduce themselves. Committee members introduced themselves to the Applicant and all other parties.

The Chair asked the Applicant and the Interested Parties to confirm that they were not attending the Committee in the capacity of solicitor, counsel or paid advocate. They each confirmed that they were not.

5. The Chair reminded everyone that the meeting had been convened to hear the application from Sanjay Majhu for the provision of general pharmaceutical services at Unit 1C, Milton of Leys Neighbourhood Centre, Milton of Leys, Inverness, IV2 6GP. The application would be considered against the legal test contained in Regulation 5(10) of the National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009, as amended.

6. Regulation 5(10) was read out:

An application shall be granted if the Board is satisfied that the provision of the pharmaceutical services at the premises is necessary or desirable in order to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises are located.

P2 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

7. The Chair then described the format of the hearing, reminding those attending that no new evidence could be introduced at the summing up.

The procedure adopted by the Committee at the hearing was that the Chair asked the Applicant to make his submission. There followed the opportunity for the Interested Parties and the Committee to ask questions. The Interested Parties would then make their submissions. There followed the opportunity for the Applicant and the Committee to ask questions of the Interested Parties in turn. The Interested parties and the Applicant were then given the opportunity to sum up. The Chair explained that under the amended Regulations, the three lay members of the Committee would be those responsible for reaching a decision as the only voting members of the Committee.

The Chair then asked the Applicant to give his statement.

7.1. The Applicant’s Case

Mr Sanjay Majhu stated “the neighbourhood we believe that this pharmacy is necessary for can be defined within the following boundaries:

1. From the north, the junction of the A9 and Sir Walter Scott Drive exit; 2. From the southwest, going down Sir Walter Scott Drive (a major road with plenty of roundabouts) (B8082). 3. From the North to West going down Sir Walter Scott Drive going through four roundabouts until one reaches Leys roundabout (which cuts into Culduthel Road then turn left heading south (B861). Which is the area represented by Inverness South Community Council and taken as their agreed definition with the A9 as an obvious barrier. 4. Heading south take a left line into farmland taking in Slackbuie. This meets at Lower Milton of Leys, south of this farmland. 5. Follow the line to roundabout at B9177 which links back into the A9.

The area south of Sir Walter Scott Drive is now called South Inverness by the Highland Council and the B861 is the line of Ward 20 council area, so in effect this is where our neighbourhood boundary is. Beyond the B861 it becomes Ward 16 and thus a different neighbourhood. This will be the case from 2011.

Going south on the A9 there are various small villages without any facilities who have to travel into Inshes or Inverness for a pharmacy. This covers areas like Daviot, Moy and Tomatin plus numerous one off homes and farms in the rural areas. All these homes would benefit by a pharmacy in Milton of Leys.

Returning to Sir Walter Scott Drive (B8082) both ends of this road. that is. Inshes and at Dores have been highlighted for major reconstruction to enable further growth for Inverness. The layout at Inshes roundabout will radically change which will not only take time to create but also involve a different and complicated route into Inshes for residents in South Inverness.

The Wades Roundabout has five exits and is now too busy a road for many people and very unsuitable to cross. There are traffic lights but these are unsuitable for the growing populations within our neighbourhood.

Within this neighbourhood there are many areas which have substantial populations or are developing”.

P3 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Applicant explained this by referring to a visual aid he had brought showing the proposed neighbourhood on boards on an A-frame stand. He then went on to say “I have evidence from different sources to clarify the population in this new and changing area and there is plenty of development in Milton of Leys and the Housing Expo development; Parks Farm, Inshes/Wester Inshes, Castle Heather and there is plenty of development in Slackbuie making a total of over 2,000 homes in my neighbourhood.

I had to get the figures confirmed via the Highland Council Website Data zone information, Land Audits and through information from the developer. I had meetings with the Council as the Census information available dated back to 2001 and has yet to be updated and it was complicated to obtain up-to-date information.

Milton of Leys Phase 2 is now under construction, affordable housing at Parks Farm is now being built and ready for sales. Ashwood Grove, which lies to the east of Milton Leys, has significant new housing, many of which are owner occupied. In all this population is now heading towards 10,000 within the defined neighbourhood, of which we think Milton of Leys has an existing 1,800 population, Inshes has 2,300 population. We believe within the next two years this will grow to over 5,000 just for that part of the neighbourhood. There are plenty of future developments in the pipeline for Slackbuie and Castle Heather and I will just read out a quote from a past judicial review, where I took guidance from for this application, and believe that in this instance the quote makes clear exactly the point I am conveying to the Committee:-

…..“The question that the decision maker must address is the adequacy of the existing provision to serve the neighbourhood in question. In addressing the question, however, it is in our opinion to have regard to probable future developments, for two reasons. First, the standard of adequacy in a particular neighbourhood will obviously change in time. The relevant neighbourhood may change, for example through construction of new housing developments or the movement of population out of inner city areas. Likewise changes inevitably occur in pharmaceutical practice and the standard of “adequate” pharmaceutical provision must accordingly develop over time…”

I believe such consideration is necessary to secure adequate services for the future of this neighbourhood.

As part of the exercise I have prepared evidence from public consultations of increased waiting times, no access to car park spaces at Balloan which is often busy, return trips for medication - all this is evidence that the bubble is bursting.

I have gone through the Data Zones and have submitted this information on Page 9 of our evidence for Data Zones S01003792, showing a population of 2014, S01003784, showing a population of 1342 and S01003778 with a population of 2590, which show complicated maps and are really a bit of a jigsaw through the Scottish Neighbourhood Statistics three Data zones, with a total population of now close to 7,000.

Since 2010 when these figures were published, there has been considerable added population to all developments, as well as a new day population within the school. This approximation is a true reflection of existing population within the neighbourhood.

P4 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The population of Inverness, as a whole, from www.Scotland.org is 56,660 to 65,000, with a surrounding pharmacy base within a close radius of 8 or 9 pharmacies but for the purpose of discussion we shall say a population of 60,000 and growing. The pharmacies within this area are Rowlands, Culloden; Boots, Retail Park; Boots, Eastgate Shopping Centre; Boots, Southside Road; Tesco, within the proposed neighbourhood; Lloyds, Church Street; Superdrug, High Street; and Rowlands, Balloan Park, which is on the outskirts of the neighbourhood. Four of these pharmacies are in the centre of town, one is in the Business and Retail Park, and Tesco sits at the tip of our neighbourhood at a fair distance from residents. This, in effect, means that within residential areas there are only two pharmacies which are both Rowlands. If you look at my map, then blue shows pharmacy and green shows a GP practice.

The majority of these pharmacies are within the town centre area and this indicates very clearly that there is a lack of pharmacy covering residential areas which is only two pharmacies sitting within a residential area with a population of 56,000 and above.

In the area of Inverness, there are 8 GP practices, none of which are within our neighbourhood and include Culloden Surgery, Culloden Medical Practice, Burnfield, Dunedin, Southside Road, Cairn, Kingsmills and Crown.

From December, 2010 information, provided by the Health Board, the total sizes of practices were 49,360 which is not always the full amount. 7,306 are over 65 which is 15% of the population which is though to rise to 23-25% over the next few years.

If we include the growing and ageing populations of development within Inverness, it is safe to say the approx population lies closer to 60,000. But as the official census is not at hand for 2011, there is enough evidence to prove that Inverness is undoubtedly the fastest growing city in Scotland, as in 2001, the population was 42,000, giving a growth of 43% in ten years and needs more infrastructure to service that population.

The 2011 census data will be published in 2013 so there is no access to recent statistics from the Scottish Government. Our information has been collected using Council data. I also phoned up every developer in Slackbuie and there is a development round the new ASDA which is getting a full third of the population of Inverness living in the triangle area I have outlined as my neighbourhood.

The total numbers of homes in that development is 1,400, some of which are dissected by our boundary Culduthel B861 Road. But from the information collected, we have confirmation from developers that 722 homes are now occupied from the 1,009 we know about. This will, in effect, push the existing population in our neighbourhood to nearly 7,000 residents the population once developed and complete to over 10,000.

A neighbourhood with a population which will pass 10,000 very soon, which has only 1 pharmacy within that neighbourhood, will result in stress of healthcare provision

Since the last application was submitted in 2010 there has been considerable material change in circumstances.

There is a fabulous new primary school built and completed and is now attended by 250 children and teachers and will grow over the years. This has completely changed the dynamics of the neighbourhood, with more people accessing the links road to drop/collect children. Teachers will be coming into the neighbourhood to attend school, and there will be a build up day population very close to the approximation of the proposed unit.

P5 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Not previously existing in March, 2011, Parks Farms is now being built and the first phase of Affordable Housing will complete within the next year, with the council agreeing with developers to take the units and within the next 6-8 months will be occupied.

The new ASDA which had received planning consent, the foundations have now been laid and it is expected to open within next 6 months. With an ASDA and a Tesco within our proposed neighbourhood, there will be less need to leave the neighbourhood to access any other needs. Both ASDA and Tesco will have an unlimited clothing range, huge grocery, non grocery and much more. The neighbourhood will become even more self reliant.

The Ashgrove development which is building a lot more towards the neighbourhood centre north of our site, is still building with plenty of new residents to come into it; and

The District Park which is now under construction and will be the largest of its kind, apparently, in the Highlands. There has been a wooden bridge built to link to the park which is going to be an exceptionally big park.

The whole neighbourhood also comprises of the primary school (up to 408 pupils and 40 staff), Inshes Retail Park (including Tesco, Matalan, Harry Ramsdens), Wester Inshes, Inshes, Slackbuie and Culduthel, Fairways Golf Course, Indoor Bowling, Parks Farm(starting this week to comprise 350 homes, 25% of which will be affordable housing), there is now full planning consent for a new ASDA which will be in the Slackbuie area within our neighbourhood and confirmed by the Highland Council , Inshes Primary School, Inshes Church as well as full planning permission for “Homes for Heroes” behind the proposed site but I don’t have much more information on that.

From what we can see, there are no other shops or commercial units to service the growing populations of Milton of Leys, Wester Inshes, Inshes, Slackbuie and soon to be Parks Farm development which is a neighbourhood population which will, in time, exceed 10,000 residents.

Healthcare access into this area is serviced by Tesco, which is within the defined neighbourhood. Tesco do not deliver medicines to patients, but do however deliver grocery.

Rowlands in Balloan do now provide a delivery service to the neighbourhood. We would not argue a case that a delivery service is as essential service as an argument within a neighbourhood under normal conditions. Milton of Leys lies above the snow line. For this reason, many patients cannot access Healthcare due to harsh weather conditions, made worse by a road with a gradient.

During winter months, the links road is often extremely unroadworthy and treacherous. This is obviously an issue arisen from public consultation. Milton of Leys is a strong and substantial community within our neighbourhood, and most people have complained that it is not an argument of convenience but one of necessity. The Milton of Leys Residents Association has many associations of neighbourhoods within its Association and the problem is now worse because children and parents will be walking along this link road whilst cars come in both directions so it is essential to have access.

It is essential that a pharmacy is closer to these people as the terrain and poor weather often make access extremely difficult. Though Rowlands only now deliver, they are not in the neighbourhood and also often patients find it hard to reach them by public transport, and there is few parking spaces for the volume of traffic required as can be seen from complaints in the public consultation, which was empty this morning but I am going on this information from the complaints received via the consultation.

P6 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

It is very important that people want to access services and the panel has to remember that the changes caused in pharmacy by the new Pharmacy Contract have caused there to be inadequacies in current pharmacy provision because a lot of the services require easy access and face to face contact with a pharmacist and trained pharmacy staff. Services such as eMAS (Minor Ailment Service), CMS (Chronic Medication Service), NRT (Nicotine Replacement Therapy), EHC (Emergency Hormonal Contraception)etc. have been designed to take some of the workload off GPs and make the pharmacy the first port of call but these services can be only be offered in the pharmacy to provide adequate delivery of these to the patient. If residents from my neighbourhood cant access these services than this is going against all recent government policy and objectives regarding having easy access to healthcare. Ease of access is one of the HEAT targets which Local Delivery Plans are setting out a delivery agreement between the Scottish Government Health Department and each NHS Board, based on the key Ministerial targets. Local Delivery Plans reflect the HEAT Core Set and state that access to services must recognise patients' needs for quicker and easier use of NHS services.

By way of my public consultation on 6th June, 2011 there was a public meeting held in Inshes Primary School. The local neighbourhood was invited to the meeting, as well as NHS Highland, the Area Pharmaceutical Committee, David Sutherland the local developer, local councillors and local MPs and MSPs. This was organised by Inverness South Community Council as part of their local meeting. The minutes are on page 37 of my support evidence for the panel. The meeting was attended by around 70 persons. I attended and introduced myself and gave out a circular. The circular detailed the reason for the public consultation, the test for the application, the details of how the public can question applications and how the public should voice their opinions on current services. I made the process clear.

In all over 95% of the audience favoured the pharmacy application, the balance either did not raise hands, none raised any objections. This was minuted and agreed by Inverness South Community Council and there is a copy in my pack for the information of the panel.

An advertisement was placed in the Inverness Courier on 7th June, 2011 and over a period of three weeks the data was collected and passed to the Health Board. In total we received over 60 responses from members of the public, which we were told was very good. This was supplemented by responses from local MSPs, Councillors and local MPs. All responses were positive toward the application, none received were against.

Invites to the public meeting were extended to the Area Pharmaceutical Committee via the Health Board, but they did not attend. Three representatives from NHS Highland did attend the meeting to answer any questions on the services the NHS provide via frontline pharmacy or questions on the application process but the biggest problem was that people don’t know how to complain.

Neither Rowlands nor Tesco attended the public meeting. I would have liked them to have. From what we know neither Rowlands nor Tesco have met with Inverness South Community Council, either before or after, to ask if there are any inadequacies of service, yet, you know, they argue there is no issue. How can you know if you don’t ask the question, nor attend any community meetings – at least put in some effort to knowing what the community needs without patronising them by telling them what is good for them.

The link road is the road which connects Milton of Leys to Inshes and hence past Parks Farm and to Tesco. The link road is roughly 1.5 miles long and ends running in the direction of the north part of the neighbourhood where it completes at Inshes retail Park. 0.9 miles of this road slope downhill, this creates a difficult gradient for those persons wishing to walk along this route to access Healthcare.

P7 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Not only is gradient an issue, like I have said before, but during winter months the road is slippery and often dangerous. Though this artery is a lifeblood route, often it can be difficult – last winter even the buses stopped - to access as well as close, as it has done during severe conditions.

With the new school now open, there are more children walking in both directions. During the icy winter months this will prove hazardous. The less traffic along this road the better. More issues of travelling along this road can be seen in written responses received from the public consultation.

We have been looking at carbon footprint over the last six months as a Company and, if a new contract was awarded here, there would significant green advantages. Firstly many people could simply walk to the pharmacy, staff and children could walk to the pharmacy. The price of fuel now is at its highest and this issue must be addressed in an area of high growth in the Highlands. There is no question of convenience in an area where the shortest journey can be made difficult simply by the weather and this will improve by the awarding of this contract.

There have been new developments in my proposed neighbourhood. In Milton of Leys there is now a primary school, completed in August 2011, built to address the growth within this area. For session 2012/2013 there is a projected children population of 311 as well as another 50 staff and support service persons. This has had a major impact on the dynamics of the neighbourhood. 500 pupils are expected by 2018.

Planning was granted for eight “Homes for Heroes” to be built on the grounds of the Neighbourhood Centre, housing approximately twenty five families affected by War. They too will require much needed healthcare access, be it a small population.

Work has now begun on one of the largest parks in the area, the District Park. This provides much required leisure amenities into the area, serving the local population.

The Parks Farm development lies between Milton Of Leys and Inshes and is accessed by the link road. It is now well underway and much of the social housing is now complete.

There is the small development of Ashwood, north of the Neighbourhood Centre and this is still being developed and built with good occupation.

There is outline planning permission for a seventy bed care home and community hall.

The statistics are not ready but the Council have a policy that 2½-3 homes out of every 10 must be affordable housing and there is proof of this in my pack and the important section is Section 13, in line with Planning Advice Note 74, the Council expect the level of affordable housing to be a minimum of 25% of the total number of houses proposed. A higher level of contribution may be expected in areas where high levels of demand exist and land supply is restricted. These higher levels could be identified through individual Local Development Plans or site specific development briefs.

Evidence of this strategy can be viewed on page 12 of evidence and pages 21/22, where Milton of Leys has 56 new homes with Cairns Housing Association in partnership with Tulloch, and Wester Inshes Homestake units. Parks Farm will have at least 25% Affordable Housing population.

There is a bus service from Milton of Leys but this is a dreadful bus service, bus number 4, and was hourly the last information we had, starting at roughly 7 minutes past the hour, on the hour.

P8 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

We took a bus with a local disabled person but the bus stops at Matalan and then you have to walk to Tesco. If you take a bus from Milton of Leys to Rowlands, then this takes 75 minutes.

To get the bus to Tesco from Milton of Leys In order to travel to Tesco by bus from Milton of Leys to access healthcare at the nearest pharmacy (Tesco), there is a 500 step walk (300m) from Matalan where you get off to access Tesco Pharmacy. In all this is a round trip of 0.6km if going by foot not including distance from home to bus stop.

On the return to the bus stop, the user will have to wait for the hourly trip, so may in fact wait longer to catch the bus home. This is not fair, people using public transport going to Tesco will often be carrying shopping bags as well as their medicines, not only do they have to get over walking 0.6km, they have to wait for the bus service which has been reduced to one hour. There is no way I could do that easily let alone the elderly, infirm and disabled.

To take the bus to Rowlands from Milton of Leys takes 75 minutes one way and is pretty much a difficult, no go service. This means a public transport user would have a round journey of 150 minutes if they accessed Rowlands for healthcare.

Even if a person tried to exit and cross the busy B9006, they would have to wait for the same bus to do its circle and come back, so there will be no reduced time taking two buses. Even at that, you shouldn’t have to take two buses to access healthcare.

Even the bus service has reduced its service to once hourly and even if you do take a bus, often the service will not even be up and running when the road is too dangerous and even if it was, the bus drops you off outside the Tesco and you still need a long walk over and above the normal walk from the car park to he pharmacy. The letters in your briefing packs highlight peoples’ disappointment on public transport. In summary public transport is not adequate for this growing population. Tesco requires a long walk which for many is simply unsuitable. Rowland’s journey requires at least an hour and a half. In relation to existing services to the neighbourhood and adequacy of service, Tesco is the one pharmacy within our proposed neighbourhood, and is situated in the upper tip of our neighbourhood in Inshes Retail Park. Recently refurbished, this store has decided to relocate the pharmacy to the back of the store.

Tesco open from 8am to 8pm which arguably is a large window of opening hours. These trading hours for normal community pharmacies are normally very unviable.

Tesco recently moved the Pharmacy to back of store, which I have always said was the worst decision ever and was done without public or customer consultation. The distance from the nearest disabled space to the back of the store at Tesco is approx 120 yards. Did Tesco ask Inverness South Community Council for their views on this – no! Did Tesco ask Milton of Residents Association for their views – no!

That’s nearly a quarter of a kilometre. This is a very unfair distance for the elderly and the infirm. If you suffer from conditions such as asthma and you have no right to disabled spaces, then your walk could be up to a third of a mile, there and back.

Tesco refuse to follow the Scottish Government initiative on Emergency Hormonal Contraception. This is a key Public Health Service which clearly defines a weakness in the delivery of healthcare. I have not checked to see if this is still not happening.

P9 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Tesco do not provide a delivery service but they do, however, deliver groceries although I cannot argue that this is an essential core service I don’t know why they don’t deliver.

One of the many complaints about Tesco is the patients don’t feel consultations are private due to the nature of the design. This is well placed by the fact that Tesco did not consult the public as to the positioning of the new pharmacy, nor did they ask the public if they felt the public areas were private enough. Our belief is Tesco want the public to shop foremost, walk past the lovely isles of grocery and they don’t really want you in the pharmacy, they want you in their shop!

If they come here today to argue that there is no problem, then by reading the comments from letters received, they cannot be concerned about patient care but they haven’t asked at all. Tesco have argued in response letters that the neighbourhood should be bigger, I would argue that they should concentrate on delivering good healthcare to the smaller one we propose, because they are not.

Minor Ailments Service is all about face to face contact with the pharmacist. With a local pharmacy, patients will no longer have to travel across Sir Walter Scott Drive to reach Rowlands, nor walk a long distance to Tesco. Both these pharmacies are difficult to access through public transport. With a non contractual delivery service into the neighbourhood, this is not enough of a service whereby patients can access minor ailments have to travel by car.

We had the support of the Milton of Leys Residents Association, the Inverness South Community Council, the Westhill Community Council, Highlands and Islands MSP, Inverness East, Nairn and Lochaber MSP and the Secretary for the Milton of Leys Residents Association. In fact, all the folk I met wanted this to happen.

The legal test requires that it is necessary or desirable in order to secure adequate provision of pharmaceutical services.

In order to show that we can secure adequate provision you will find in the packs a management profit and loss for a pharmacy doing, say 1,500 items per month, which is roughly 600 scripts or 142 per week. We believe we need 250 scripts a week for a pharmacy to be viable, 3.5% of our population as it stands today. Harminder and I have run a few businesses and this is very viable for a pharmacy business. This will not be a hard task for a population neighbourhood of 7,000 growing to 10,000 within next two years, which is shared with Tesco.

Tesco, also as a superstore, has a larger catchment area with people from outside the neighbourhood coming in to shop. We do not see our contract as a direct threat to Tesco as many of our patients will be new to the area, just the surrounding area will have 3,000 people (Milton of Leys). 142/8,000 is just over 1% to make this viable. The pharmacy will be viable.

The legal test requires that it is necessary or desirable in order to secure adequate provision of pharmaceutical services. There are many inadequacies in the neighbourhood. Firstly, access. Our evidence shows that public transport is not sufficient. Buses are on the hour and stop nowhere close to Tesco. The elderly and infirm will find this very difficult. Even able bodied persons will have to walk a long distance once in the car park. There have been many complaints regarding access.

Tesco does not follow the Scottish government initiative to do Emergency Hormonal Contraception for free, they charge £25 for the privilege of asking. Tesco do not deliver, unless you want groceries, again, this is inadequate. This is a Scottish Government Initiative not followed by the UKs largest retailer. Again this is a weakness in healthcare delivery.

P10 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Many of the complaints show inadequacies, waiting times can be high and there are often repeat visits. This evidence is within the letters received. There are many issues which the panel can read within responses to public consultation and contractors can complain.

There is no delivery service within the neighbourhood, nor was there from the closest pharmacy out with the neighbourhood, Rowlands. Rowlands began a delivery service after an application was put into this area. We believe that Rowlands did this to safeguard territory, as if it was about patient concerns it would have been there from day one.

We have shown it is necessary. There is a significant ageing population as well as 25% of houses set aside for affordable housing. 23% of the population is over 65, and this will grow in time as the population swells and more people move into a pensionable age with 35-40% of these being pensioners and those from areas of deprivation.

There is a mixed population with chronic conditions, acute conditions, many elderly retired folk who will be taking anti-hypertensives, statins who need to access eMAS. There will be children in the vicinity who need a pharmacy close by. This evidence is in the letters received from residents. The Census in 2011 is not published. We have collected Council data zone information which gives an insight to ages of populations as well as affordable housing breakdown. In all, 23% of residents in the local area are over 65 and 25% of all new housing comes under affordable category. This covers low income, elderly and infirm and disabled. At present this group is not catered for. These people need a pharmacy in their retirement.

The over 65 age group still need access to healthcare and not only put pharmacy into a deprived area let down by developers.

To support desirability we have support from Inverness South Community Council which covers the whole neighbourhood, Milton of Leys Residents Association who represent the fastest growth area of the neighbourhood, local MSP Mary Scanlon, who is a resident in the neighbourhood, MSP Fergus Ewing, SNP as well as many letters of support. Not one letter we received was against the proposal – not one.

With the Affordable Housing Planning Guidance from the Highland Council, it is safe to say that a quarter of our population will require public transport access, as well as a higher than average need for access to healthcare. There is already plenty of evidence to show that these targets are beginning to be met.

There are many elderly people who have written to us to tell us, very soon they will not be able to drive, they will need closer access, we cannot argue back to these elderly people that the convenience argument comes into effect, I believe.

Our opening times will be Monday-Friday, 9am to 6pm and Saturday, 9am to 1pm. We will request an extension to 6pm on a Saturday if there is any requirement but because the GP practices are closed on Saturdays, we believe the extended hours operated by Tesco will cover this normally quiet period.

Our unit will be 3,000 square feet of absolutely brilliant healthcare, and 500 square feet for disability products. We propose to build a state of the art pharmacy with the following services, including all of the core services:

P11 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

1. Dispensing of NHS prescriptions 2. Private & vet prescriptions 3. Advice and consultations (in state of the art private rooms with sinks) 4. Emergency hormonal contraception 5. NRT 6. eMAS 7. Public Health Services(EHC, NRT) 8. Screening for diabetes 9. BP reading 10. Cholesterol testing 11. Health promotion 12. Stoma appliances 13. Methadone supervision 14. Weekly dosettes 15. Full collection and delivery service.

We propose to employ local staff and put in disabled access/ramps. Our proof of inadequacy is demonstrated through the public consultation carried out which resulted in over 60 responses. These have been sent direct to NHS Highland. We analysed some of the complaints and I summarise some of these:-

1. Too long a journey, lots of out of stocks. Pensioners, may need to use public transport soon. 2. Tesco at back of store. Would use public transport but not at present due to service. Dangerous roads in winter. 3. Feel isolated in Milton of Leys. 4. Full support of seven community councillors and three local Highland councillors. 5. Access - hill too steep. Public transport not good. Not happy with Tesco’s move to the back of the store. Rowlands have lack of sufficient car park spaces for volume of business, often cannot get a space, reduce carbon footprint. 6. Public transport not good, existing provision inconvenient, too many queues in Tesco, not good for disabled people, travel can be dangerous during bad weather. 7. The steep hill is dangerous, bad weather can make access difficult, delivery service does not replace consultations and eMAS. Rowlands too busy, eight assistants. Tesco back of store - not good for disabled. 8. Lack of community support services. Retired pensioners. 9. Weather in winter treacherous. 10. Weather problems. Rowlands very small and has queues, waiting times too long. 11. Public transport an issue, waiting times a problem at Tesco. Weather can be a problem. 12. Winter a problem. Car got stuck last year. Public transport a problem for family members who require access to public transport. 13. Convenience not the argument, necessity is. Winter difficult. Tesco now at back of store makes access worse, long queues. 14. Rowlands too busy. Tesco sited at back of store a problem.

This is a short excerpt but can be multiplied by the number of people who complained. It is very evident from existing replies that the service as it stands is not adequate.

I ask you to stop the suffering of local people”.

The Chair thanked Mr Majhu for his statement in support of the Applicant and invited the Interested Parties and then members of the Committee to ask questions of him.

P12 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

7.2 Questions from Ms L Gellatly, Tesco Pharmacy to the Applicant

Ms Gellatly enquired if the Applicant was suggesting that patients from Slackbuie would pass two pharmacies to access his pharmacy? Mr Majhu answered that Tesco have defined a larger neighbourhood than he, but that if the contract were to be awarded then people would have a choice.

Ms Gellatly asked the Applicant if he would agree that Rowlands Pharmacy, Balloan Park is not sited within the neighbourhood as defined by the Applicant. Mr Majhu agreed with this question advising that Rowlands Pharmacy, Balloan Park was across Sir Walter Scott Drive, which he considered to be a boundary.

Ms Gellatly then asked whether it was true that all patients could use any GP they chose to within Inverness should they so wish. The Applicant replied in the affirmative.

Ms Gellatly then enquired if all pharmacies collected prescriptions from every one of these GP practices. The Applicant replied in the affirmative but advised that he was not sure what Tesco’ arrangements were in respect of such a service.

Ms Gellatly asked the Applicant to confirm that they were free to do so. The Applicant replied that pharmacies will deliver from one side of any city to another but not necessarily in any neighbourhood and for the purpose of this application, the people of Tomatin, for example, did not currently have a choice.

Ms Gellatly enquired whether the Applicant felt further planned growth would still proceed. The Applicant advised that people were already moving in to new housing and affordable homes so, yes he did.

Ms Gellatly wondered of the Applicant the source of his information to which he advised he obtained via the Council and Scottish Neighbourhood Statistics, which were more up to date than the 2001 SCROLL data. He noticed there had been significant growth illustrated in the Council and Scottish Neighbourhood Statistics within the last year.

Ms Gellatly enquired if this could, however, be guaranteed to continue which the Applicant advised that he could not provide any more data than that which was available.

Ms Gellatly enquired if the Applicant felt it was an ageing population within his proposed neighbourhood. The Applicant answered that, from the data zone information 23.8% of the population are currently over 65. He has asked the Council and Milton of Leys Residents Association to ask these questions but did not think that Tesco have asked these question of them.

Ms Gellatly acknowledged that the Applicant had referred to the new primary school at Milton of Leys in his submission and wondered if he realised that the population of that school comprised half of Inshes resident pupils and half of Milton of Leys resident pupils and asked him to explain why a new primary school would impact on pharmaceutical services.

The Applicant advised he could not believe that Ms Gellatly was asking that question of him as, if a new school was opened, then that could only mean there were children in the area, which would mean that soon there would be 4-500 school pupils who may require to access such services.

P13 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Mrs Gellatly enquired if the Applicant felt this changed the population. The Applicant advised that the day population would change because 400 human beings want to access services and that there would be more of a need. He advised that though the population did not change as a whole this did not necessarily mean there was no increased demand. He highlighted that in the current economic climate Councils had no money for schools, therefore would not invest in building one in an area where this would not be required.

Ms Gellatly asked the Applicant if this had not been planned for in any event but the Applicant refuted that, advising that this had been triggered by the demands of the growing population in the area, advising that he did not want to get into politics but that it would not have happened solely by force of the developers.

Ms Gellatly wondered how the Applicant felt that the mention of ASDA in his submission had backed up his case. The Applicant replied that his neighbourhood was larger than Milton of Leys and his point was that the triangle of a neighbourhood is very self reliant, however, not serviced for by way of healthcare. He advised that it was now almost a neighbourhood fit for all purposes, one which did not necessary require a bank and that ASDA would have within it many services i.e. a butchers and non food and that this would service the whole neighbourhood, recognising that ASDA could be a threat to Tesco. Ultimately, it should be acknowledged that the neighbourhood has serviced infrastructure.

Ms Gellatly enquired if the Applicant did not think that the population currently accessed these services from Tesco. The Applicant advised that the opening of ASDA may affect Tesco business but not pharmacy business.

Ms Gellatly asked the Applicant to explain the great deal he had made in his submission around snow. The Applicant advised that, first of all he would struggle himself getting there (to the proposed premises) in times of snow but would be prepared to walk with a bag if required. It had to be acknowledged that the snow was a major problem in winter months which was another strong argument for a pharmacy with the links road. He highlighted that Tesco deliver grocery but not healthcare and that if it did snow then he would be trying harder than they to reach those residents.

Ms Gellatly pointed out that you could not open a pharmacy without staff and wondered how the staff would get to the pharmacy in the winter months if the area is effectively cut off. The Applicant advised that he would be looking to recruit local staff from within the neighbourhood so he did not expect to encounter weather related problems and that, though the weather may be bad and they could not even get out of their front drive, he would make sure staff would be able to get there.

Ms Gellatly enquired if the Applicant would also require to have a local pharmacist to ensure that the pharmacy would be able to open in such circumstances. The Applicant enquired if Ms Gellatly was suggesting that there would not be a pharmacist resident in Inverness. Ms Gellatly replied, no, but was it not true that the pharmacist would require to also be resident from within the proposed neighbourhood. The Applicant advised that this should not be an issue if they were accessing Milton of Leys via the A9 slip road and if that was not the case, then it may be required for them to access the premises from that avenue.

Ms Gellatly acknowledged the reference made by the Applicant to his Company’s views around carbon footprint and enquired if he did not feel that his proposed delivery service would have an impact on that. The Applicant advised that he only delivered when there was a need to deliver and if he was required to deliver to an elderly person who was housebound then he would.

P14 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Ms Gellatly referred to the Applicant’s mention that people did not know how to complain and enquired if he felt that he had received many letters in his consultation that this may have been because he, in fact, advised them how i.e. the move of the pharmacy at Tesco from the front to the back of the store. Ms Gellatly made reference to a letter written by the Chair of the Milton of Leys Residents Association which directed how letters of submission should be written. The Applicant advised that he had never influenced people over how to complain but when asked for guidance on this, with the new process for public consultation and having attended a public meeting where he was asked how to complain, he advised that the process was to first complain to the local pharmacy and then to the NHS Board. He assured Ms Gellatly that he had never put words in other people’s mouths and that the people of Inverness had asked him to come - from Glasgow - to help them out. He advised that he did not have the letter Ms Gellatly referred to from the Chair of the Milton of Leys Residents Association, nor had he been aware of this, advising that he had not asked them to compose such a letter nor had he had sight of it. The Applicant advised that the Milton of Leys Residents Association have their own meetings and views on how to complain but that this was nothing to do with him.

Ms Gellatly went on to ask if the Applicant had ever led people in a certain way. The Applicant advised that he had not led them before or during the public consultation process. He added that there were also three people in the room today who attended that meeting, who also had not led them in any way.

Ms Gellatly advised that she was not suggesting that he had personally influenced the Milton of Leys Residents Association but that this could have influence over the whole consultation process. The Applicant advised that he had tried to put in place a neutral system, advising that when he comes to Inverness he has been speaking to people in a group process and that people know what their issues are and that they had given them to him to present to this Committee. He reiterated that he did not lead them, advising that all that had happened was that they had discussed at the meeting how to complain.

Ms Gellatly enquired whether it was more a shop that the residents were looking for. The Applicant replied no, that their requirements were for a pharmacy, acknowledging that there were many elderly, ill, disabled and those with no transport living within the area. He advised that had the residents said to him they did not require a pharmacy then he would not have pursued submitting an application for one.

Ms Gellatly referred to the Applicant’s reference to eight pharmacies. Mr Majhu advised that these were mostly in the City centre and there were very few in residential areas.

It was clarified by Helen MacDonald of NHS Highland that, for the purpose of this application, the community pharmacies affected were the eight situated on the side of the River Ness where the proposed premises would be.

7.3 Questions from Mrs J Lumsden, Rowlands Pharmacy to the Applicant

Mrs Lumsden referred back to the issue raised of snow where the Applicant had advised that the pharmacist could have access, if necessary, via the A9 slip road and wondered if that was also how he would receive deliveries from wholesalers. The Applicant advised that he would not know from where his deliveries would be coming, however, the same process would follow to receive deliveries as that experienced by Rowlands when they themselves place an order.

Mrs Lumsden then enquired if access could be made to Milton of Leys from the A9, whether you would then be able to access the A9 from Milton of Leys. The Applicant advised yes, if you can get in then you can get out.

P15 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Mrs Lumsden suggested that residents of Milton of Leys could then visit a pharmacy in the City centre. The Applicant said that if Mrs Lumsden was suggesting that there should not be community pharmacies in residential areas that residents should go into town then if the Committee believed this it was a matter for them not to grant this contract.

Mrs Lumsden argued with the Applicant’s definition of the neighbourhood, enquiring if this was solely Milton of Leys and not Slackbuie. The Applicant advised that as part of the process he had to define his neighbourhood. There were not enough barriers to enable him to do this in Milton of Leys alone and Inverness South Community Council considered themselves to be the neighbourhood as mirrored in his application. The Milton of Leys Residents Association have been in a situation where Rowlands have argued that their neighbourhood should be Inverness. I am following process and there are no barriers. Sir Walter Scott Drive has a barrier of five roundabouts on it. So, as far as I am concerned, I am following the procedure of a neighbourhood with barriers and the neighbourhood as defined by Inverness South Community Council which is considered to be one large neighbourhood. Let the Committee decide the neighbourhood as there are barriers there which separate them out.

Mrs Lumsden then enquired whether a pharmaceutical neighbourhood must follow the boundaries of a Council neighbourhood. The Applicant replied that absolutely not, however, the line is very obvious and the obvious thing is that Rowlands is not in it. I think you are safeguarding your business territory. If you really cared about the population of the neighbourhood proposed in my application then we would be hearing very differently from you today with the need for face to face pharmacy contact and public transport not being readily available.

Mrs Lumsden then enquired what the Applicant defined as adequate car parking spaces. The Applicant advised that all the information he could take was from that offered from the public consultation which he was hoping would be available to the interested parties but had not been due to privacy laws, preventing the individuals from being identified. He was just reiterating what was being requested from that information.

7.4 Questions from Mr P Mutton, Area Pharmaceutical Committee to the Applicant

Mr Mutton had no questions for the Applicant.

7.5 Questions from the Committee to the Applicant

The Chair advised that they would be looking to question the Applicant around advertising, consultation, neighbourhood, adequacy of existing service and the services he would like to provide and that some of these issues may have been adequately covered in other questions.

Neighbourhood:

Mr Cumming advised that he has lived in Inverness since 1973 and had seen growth over that period with Community Council boundaries coming and going and that these may change again in the future and that the neighbourhood was not homogenous. He wondered how the Applicant saw changes, for example to infrastructure improving dramatically impacting in the future. The Applicant felt that improvements would augment his argument as Sir Walter Scott Drive would become busier. He had taken information from the Inverness South Community Council who felt that especially with the Parks Farm development it could become busy similar to A9 and access would require to be cut through it as his argument of triangle solidifies. As it stands today, it will be a solid boundary very soon and will make what you are saying even more credible.

P16 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Mr Cumming advised that he was not convinced as he did not think society would allow Sir Walter Scott Drive to become as busy as the A9 and safer crossings would need to be sought. It was inevitable better bus services were required to create improved access to all services points and amenities bringing into discussion the changing dynamic in the years forward. The Applicant felt that if the case, then more people would require access to pharmaceutical services and, even today if the panel felt there was a larger neighbourhood and things would change in the future and an extra 20,000 population was added, then your argument augments that a further pharmacy will be required, particularly if you are suggesting that Sir Walter Scott Drive will become busier.

Maureen Thomson enquired how the Applicant would define neighbourhood. The Applicant replied that he finds that difficult to do and wherever he has been some people think this is cross proximity to the fellow neighbourhood. He advised that he has taken guidance from Inverness South Community Council and they agree with his definition of neighbourhood to be the same as theirs, adding that he could have argued it to be half of that. But he advised that he just didn’t think, going on back to Mr Cumming’s point that it is larger than that and he would have to try to determine it in terms of boundaries. He said that the people in Milton of Leys think they have an ASDA on their doorstep and a Tesco and he had only taken that information from Inverness South Community Council.

Maureen Thomson advised that she heard what the Applicant was saying but thought, as a Committee, they would have their own specific reasoning around definition of the neighbourhood. She acknowledged that the Applicant had said himself that there were seven little groups of population within his neighbourhood and wondered what he thought, for example, the people of Castle Heather would say about being included in his definition of the neighbourhood. The Applicant felt the people of Castle Heather would say they belonged to Castle Heather and Milton of Leys residents would say Inverness South. There were pockets of communities but in Milton of Leys there was a Residents Association, not a Neighbourhood Association and that Milton of Leys may become a population of 5,000 but at the present moment in time it is a pocket of a neighbourhood which is developing.

The Chair advised that “neighbourhood” was a word used in a particular sense in Pharmacy Applications. It was about people in a neighbourhood feeling part of the same community, togetherness. With this definition of neighbourhood in mind, the Chair asked the Applicant to explain if we use Castle Heather as an example, how one would access the proposed pharmacy. The Applicant replied that you would need to go out to the perimeter of the neighbourhood, along the perimeter and then go back into the neighbourhood.

The Chair went on to enquire that between Castle Heather and ASDA was there a big void which goes down southwest, effectively splitting the neighbourhood in two. The Applicant replied in the affirmative.

The Chair then asked if it was difficult to walk from one area of the proposed neighbourhood to another which The Applicant replied yes, there was a golf course between the areas referred to but he hoped this would be more accessible in the future. The entry onto the A9 is good way in which to access into Milton of Leys but in time, further access structures would be built.

The Chair then commented that, at the moment, Parliamentary boundaries were being re- drawn to reduce the number from 660 to 600. He put it to the applicant community wards or council boundaries were not necessarily a basis for defining “neighbourhood” for the purpose of this Committee. The Applicant made the point that there was still enough of a population for his proposed pharmacy to be viable to cover the shortfall.

P17 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Advertising and Consultation

Margaret Thomson asked the Applicant to advise her about his consultation and the issues that he wanted to tell people about. The Applicant advised that the public meeting was on 6 June 2011 and used as part of the evidence by attending the Inverness South Community Council meeting where he had asked them to explain what their issues were and how they could complain. He had provided them with a meeting form which identified the issues such as core services and information that he was considering putting a pharmacy into the neighbourhood and how the Pharmacy Practices Committee works, informing of the new process and that the meeting was part of the public consultation required to be undertaken by him.

So, Margaret Thomson enquired, the goal was to inform and gather the views of that community. Was this taken at the meeting. The Applicant advised that no, he did not ask for evidence it was a show of hands and that the day after the meeting his advertisement went into the Inverness Courier which they could read and reply in any way which they felt best.

Margaret Thomson then asked the Applicant if he had a no-show of hands at the public meeting to the idea of a pharmacy what would have happened. The Applicant replied that he would not have submitted an application.

Margaret Thomson shared with the Applicant that in her experience of Pharmacy Practices Committees and National Appeal Panels she had never heard of a case where the community advised they did not want a pharmacy. She enquired if the Applicant thought that the communication he had with the community was about what the community wants or specifically about what it needs as she had felt there was not a terribly clear view of that sometimes. The Applicant advised that entirely his angle was coming from the perspective of the Inverness South Community Council who had first approached him to put a pharmacy in the neighbourhood – why, he did not know and he has asked them what they viewed their needs to be. He advised that he was collecting as much information as possible and then making suitable judgements dependant on that. He advised that they had been complaining about access to Tesco pharmacy now that it had been moved to the back of the store and also public transport. He advised that he did not force anyone and at the public meeting a show of hands was requested and they were advised that they should decide the issues they have and reply to the consultation process accordingly. He further advised that he specifically tried not to exert any influence over this.

Margaret Thomson then enquired whether there was any other form of consultation in gathering views, other than his own and the NHS, carried out by email. The Applicant advised that when the consultation process was happening, he spoke to the residents of Milton of Leys. He explained that he invited everyone to the public meeting. He advised that representative from NHS Highland were present but not the Area Pharmaceutical Committee, nor any other of the Interested Parties. He highlighted that had Tesco attended that meeting then they could have had their views expressed. He explained that the process was about taking people from different community groups within the area and asking their views.

Mrs MacRobbie reminded the Applicant that he mentioned something earlier on about that meeting being closed. Was this meeting closed? The Applicant advised that it was closed only in the way that they closed a door and there had been a celebrity appearance form the developer, David Sutherland. He advised that it was quite important that Mr Sutherland attended as residents had seen the developer as the main problem, so he was able to defend himself which could have been a hit or a miss. No, he advised it was a completely open meeting. There were Councillors and Community Councillors there but no MSPs or MPs and it was a very exciting meeting.

P18 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Mrs MacRobbie enquired how this meeting was publicised. The Applicant wondered himself, if this had been done by email or perhaps a notice but he did not know as he had no influence over its organisation. It had been a scheduled meeting and he just asked if he could attend.

Mrs MacRobbie acknowledged the public consultation by way of newspaper advert and wondered if there had been any attempt to consult with the public by any other means. The Applicant advised no, that he had followed process and was not aware of any other way of carrying this out at the time. He felt that the public meeting covered this as best as could possibly be done.

The Chair commented that the advertising and consultation seemed to depend on two fundamental vehicles. One was the advertisement in the Inverness Courier and the other the meeting of the Inverness South Community Council. He wondered why the Applicant chose the Inverness Courier to advertise in. The Applicant advised that he took advice from local people and the Inverness Courier was the one which he was advised was the most popular.

The Chair noted that the Applicant had simply used an advert and had not carried out any editorial coverage whatsoever. He enquired why he did not seek to use the local Radio Station. The Applicant advised that he did not want to do anything from a publicity stunt to influence the process.

The Chair asked if the Applicant thought if 60 was a good response out of 1,500. The Applicant advised the Chair that he did not know what to gauge the response on but felt that this was good and a show of hands of 70 at the Inverness South Community Council was good. He had spoken to other people and the most they had received was 5 and so far, no- one else in Scotland had received any more than him.

Adequacy of Existing Service and Services Proposed by the Applicant

Mr McNulty reported that the neighbourhood referred to by the Applicant has pharmaceutical services at a northern edge and from the outset he had gone on at great length to say they were inadequate. He was interested to see how as the Applicant he would resolve this, advising that from his perspective the proposed pharmacy is on the perimeter and from what he could see people coming from Culduthel, Castle Heather or Parks Farm would go to Inverness to collect prescriptions as there was no GP within the neighbourhood. He was interested to see how they would travel back to the pharmacy if there was one. If they had to go to Inverness to collect prescriptions why would they travel back, possibly past their own home to have their prescription filled. Mr McNulty thought that they would orientate northwards and to Tesco for services so why would they double back all the way to Milton of Leys. The Applicant advised that if they are going to Tesco they are still going in the direction of his proposed pharmacy. He advised that they would have a choice not to go to the town centre to collect their prescription and that often these were sent to the pharmacy of choice and not collected at the GP surgery. He advised that people have a choice and acknowledged, that, yes, they may go to Tesco and because part of neighbourhood was on the perimeter of the neighbourhood that often, as is the case for the people of Castle Heather that they may wish to drive to Rowlands but that that was their choice.

Mr McNulty enquired if the Applicant was proposing to collect prescriptions from GP practices. The Applicant replied yes, and that he thought that was the case for all pharmacies.

Mr McNulty enquired if the Applicant would have a van. He replied in the affirmative. Mr McNulty asked how often he would carry out the collection of prescriptions from GP practices. The Applicant replied twice daily.

P19 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

Ms Sinclair had noted that one of the last things the Applicant had said was that services were bursting at the seams, acknowledging these services and wondered where he had obtained these examples. The Applicant said that this had been noted entirely from the consultation and that a resident virtually said to him that services were “bursting at the seams”. He was just reiterating what was said.

Margaret Thomson enquired if the Applicant would be required to provide the services under the contract to which he replied in the affirmative. She then enquired whether there was anything else he could add to those. The Applicant advised that he did not want to show-off but that he planned to have the best disability products in the whole of Inverness covering an area of 500 square feet. She asked him to clarify what this would entail. The Applicant advised that this would include the availability of products and certain items they would be unable to get elsewhere. He would have a Cardio pod installed which was capable of carrying out a host of various functions such as analysing blood pressure, blood sugar monitoring and was a very good screening machine. He would want to make this exciting and different and was open to any thing else required to be trialled by the NHS.

Margaret Thomson commented that the area for the pharmacy looks quite big. The Applicant confirmed that it was. She then enquired where the consultation rooms would be located in relation to the front door of the shop. The Applicant advised that these would be sited immediately on the right.

Margaret Thomson then enquired if access would be protected. The Applicant replied that yes, of course, there were two private consultation areas and seating in the shop floor area for people to sit down and rest and that the pharmacy would be at the front. He found that, generally, elderly and other people liked to take a seat while waiting for their prescriptions.

Margaret Thomson asked the Applicant to confirm whether there was only one consultation area planned. The Applicant confirmed there was to be one at the front of the shop and one at the back.

THE HEARING WAS ADJURNED FOR LUNCH AT 1315 HOURS AND RE-CONVENED AT 14OO HOURS

8. The Interested Party’s Case – Ms L Gellatly, Tesco Pharmacy

Ms L Gellatly stated “thank you for allowing me the chance to speak today.

First of all, can I just point out Tesco were not invited to the public meeting referred to by the Applicant earlier today.

I would like to refer to the legal test. We do not agree that this application passes the legal test. If the Applicant is suggesting that the neighbourhood defined is solely Milton of Leys, then we do not believe this constitutes a neighbourhood as at present it is solely a residential area in which residents are required to leave in order to access essential services such as GP surgeries, banks and supermarkets.

If, the Applicant is suggesting, however, that the neighbourhood is bigger, then we need to take into account the entire city of Inverness due to the make up of the city as patients can be registered at any of the GP surgeries in Inverness and can, and do, access pharmaceutical services on the other side of the city, for example, we have several patients at Tesco who are registered at Kinmylies Surgery on the other side of the City. Within the neighbourhood of Inverness, then, there are already eleven GP surgeries whose prescriptions are already dispensed by eleven pharmacies, who have all worked hard to develop and maintain good professional relationships, something that was displayed in the recent national stock shortages when pharmacies shared stock with each other.

P20 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

We believe that pharmaceutical services offered across these eleven pharmacies are adequate.

We do not believe that it is necessary or desirable to grant the application in order to secure the adequate provision of pharmaceutical services in the neighbourhood.

I’d now like to go on to tell you a little bit about our pharmacy at Tesco, Inshes and the services that we offer, ranging from blood pressure, diabetes and cholesterol testing to prescribing for travel health and erectile dysfunction. We also offer health checks and flu injections. We do the core NHS services including eMAS, CMS, Public Health and AMS and run a very successful nicotine replacement therapy service. I was quite interested to hear about your cardio pod technology as we also provide this type of health check advice, but this is done with a member of staff, not a machine, and through consultation with the patient.

Unfortunately, at present, we do not offer EHC but this decision is being reviewed by the Company in early 2012. Currently any requests for EHC are dealt with by our pharmacists in a discreet and professional manner and patients are offered a range of options, one of which is us contacting the nearest pharmacy of the patient’s choice to arrange the supply. We have never had any complaints from patients about this situation and many have commented on how grateful they are for the effort we go to.

On the question of access to our pharmacy, I am aware from the previous meetings that the Applicant raised concerns regarding the positioning of our new dispensary in the store. The positioning of the dispensary to the back of the store is actually usual for pharmacies generally for security and privacy reasons. In our store, our new location has helped us integrate patients who would normally self select medication into the pharmacy and provide them with advice from our trained staff. It is Tesco policy to assist any disabled customers and we provide wheelchairs for this purpose. All staff are briefed on this policy and a member of the customer services team is always available to assist customers around the store, or to the pharmacy. We also have many disabled and mother and baby car parking spaces at the front of the car park beside the front doors.

Access to our pharmaceutical services is also greatly affected by our extended opening hours. We are open from 8am to 8pm six days a week and between 10am and 4pm on Sundays. Therefore, many of our services are accessed by people after their own working hours, or at weekends when other pharmacies (including the one proposed by the Applicant) will already be closed.

As mentioned earlier, the pharmacy was recently refurbished and now has a much larger dispensary to allow our capacity for offering services like methadone supervision and dispensing of dosettes to grow. While the refurbishment was taking place, the pharmacy operated from a portakabin and it is a credit to both the service provided by Miss Macintyre (Miss Macintyre) and the rest of her staff and the loyalty of their patients that they managed to maintain 60% of their business during this period, a much greater figure than usual. Where patients choose to use other pharmacies during the refit, we have not noticed that the vast majority of them have returned to use Tesco, which again proves the perception of great service and convenience offered by Tesco, Inshes.

P21 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The staff at Tesco, Inshes do value their patients and customers greatly and reflect on the standard of services that they offer on a regular basis. As Miss Macintyre has been back in her role as Pharmacy manager for a year, along with the store having been re-opened for around the same time, she decided to carry out a patient questionnaire to gauge patient opinion on the services that we offer. We asked a range of questions, from the convenience of the pharmacy to the friendliness and professionalism of staff, and satisfaction with the services that we offered and myself, as the Regional Manager. Miss Macintyre and all the staff were overwhelmed by the response we got. Out of 120 questions, 103 were graded as “excellent”, 16 were “good” and only one was “average”.

A few examples of comments are:

“staff are brilliant and helpful”, “the service I get is wonderful and I rely on them”, “I was going to get my medicines from the pharmacy beside my house but I would rather spend half and hour extra to get here”.

We are very proud of the level of excellent service that we’ve built into our business and believe it is a clear and direct result of mix of existing experienced staff and the addition to the team of newer staff who were head-hunted from other pharmacies in the area. It would be good to point out here the base of the pharmacy is Emily (Miss Macintyre). It is Emily’s (Miss Macintyre’s) pharmacy.

One thing that Miss Macintyre wanted to look at was to provide a more comfortable environment for patients waiting in the pharmacy. She did this by introducing a queuing system to increase patient privacy and also worked on making patients aware that a private consultation room was available for their use if required.

I do hope from your visit to Tesco that you did earlier today that you saw our great pharmacy and consultation room facilities and realise the potential and capacity we have to take on more services, like I mentioned earlier, dosettes and methadone supervisions.

In conclusion, we feel that we offer a fantastic pharmaceutical service at Tesco, Inshes which is greatly appreciated by patients and the other healthcare professionals that we enjoy close relationships with.

Finally, I would like to bring to the Committee’s attention a letter displayed on Milton of Leys notice board by the Chair of the Residents’ Association asking residents to submit letters of support by saying in order to “get a retail foothold in the amenity area” residents will need to address specific points as to “why the current pharmacy provision is unsatisfactory”. The letter instructs residents to mention specific points, for example, “pharmacy situated at back of Tesco store”. This must call into question the responses given in the consultation process, and if we found this letter on a public notice board, where else has it been distributed?

One of the final points on this letter is, and I quote “it is essential that as many letters of support are generated as possible, please take five minutes and help get a shop within your community”. I’d ask the Committee to ponder the question – does this community need (or indeed want) a pharmacy, or does it in fact see a pharmacy opening as a means of getting a shop into their area?

Thank you all very much for your time”.

The Chair thanked Ms Gellatly for her statement and invited the Applicant, Interested Parties and then members of the Committee to ask questions of her.

P22 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

8.1 Questions from the Applicant to Ms L Gellatly, Tesco Pharmacy

The Applicant asked Ms Gellatly if, from comments she had made, whether she was suggesting that Milton of Leys was his neighbourhood, in its entirety. Ms Gellatly replied that it was either Milton of Leys or a larger area and that she had been unsure of his definition until he presented his submission today.

The Applicant then enquired what was Ms Gellatly’s definition of the neighbourhood. She replied solely Milton of Leys, as anyone else who lives further down the hill already has adequate provision and you would need to pass pharmacies on the way up to arrive at the proposed pharmacy.

The Applicant asked Ms Gellatly to confirm that Tesco does not deliver medicines to their patients. Ms Gellatly advised that they did not do so as part of a daily service, however, they had offered it where there was a need and a trained member of staff was available such as Miss Macintyre.

The Applicant then asked if this was only offered to patients when desperate. Ms Gellatly replied that this was not the case. The Applicant then advised that he was trying to establish whether there was a delivery service, or not and was asking was there one. She replied no and that she had never claimed so.

The Applicant enquired whether it was felt that in times of inclement weather i.e. snow, that a delivery service may be important into the area. Ms Gellatly replied that she could see why he would say that but they had never been asked to provide a delivery service and in the questionnaires no one had looked at that as a service which could be offered.

The Applicant wondered if consideration had ever been made to ask the Inverness South Community Council or Milton of Leys Residents Association this. Ms Gellatly replied that the residents of Milton of Leys were included in the questionnaire process.

The Applicant then asked whether Tesco had ever considered asking Inverness South Community Council. Ms Gellatly replied no, apart from as patients as part of the questionnaire referred to already. Miss Gellatly wondered why the Applicant would ask that. He advised that the whole point of asking the Association would be to ask on a neutral basis. Ms Gellatly advised that it was the Applicant making the application for a new pharmacy, not Tesco and that they already had their contract and customer base which they were addressing the needs of through the questionnaire.

The Applicant advised that it was Tesco response and due diligence to ask customers within that neighbourhood in a proper consultation manner which they had not really done but it was noticeable that they had felt they were speaking to residents in that area. He went on to ask whether Tesco had consulted their customers when they carried out their questionnaire about the issue of moving their pharmacy to the back of the store. Ms Gellatly replied that the reason they carried out the questionnaire was not due to the relocation of the pharmacy but because Miss Macintyre, the pharmacist had been in post for three years now and wanted to gauge customer satisfaction, explaining that the move to the back of the store was outwith their control.

The Applicant then asked Ms Gellatly to clarify that they had carried out a questionnaire to ask if the service was okay, but not to move the pharmacy to the back of the store. Ms Gellatly replied that was the case.

P23 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Applicant then enquired whether Tesco felt it was in the control of the patients to give Tesco their opinion on this, Ms Gellatly explained, as earlier, that Tesco had managed to keep 60% of business whilst they were located in the portakabin during the refit and were almost back up to nearly 100% of business from before and no one was forcing customers to their moved pharmacy.

The Applicant asked whether Ms Gellatly felt that patients had the right to obtain healthcare services without having to shop. Ms Gellatly replied, yes but every pharmacy is a shop, including the pharmacy proposed by the Applicant, highlighting that he previously mentioned providing a disability section and that he would be selling these products, not giving these away.

The Applicant enquired what her thoughts were on having to walk to the relocated pharmacy within Tesco. Ms Gellatly replied that Tesco will assist people to access the back of the shop when they require this.

The Applicant asked Ms Gellatly whether she agreed that public transport is difficult for elderly or infirm i.e. for them to get off the bus at Matalan, walk to Tesco, go to the pharmacy at Tesco and then go back to the bus stop at Matalan and then go back home. Did she think that public transport to Tesco was good. Ms Gellatly replied that there must be a reason why public transport had been reduced. She advised she had observed that the people of Milton of Leys have one or two cars in their driveways.

The Applicant enquired whether Ms Gellatly really believed that if the patient decides to come to Tesco that it was okay to carry bags. Ms Gellatly replied that the Applicant had asked this question well in that it was the patient’s decision to shop at Tesco.

The Applicant wondered if Ms Gellatly agreed that it is a suffering process to walk 0.6 km from the bus stop and back to access services. Ms Gellatly advised that she felt that the Applicant was trying to lead her into answering something which she did not want to answer.

The Applicant enquired whether Ms Gellatly saw it as a weakness that Tesco do not provide Emergency Hormonal Contraception Service. Ms Gellatly replied no and her reasoning for answering no was because Miss Macintyre and her team deal with the issue very well and they had not received any complaints to the contrary.

The Applicant advised that as part of the consultation process he carried out and the replies received, people advised that they did not feel that Tesco was private enough. With that in mind the public, that you look after so very well, do you agree there is a weakness in how people get to the shop? Ms Gellatly advised that as she had already mentioned these complaints had been led by certain people and she believed that people had been fed that line.

The Applicant wondered if Ms Gellatly had any evidence that he had provided information to enable people to do this and whether she would disagree that the residents of Inverness South Community Council were an organised group who decide the boundaries. Ms Gellatly replied no, but that she did disagree with what he was saying, reminding the Applicant that we are talking about putting a pharmacy here and Milton of Leys requires amenities and not necessarily a pharmacy. It is not the fact that a pharmacy is needed. The Milton of Leys Residents Association letter that she had seen quite bluntly looked for arguments that a pharmacy is required.

P24 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Applicant enquired whether Ms Gellatly agreed that had proper consultation been carried out by Tesco and they had met with the Milton of Leys Residents Association then she would not be misguided about what was required, rather than judging a letter on a notice board. Ms Gellatly replied that the fight is not for a pharmacy, it was for a shop and that it was not Tesco who were fighting for a contract. She advised that neither Tesco nor Rowlands was on trial here so for the Applicant to be “harping on about this consultation that I should have had” was not an issue here. We are here to defend our business.

The Applicant asked whether Ms Gellatly thought that a new application awarded in this area would affect Tesco’ business. Ms Gellatly could not be sure that it would but advised that they had a high level of loyal customers.

8.2 Questions from Mrs J Lumsden, Rowlands Pharmacy to Ms L Gellatly, Tesco Pharmacy

Mrs Lumsden had no questions for Ms Gellatly.

8.3 Questions from Mr P Mutton, Area Pharmaceutical Committee to Ms L Gellatly, Tesco Pharmacy

Mr Mutton had no questions for Ms Gellatly.

8.4 Questions from the Committee to Ms L Gellatly, Tesco Pharmacy

Mr Cumming referred to the point raised around the distance relating to public transport and wondered whether Tesco, as a company, had made an effort to try to address that. For example, had they written to complain, or done anything proactive to address that. Ms Gellatly replied that not as far she had been aware but that no specific complaints had been made so because of that it had not been raised. The questionnaire did ask about access and Tesco were highly ranked for this and nothing else was raised from that process.

Maureen Thomson referred to the two options suggested by Ms Gellatly relating to possible neighbourhood, one being either Milton of Leys and the other being Inverness. If Milton of Leys was the neighbourhood what would Ms Gellatly determine as services for that particular area i.e. if she was sitting in the position of the Committee today, with Milton of Leys as the neighbourhood what would she think was adequate for Milton of Leys. Ms Gellatly replied that, as she understood, there are no services within Milton of Leys, but that the residents there have to travel outwith the neighbourhood to access services, therefore, as the neighbourhood grows these services will come but the point that she was making earlier on growth is not guaranteed to happen anymore. Perhaps so five years ago but not necessarily now.

Maureen Thomson noted that once or twice Ms Gellatly had said that in order for pharmaceutical services to be in place there also requires to be GP services together. Ms Gellatly replied that these services do go hand in hand and that they always would. With eMAS the doctor was out of the consultation process but that the bread and butter would always come from prescriptions and there would always be acute prescriptions.

Maureen Thomson then enquired what percentage of prescriptions would Ms Gellatly say were acute prescriptions. Ms Gellatly replied around 40%. Maureen Thomson noted this to be high which Ms Gellatly acknowledged but advised this was probably due to a lot of their business being out of hours.

P25 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Chair enquired over the past year how many complaints had been received from customers about pharmaceutical services. Ms Gellatly replied they had not received any. He then enquired of her over the past year how many times had Tesco not fulfilled their contractual obligations. Ms Gellatly replied none.

9. The Interested Parties’ Case – Mrs J Lumsden, Rowlands Pharmacy

Mrs J Lumsden stated “thank you, Chair and panel for allowing me to represent the views from Rowlands Pharmacy as to why we believe the application for a new pharmacy at Milton of Leys in Inverness is neither necessary nor desirable.

The first issue that I’d like to address, in order to cover the legal test, is the issue of neighbourhood.

I believe the neighbourhood we should be referred to is Milton of Leys and Wester Inshes. That is General Wades Military Road to the west, running to Sir Walter Scott Drive to meet the A9, then running south to the B9177, then across the open land back to General Wades Military Road.

I don’t believe you can include settlements such as the one at Slackbuie, as there is no real access from these properties into this neighbourhood. I would estimate the population of my defined neighbourhood as around 4,500. Within this neighbourhood there is one existing pharmacy contract, and we must remember that consideration must be given to pharmaceutical services in adjoining neighbourhoods, which would include our pharmacy at Balloan Park. Access to these pharmacies was improved further with the new access road. If patients travel a little further, which I believe these residents will do on a regular basis, then they have the choice of eleven pharmacies within Inverness, all providing the core pharmaceutical services, and additional delivery services.

The people of Milton of Leys have to travel to access their day to day services – shopping, banking, post office services, libraries and GPs. They certainly cannot sustain themselves in the neighbourhood. Access to existing services, by foot, car or public transport is adequate. Is access to pharmaceutical services really a problem? I would suggest the answer is no.

It is also worth considering the development where the proposed pharmacy would be. Will this become a destination for those at Wester Inshes, Parks Farm and Slackbuie? No, I don’t think it would. They will continue to use the services that they do at the moment, primarily as they are closer, easier to get to and have all the services they need. Any pharmacy service at Milton of Leys will serve the residents of Milton of Leys only.

I am the employed pharmacist for Rowlands at Balloan Park. We provide all the core services of the contract, Minor Ailments, Public Health, including smoking cessation and emergency hormonal contraception, AMS and CMS. We see pharmaceutical services as the key to moving ahead with pharmacy in the future, and our modern concept refit reflects this. Waiting times are low, we have no capacity restrictions for methadone or NOMAD trays, and we provide a delivery service to those who need it using a dedicated delivery van. This includes the residents in all parts of the Applicant’s area.

I, along with the other Rowlands pharmacists, have built up good relationships with the local GPs, nurses and patients. There is nothing to suggest our pharmacies are offering poor or inadequate service.

P26 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

In March of this year, the application for a pharmacy at this site was refused. The school and future housing developments in the neighbourhood were considered at that hearing and pharmaceutical services were deemed adequate. In reality, nothing has changed since that application, so services are still adequate.

I can see no need for another pharmacy contract to be granted in this neighbourhood.

Thank you”.

The Chair thanked Mrs Lumsden for her statement and invited the Applicant, Interested Parties and then members of the Committee to ask questions of her.

9.1 Questions from the Applicant to Mrs J Lumsden, Rowlands Pharmacy

The Applicant advised that Mrs Lumsden had defined the neighbourhood but wanted to just confirm that she did not believe this to be the larger neighbourhood as he had outlined nor the smaller area of solely Milton of Leys, like Tesco, but that this was somewhere in between the two. Mrs Lumsden confirmed this.

The Applicant wondered if Mrs Lumsden agreed that the populations within his proposed neighbourhood would consider themselves to be neighbours. Mrs Lumsden advised that she disagreed that a resident at Milton of Leys thinks of Slackbuie residents as their neighbour.

The Applicant wondered whether Mrs Lumsden agreed that Rowlands, Balloan Park was outwith his proposed neighbourhood. She replied that Rowlands, Balloan Park was on the outskirt.

The Applicant enquired when Rowlands, Balloan Park commenced their delivery service. Mrs Lumsden replied that this had commenced in March, 2011. The Applicant advised that this service commenced just a couple of weeks prior to the National Appeal Panel hearing but prior to that there had been no delivery service offered via Rowlands, Balloan Park and that before it had been Rowlands, Culloden who had provided the delivery service into the Balloan Park neighbourhood. Mrs Lumsden clarified that they would have delivered to those who required it if desperate before then.

The Applicant enquired whether Rowlands, Balloan ever sought comments from residents in the neighbourhood to ascertain whether this was an issue for them. Mrs Lumsden replied that they had not. The Applicant then enquired why they had not attended the Inverness South Community Council public meeting. Mrs Lumsden advised that she had only heard of this by word of mouth at the very last minute and was unable to attend.

The Applicant asked Mrs Lumsden to share her thoughts on the Tesco pharmacy moving to the back of the store. Mrs Lumsden replied that this was nothing to do with her, obviously, and was a decision made by Tesco.

The Applicant enquired whether Mrs Lumsden believed that she should be defending Tesco and have an opinion on this as part of your defence. Mrs Lumsden replied no, that she was not defending Tesco, other than to say that they contact her when they require one of their patients to access Emergency Hormonal Contraception service and that they worked well together and help each other out during times when there are issues with supply.

The Applicant commented that everyone could have helped each other out by attending the public meeting of the Inverness South Community Council.

P27 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Applicant asked Mrs Lumsden how long the bus journey from Milton of Leys to Rowlands, Balloan Park took. Mrs Lumsden replied 75 minutes. The Applicant wondered how Mrs Lumsden was aware of that. She advised that she had read this in previous minutes.

The Applicant asked Mrs Lumsden what her thoughts were on this. She advised that she felt that if patients were using a bus that, to be honest, it would be simpler to go directly into the centre of the City.

The Applicant enquired what would happen in the event of extreme bad weather. Mrs Lumsden replied that Rowlands have their own dedicated delivery van and to give Sheila, the delivery driver, her credit she walked last year in the bad weather.

The Applicant then asked if Mrs Lumsden believed that since the National Appeal Panel there had been a material change of circumstances now with the school up and running and other developments now being occupied. Mrs Lumsden replied that she could not see why the school now being open made any difference as the children were already part of the Milton of Leys population and have simply moved schools but replied that she could see how the new houses had made a difference.

The Applicant enquired whether the people of Milton of Leys require any other services. Mrs Lumsden replied that they need a shop but no services pharmaceutically.

The Applicant enquired whether she thought the Milton of Leys residents could make use of a convenience store. Mrs Lumsden replied yes, she thought they could do with that.

The Applicant then asked if Mrs Lumsden felt that the message coming across from the residents was that if they need a shop in the neighbourhood they had Tesco and soon to be an ASDA. Mrs Lumsden replied that they did not have amenities in their immediate neighbourhood. The Applicant then enquired whether Mrs Lumsden thought they would get healthcare from their grocery shopping. Mrs Lumsden replied no.

9.2 Questions from Ms L Gellatly, Tesco Pharmacy to Mrs J Lumsden, Rowlands Pharmacy

Ms Gellatly had no questions for Mrs Lumsden.

9.3 Questions from Mr P Mutton, Area Pharmaceutical Committee to Mrs J Lumsden, Rowlands Pharmacy

Mr Mutton had no questions for Mrs Lumsden.

9.4 Questions from the Committee to Mrs J Lumsden, Rowlands Pharmacy

Mr Cumming enquired with regard to the neighbourhood whether Mrs Lumsden could see any validity in accessing pharmaceutical services to the proposed pharmacy from area further south, for example, from areas such as Daviot and Tomatin. Mrs Lumsden replied that, to be honest, she felt that these people would travel into Inverness for a weekly shop rather than cut off the A9 to access services at the proposed premises.

P28 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

10. The Interested Parties’ Case – Mr P Mutton, Area Pharmaceutical Committee

Mr P Mutton stated “Thank you. Ill start by introducing myself, I am the Head of the Pharmacy Department of Raigmore Hospital, Inverness and a member of the Area Pharmaceutical Committee. Firstly I note that Mr Majhu mentions that the Area Pharmaceutical Committee had not responded to the invitation to attend the public meeting. I apologise if apologies had not been submitted, I thought that they had but, the Area Pharmaceutical Committee is an advisory committee to the Board. Although it did not attend the public meeting, a member of the Committee did attend as one of the Board representatives; she fed back to the Area Pharmaceutical Committee on the meeting. Her report was then taken into account when the Committee considered this application.

The NHS Highland Area Pharmaceutical Committee had considered this application in some detail. A small sub-group of the Committee looked at the issues and reported back to the full Committee. In summary the Area Pharmaceutical Committee considers that:

1. Current pharmaceutical services for residents of Milton of Leys are adequate 2. A new contract is not necessary 3. A new contract is not desirable.

This was a majority view with one member feeling the application should be granted.

The Committee agreed, in general terms, with the neighbourhood as defined by the National Appeal Panel but felt that debate on the definition of what constitutes the neighbourhood was, in many ways a bit irrelevant. The issue of whether the pharmaceutical services to Milton of Leys are adequate or not regardless of whether it is a neighbourhood in its own right or part of a larger neighbourhood. The bottom line is that if described in a wide context by Tesco or anyone else then if it were felt not adequate that this was okay for some but not others and that if defined narrowly then it could be said that it was inadequate. The Area Pharmaceutical Committee are not overly concerned with definition of the neighbourhood.

The Committee also agreed with the National Appeal Panel that residents outwith that defined area (at the bottom of the hill) were unlikely to access services at the top. Patients in Inverness access services all over the City and residents of Milton of Leys shop outwith the area defined by the National Appeal Panel, relatively speaking. Both Tesco and Rowlands provide pharmaceutical services within or just outside the neighbourhood, however, it is defined, and which are accessible by foot or by car. Delivery of prescriptions is available from Rowlands Pharmacy. We subsequently heard also from Tesco that they are available to deliver into the neighbourhood, if required.

The Committee noted the National Appeal Panel view that “in reaching its conclusion, consideration could be given to future developments which could be considered probable rather than speculative” and that the National Appeal Panel concluded that pharmaceutical services were adequate both for current population and for new residents of houses currently under construction and for the needs generated by the new school. The Area Pharmaceutical Committee then considered that the opening of the primary school does not constitute a material change and there are many communities in the Highlands where there is a primary school but no community pharmacy. The possibility of an increase in population in the future in these uncertain times must be considered as speculative rather than probable.

The Committee acknowledge that a small number of residents do experience difficulties in accessing pharmaceutical services but then that will be true of all communities. You may have residents in the Drakies estate who are disabled and have difficulties in accessing services, even in Tesco, perhaps?

P29 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

With regard to complaining to the Health Board, I would argue that people do know how to make a complaint. We have a Complaints Team who deal with these. In fact, I was dealing with a complaint this morning before I cam here. Complaints can sometimes be trivial and sometimes not but there is a channel there where to place these. You mentioned the ASDA development. People have a choice and taking in this and around this area extends the area considerably. This is a long journey for people, even by car. Pharmacies meet the terms of their contract through the Health Board and through the General Pharmaceutical Council so the current services are deemed to be adequate, even if service could be better this may be the case but they are, in fact, adequate.

The Committee fully understands how the public would value a community pharmacy in the heart of each neighbourhood but believe granting this application could potentially put at risk vulnerable contracts in areas of Highland where there are lone contractors providing a vital service over a large area. It will also reduce the chance of applications being made in areas of the Board where there are currently no pharmaceutical services. The reason for this is that funding for contractors is from a global sum provided by Government which is divided amongst contractors. Community pharmacies can no longer rely on retail sales to subsidise NHS income and it follows that each additional contract will diminish the income for others.

The constraints of the global sum mean that increasing the number of pharmacies in areas where there is already an adequate service reduces the ability of pharmacies everywhere else to develop services. There is a need for pharmacies to have workload levels which allow for cost effective use of staff time and a reduction in overheads and infrastructure costs. This is essential if the professional time is to be freed up to develop services in line with the contract. It also means that potentially the pharmaceutical needs of the residents of Milton of Leys will be best served by having fewer but more cost effective pharmacies in Inverness rather than opening a newer one which may offer greater convenience to a minority and perhaps a better service in the short term.

In summary, the view of the Area Pharmaceutical Committee is that there is an adequate pharmaceutical service to the neighbourhood in which Milton of Leys sits. A new pharmacy is neither necessary nor desirable in ensuring an adequate service”.

The Chair thanked Mr Mutton for his statement and invited the Applicant, Interested Parties and then members of the Committee to ask questions of him.

10.1 Questions from the Applicant to Mr P Mutton, Area Pharmaceutical Committee

The Applicant stated that Mr Mutton was here to represent the Area Pharmaceutical Committee today and wondered whether the Area Pharmaceutical Committee had ever met or spoken to residents within the proposed neighbourhood as this seemed to have been missed out that no-one, except for himself had done this. Mr Mutton advised that the mechanism of obtaining those views was a report back from a representative of the Area Pharmaceutical Committee who had attended the public meeting as an NHS Highland representative.

The Applicant enquired whether Mr Mutton was aware that no-one had ever heard about the Area Pharmaceutical Committee or knew the complaints process. Mr Mutton reiterated that the Area Pharmaceutical Committee was an advisory committee to the NHS Highland Board so a complaint would not necessary come to them as that was not the route.

The Applicant enquired what the route was for complaints. Mr Mutton replied that writing a letter to the Health Board saying Dear Sirs would reach the appropriate persons and that there was a Complaints Department who dealt with complaints. He advised that he was not aware of any letters complaining about pharmaceutical services having been received by the Health Board.

P30 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Applicant set a hypothetical scene that many letters had been received by the Health Board and that if the Area Pharmaceutical Committee did not know that these had been received and replies had been issued to, for example, MSPs, then it was safe to say that the Area Pharmaceutical Committee were out of touch with the public. Mr Mutton advised that it was safe only to say that they would not have been aware of these letters, if indeed they had been written.

The Applicant enquired whether Mr Mutton was aware that the previous Pharmacy Practices Committee agreed with his definition and that current services then were inadequate. Mr Mutton replied in the affirmative.

The Applicant wondered why the Area Pharmaceutical Committee did not bring up this issue. Mr Mutton replied that was because of the appeal which was the most recent decision.

The Applicant then enquired whether the Area Pharmaceutical Committed listened to his comments on public transport, access and representing local people. You are not aware of what they are upset about because you don’t know but I am telling you they have to walk 0.6 km . Were you aware of the lack of transport access at your Area Pharmaceutical Committee meetings. Mr Mutton replied that the Area Pharmaceutical Committee would agree that the level of public transport is not ideal but better than in some areas with the area of NHS Highland where there may be no pharmaceutical services at all or as in other areas where there are services, serviced by only one or two buses per day. To answer his question, though the public transport is far from ideal, it is better than in some areas and the overall view had been that it was adequate.

The Applicant asked Mr Mutton to confirm that he thought public transport services were adequate but not ideal. Mr Mutton replied, yes.

The Applicant asked Mr Mutton if he was saying there were shortcomings in service and if so what does he mean? Mr Mutton replied that it could be perceived by some that some services could be better.

The Applicant enquired whether current services provided were adequate. Mr Mutton advised that it would be fair to say that the Applicant had not considered public opinion. The Applicant advised that he had taken into consideration the views of the public meeting.

The Applicant wondered whether Mr Mutton agreed that it was not a significant test that it is desirable but Mr Mutton advised that such discussion should not be the test. The Applicant agreed but advised that ultimately this was not good for the people of Milton of Leys if those who have an adequate service could have a better service.

The Applicant enquired whether Mr Mutton had driven round the development and agreed that new developments were happening rather than speculative. Mr Mutton advised that clearly those which are happening are happening and that he had quoted from the National Appeal Panel and what they talked about previously.

The Applicant then enquired if the Area Pharmaceutical Committee had attended some of the meetings or canvassed some of the residents whether he though they would have a different view. Mr Mutton felt that these things were taken into consideration and that there are stories that people have to tell, some expressing difficulties in accessing pharmaceutical services but that it was a question of what the level of the community is that really makes that difference in whether you need a particular pharmacy or not.

P31 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Applicant asked Mr Mutton if the Area Pharmaceutical Committee believed that Tesco made a bad move, moving from the back of the store or not. Mr Mutton replied that this had not been discussed by the Area Pharmaceutical Committee but that it was felt that this was unfortunate and were disappointed it had been moved but having heard from Tesco today there are reasons for that and he did not think this would influence the committee in making their decision. He went on to say that the Area Pharmaceutical Committee had not specifically asked Tesco the reason behind the relocation but the pharmacy was where it was now so will not make a material difference.

10.2 Questions from Ms L Gellatly, Tesco Pharmacy to Mr P Mutton, Area Pharmaceutical Committee

Ms Gellatly had no questions for Mr Mutton.

10.3 Questions from Ms L Gellatly, Tesco Pharmacy to Mr P Mutton, Area Pharmaceutical Committee

Mrs Lumsden had no questions for Mr Mutton.

10.4 Questions from the Committee to Mr P Mutton, Area Pharmaceutical Committee

Mrs MacRobbie wished to pick up on the point made by Mr Mutton about complaints, enquiring if there were any received by the Health Board, relating to community pharmacy would these not go to the Head of Community Pharmaceutical Services. Mr Mutton replied in the affirmative but added that they would be remitted to the Area Pharmaceutical Committee should they be more general in nature.

Maureen Thomson referred to Mr Mutton’s reference in his submission to how granting an application diminishes the income available for other pre existing pharmacies and ideally he may wish to change some issues around the number and where sited other pharmacies are in the City. Maureen Thomson wondered about the mechanism by which this could be addressed. Mr Mutton replied that the Area Pharmaceutical Committee had no powers over this and at the moment his comments were speculative but for the future imagined that you could only respond to individual requests there may be in the longer term but that the facility to plan services was not there yet.

Maureen Thomson asked if there was a blank piece of paper would the current pharmacies be where they are currently situated. Mr Mutton advised that his impression was that you may be looking for fewer but more strategically placed pharmacies in the future. He added that this was his own personal view and not that of the Area Pharmaceutical Committee.

11. Summing up

The Applicant and Interested Parties were then given the opportunity to sum up.

11.1 Mr P Mutton, Area Pharmaceutical Committee stated “the issue is not about whether a new pharmacy at Milton of Leys will provide a better service than is currently provided. It is about whether or not the current provision is adequate. The Applicant has presented evidence which demonstrates that the current service is not particularly convenient for some and could, perhaps, be better in some aspects, but has not, in our view, presented evidence which demonstrates the current service provision is actually inadequate.

It is therefore the view of the Area Pharmaceutical Committee that this application should be refused”.

P32 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

11.2 Mrs J Lumsden, Rowlands Pharmacy stated “I believe the neighbourhood as to be as I defined earlier in the hearing. Milton of Leys is not a destination for outlying areas and will serve only the population of the neighbourhood itself. Current service provision is adequate, as it was six months ago, when the previous application was refused. As such, the application is neither necessary nor desirable”.

11.3 Ms L Gellatly, Tesco Pharmacy stated “we do not believe that this passes the legal test. Across the 11 pharmacies there is access to adequate pharmaceutical services therefore this application is not necessary nor desirable. Tesco offers great services to all customers and patients.

Go back to the point I made, it is not that people of Milton of Leys do not require amenities, just not a pharmacy”.

11.4 Mr S Majhu, Applicant stated “Let us once again remind ourselves of the Legal test. The Legal Test requires that it is necessary or desirable in order to secure adequate provision of pharmaceutical services.

We have shown that our defined neighbourhood does not have adequate provision. At times people find the link road too dangerous. The bus service has already been reduced to one per hour and the distance walking to Tesco is very unreasonable. The Area Pharmaceutical Committee contradict the reasoning for this. The journey to Rowlands, Balloan Park is a 2½ hour round trip or two buses trips.

Tesco does not follow a Scottish government initiative. Tesco do not deliver, unless you want groceries. This is a weakness and displays arrogance. There is no delivery service within the neighbourhood, nor was there from the closest pharmacy out with the neighbourhood, Rowlands. They did not turn up at the public meeting on 6th June 2011. They do however deliver now, which I hope the panel will see through. They are only doing it now to avoid debate at this hearing.

We have shown as necessary that there is a mixed population with chronic conditions, acute conditions, many elderly retired folk (over 23%) who will be taking anti-hypertensives, statins and who need to access EMAS. There will be children in the close vicinity who need a pharmacy close by.

With a target population of 7,000 patients, we would say that 2000 items per month would be able to secure provision for this business. That would be 1,000 patients a month if average items are two per patient. In a week that would be 250 patients a week, or 3.5% of our neighbourhood population. Considering 20% will be over 65 years and 25% will be affordable, this will not be a difficult target.

Who agrees with the neighbourhood – nobody? The Pharmacy Practices Committee can’t agree the neighbourhood, Rowlands couldn’t agree the neighbourhood, the National Appeal Panel couldn’t agree the neighbourhood and, people who have lived here a long time can’t agree the neighbourhood – I am confused! There are lots of different versions of the neighbourhood. Some parts may be closer to an existing pharmacy than others. I have stuck to boundaries but this is an issue for the panel to decide but remember that Tesco don’t deliver in an area above the snow line.

Is it desirable? We have had support from Inverness South Community Council which covers the whole neighbourhood, Milton of Leys Residents Association who represent the fastest growth area of the neighbourhood, local MSP Mary Scanlon, who is a resident in the neighbourhood, MSP Fergus Ewing SNP as well as many letters of support – it is not about convenience for them.

P33 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

This is about a bustling population of 60,000 where it is getting more and more difficult. Take on the points made by Lord Nimmo Smith that it is highly probably there will be an increase in population. Not one letter did we receive against the proposal - not one but there have been many complaints received.

I am unsure what the Area Pharmaceutical Committee do or do they sit around just having cups of coffee. They have lost touch with what people need.

With the Affordable Housing Planning Guidance from Inverness Council, it is safe to say that a quarter of our population will require public transport access, as well as a higher than average need for access to Healthcare. There is already plenty of evidence to show that these targets are beginning to be met.

I find it incredible that with an area above the snow line, that no pharmacy (up until the previous Pharmacy Practices Committee hearing) within the neighbourhood, nor Rowlands delivered into the neighbourhood. Tesco are creating a false impression – they don’t deliver and I am really surprised that consultation is not an issue for them.

Again this augments our argument that there is inadequacy, especially during the winter months when the link road could be closed. I find it contradictory that Tesco will deliver groceries and not medicines. It is unsustainable to service this neighbourhood adequately. Customers are already telling you so. This highlights our argument that Tesco want you for grocery not healthcare.

It is unsustainable for Tesco to continue servicing a neighbourhood its pharmacy will find hard to cope with. There were two pharmacists when we visited, from what we know there are issues with waiting times and often people have to go back for their medicines.

The residents in our neighbourhood were promised many things. We have sat in on meetings many times and heard some sad stories and some political but many people bought their houses there believing that there would be essential services. We found the stories very sad, they feel they have been cut off and lied to by Tulloch, the Planners, their Representatives.

In our opinion provision has been lazy to say the least, they may go on about what services they provide in their shops, but I for one am appalled at the extent of lack of services in this neighbourhood, the Residents of this neighbourhood deserve better but quite clearly stated by Peter the business view.

The residents of the Inverness South Community Council area deserve better and I hope the panel approve this application today”.

At the conclusion of the summing up, the Chair asked the Applicant and all of the interested parties if they considered that they had had a fair hearing. Mr Majhu, Mr Shergill, Ms Gellatly, Miss Macintyre, Mrs Lumsden and Mr Mutton replied yes, that they did consider they had had a fair hearing. . The Chair advised that a written decision would be sent out in writing within 15 working days. A letter would be included with the decision advising of the appeal process. The Chair then thanked the parties for attending.

Mr Majhu, Mr Shergill, Ms Gellatly, Miss Macintyre, Mrs Lumsden and Mr Mutton left the meeting.

P34 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

12. DECISION

Having considered the evidence presented to it, and the Committee’s observation from the site visit, the Committee had to decide firstly, the question of the neighbourhood in which the premises to which the application related, were located. It took into account a number of factors in defining the neighbourhood, including those who were resident in it, that it had natural boundaries, the presence or otherwise of schools, shops, and health services, land use and topography, and the distance over which, and the means by which, residents require to travel, to obtain pharmaceutical and other services.

The Committee considered the various neighbourhoods put forward by the Applicant, the Interested Parties, and the Area Pharmaceutical Committee in relation to the application, as well as comments received from the public consultation.

The Committee took into consideration, the Committee’s obligations in terms of the Equality Act 2010:–

the need to eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act; advance equality of opportunity between people who share a protected characteristic and those who do not; and to foster good relations between people who share a protected characteristic and those who do not.

The committee considered it unlikely that people living in Culduthel, Castle Heather, Wester Inshes and Slackbuie would consider that they were neighbours with people in Milton of Leys due to the distance, the golf course, the District Park, the open ground between them and the difference in elevation. Many of those responding to the consultation made note of the steep hill which separates those living in Parks Farm and Milton of Leys in the neighbourhood at the top of the hill and the majority of the responses to the consultation where from within this neighbourhood. These new housing developments all include a proportion of affordable housing therefore there was no requirement to consider differences in social factors when deciding the neighbourhood.

12.1 Neighbourhood: the Committee considered that the neighbourhood should be defined as follows:

North: the northern boundary marks a change from residential housing to open ground between Parks Farm and Balvonie of Inshes; East: the eastern boundary is the A9 which marks a physical boundary; South: the southern boundary marks the extent of residential housing and the commencement of the countryside to the south of Inverness (i.e. the belt between Milton of Leys and Inshes); and West: the western boundary is Old Edinburgh Road South / General Wade’s Military Road from its junction with Park’s Farm Cottages which marks the extent of residential housing and the commencement of open ground and the Fairways Golf Course.

In general, the above area could be described as the residential area “up the hill”.

12.2 Adequacy of Existing Provision of Pharmaceutical Services and Necessity or Desirability:

Having reached that decision, the Committee was then required to consider the adequacy of pharmaceutical services within that neighbourhood, and whether the granting of the application was necessary or desirable to secure adequate provision of pharmaceutical services in that neighbourhood.

P35 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The Committee noted that within the neighbourhood as defined by the Committee there were no pharmacies and that services were provided from several pharmacies outside of the neighbourhood including Tesco at Inshes and Rowlands at Balloan Road and Culloden. The Committee surmised that services were also provided to people in the neighbourhood from pharmacies in the centre of Inverness.

The Committee considered the overall services provided by the existing contractors within the vicinity of the proposed pharmacy, the number of prescriptions dispensed by those contractors in the preceding 5 years, and the level of service provided by those contractors to the neighbourhood. The information provided to the Committee detailing monthly dispensing data, activity related to MAS, PHS, AMS and CMS, and information on provision of locally negotiated services showed that these pharmacies provided a comprehensive range of pharmaceutical services including NHS core services and supplementary services. Whilst Tesco does not provide the PHS EHC service directly they do direct patients to another provider in line with the requirements of their contract. Information relating to occasions when Rowlands had not met their contracted hours were discussed and it was considered sufficient that Rowlands now understand the requirement of their contract to get prior permission for periods of closure during contracted hours in emergencies. Tesco and Boots also provide pharmaceutical service beyond their core contracted hours allowing evening and Sunday access to services at these pharmacies at both Inshes and Inverness Retail Parks. There had been no complaints to NHS Highland either about current pharmaceutical services or the lack of pharmaceutical service provision other that the responses to the consultation for this application.

The Committee noted the letters produced by the Applicant from a number of individuals, their political representatives and community organisations some of which it had been noted by the Board when received were duplicates. Thirty two were submissions received by letter or email by the Applicant and remitted with the application.

Eight were submissions received by letter or email by the Board as a result of their separate public notice inviting comments and two submissions had been received from the separate consultation undertaken inviting comments from the eight bounding community councils/residents association at time of notification of application, 28 June, 2011. It was also noted that there had been other letters/emails received by the Board prior to the new application process.

Thirty four of these submissions came from people living in Milton of Leys itself - a tiny part of the proposed neighbourhood. Only one came from another part of the proposed neighbourhood. This evidence appeared to support the Committee's definition of the neighbourhood.

Twenty three of the submissions were solely "expressions of support" and did not evidence inadequacies in the existing provision, focussing on convenience. Fifteen submissions cited any inadequacy, mainly on two issues – access to Tesco and Rowlands and the location of the relocated pharmacy within Tesco which were viewed by members of the Committee to be essentially issues of convenience also.

Concerns from patients about privacy during consultations in the pharmacy were considered to have been successfully addressed by Tesco with changes to layout and signage. These were considered to have improved patient consultation confidentiality and made patients more aware of the availability of a consultation area if desired. The Tesco pharmacy customer service questionnaire also showed high levels of satisfaction with services and access.

P36 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc

The consultation carried out by the Applicant had raised questions about physical access to pharmaceutical services. The committee first discussed issues related to the bus service. From observation during the site visit if was noted that although the bus stop is quite a distance from Tesco, the service did not appear to be busy and most patients appeared to use cars or taxis to access pharmacy services there. Levels of car ownership in the neighbourhood had been observed to be high. The committee observed no problems with parking at either Tesco or Balloan Road and disabled parking was available at both locations.

The committee observed an individual with a significant mobility problem entering Tesco and concluded that the availability of the wheelchair service adequately addressed the access difficulties for this patient group. It was acknowledged that a small number of patients in all communities will experience difficulties in accessing pharmaceutical services. There was no evidence of higher levels of patients with long term conditions or other mobility difficulties in this neighbourhood or with a higher level of need for additional access to pharmaceutical services.

Across the whole of NHS Highland there can be periods where snow makes it difficult to access services. This area of Inverness is higher and more affected by snow but the Applicant conceded that access to the A9 was generally available. Therefore the population of the neighbourhood would be able to access services by following the A9 to Inverness.

It was also evident to the committee, from the lack of other service in the neighbourhood, that the population has to access services such as shopping, banking, post office, church, secondary education, etc. from other locations across Inverness and would normally choose to access pharmaceutical services while accessing their workplace or other facilities located outwith the neighbourhood or while shopping. Prescription collection and delivery services were available to patients who required them in the neighbourhood. Though the population of Inverness is growing it was agreed that there are sufficient pharmacies in place to meet the need for pharmaceutical services.

While there had been evidence submitted that the current service is not convenient for all patients there had been no evidence of inadequacy provided by the Applicant, or had been made available to the Committee via another source, which demonstrated that the services currently provided to the neighbourhood were inadequate. The committee considered that the level of existing services to the defined neighbourhood, provided satisfactory access, for those residents in the neighbourhood, to pharmaceutical services.

The committee recognised that new houses are being built, more people are moving into the area and that there are plans in place to construct more housing and other buildings associated with the Milton of Leys Neighbourhood Centre which will cause population growth, however the Panel did not feel in a position to predict when the full potential of that growth will come to fruition, particularly in the current economic recession. The Committee recognised that it required to determine the adequacy of existing provision of pharmaceutical services at the time of its decision but that in reaching its conclusion consideration could be given to future developments which could be considered probable rather than speculative, although it had no way of confirming that these were probable.

The Committee agreed that the existing pharmaceutical services in the neighbourhood were adequate. It was clear that residents in the neighbourhood had expected significant development of a range of services including retail and fast food outlets at the Milton of Leys Neighbourhood Centre. These developments have failed to materialise and there was some indication that this pharmacy application was being supported in order to “get a shop” at the site and to start amenity development. However the Pharmacy Practices Committee’s remit is to assess the need for health services on behalf of the NHS by applying the legal test.

P37 Sanjay Majhu Milton of Leys_3 PPC 27 September 11 NOTES.doc