Start of main content

The crisis of rural pharmacies: obsolescence of the legal framework, precarious employment and economic inefficiency

| News | Public and Regulatory Law

Carlos Mínguez and Patricia Mendilibar analyze in the newspaperfarma the crisis that are suffering the rural pharmacies affected by "España vacía" (Empty Spain)

The rural pharmacy is immersed in a deep crisis, silent and far from the media spotlight. Election programs, social networks and conversations, tertullian or not, turn a deaf ear to a reality that is as alarming as it is hopeless.

The rural pharmacist guarantees equity and universality of access to pharmaceutical services in the most vulnerable areas of Spain. In many cases, it is the only health professional who is permanently present in these populations. The pharmacy becomes a true social and health centre, far from the image that is otherwise intended to give it as a mere dispensing centre for medicines. According to the report "La distribución de la Farmacia en el medio rural" (The distribution of the Pharmacy in the rural environment), published in 2014 by the General Council of Official Colleges of Pharmacists, there are 5,267 rural pharmacy offices, which means that one out of every four offices is in what, thanks to Sergio del Molino's very interesting essay, is known as the "empty Spain". 

It is surprising that although the problem of empty Spain has managed to get into the public agenda, the debate on the need to modify the rules that guarantee the existence of a pharmacy in rural areas has not even been raised by public officials. The pharmacy is an element that strengthens these municipalities and constitutes an incentive for those who have decided to stay in rural areas, despite the opportunities offered by large and medium-sized cities.

The existence of the rural pharmacy is not being properly promoted by the State. The legal framework that affects the management of these offices is not in line with their reality and needs.  The pharmaceutical zoning and obligations imposed on rural pharmacists are disproportionate and do not provide any incentive to improve their quality of life.

In recent years, the state has taken small steps that, far from contributing to improving the conditions of rural pharmacists, have made up the reality they face. The approval of Royal Decree-Law 9/2011, of 9 August, meant an increase in margins for those pharmacies that fulfilled two conditions: to have total sales of less than 200,000 euros per year and to be in rural and/or marginal areas. These pharmacies became VECs (pharmacy of low economic viability) and, depending on their monthly sales, could see their turnover increase by between 0 and 833.33 euros.

State aid is insufficient: many rural pharmacies are in a critical situation

Although RDL 9/2011 was created with the aim of "contributing to the viability" of rural pharmacies, the efforts of the State to correct this situation are imperceptible for those affected. The numbers speak for themselves: aid to VEC pharmacies accounts for 0.03% of the State's total pharmaceutical expenditure, according to the report "RDL 9/2011: Study on the Impact of its Application in the Pharmacy Office", carried out by the Spanish Rural Pharmacy Society. According to this study, although VEC pharmacies can receive a maximum of 833.33 euros per month, the reality is that the average is 300 euros/month. Thus, the impact sought by RDL 9/2011 is minuscule: VEC pharmacies continue to have expenses like non VECs and their income is still much lower than the average for purely geographical reasons. 

Job Insecurity: the problem of duty shifts and the impossibility of hiring staff

In addition, rural pharmacists are forced to comply with disproportionate duty calendars. Despite the efforts of some autonomous regions to rationalize the emergency service, the guard model does not sympathize with the low demand for the service in rural areas.

The autonomous rules regulating the guards organize the pharmacy offices by pharmaceutical zones, so that the offices located within the same pharmaceutical zone can be rotated for the performance of the duty shifts. The dispersion of the rural pharmacy makes it difficult, if not impossible, the shift so that the holder of the rural pharmacy office is forced to do guards with a very high frequency, while his income does not allow him to hire an employee with whom to take turns to do the duty shifts.

The future of rural pharmacy is uncertain. The fixation of population in the territory seems to be going to be an element present in the public debate and in the public agenda in the times to come. The rural population aspires to services provided under the same conditions as in the urban environment and it is known that the principle of equality is broken when different situations are treated equally. It is therefore necessary to open a full debate where actions such as renewing the map of pharmaceutical areas, remunerating the guards or lowering the tax burden are put on the table for their approach from the perspective of the global renewal of the rural pharmaceutical system.

You can read the article in Diariofarma.

End of main content