A Doctor in the Chemist's
There is a small alcove at the back of most chemist shops these days, usually curtained off, where a pharmacist jabs your arm with a flu vaccine or a Covid booster while you sit with your sleeve rolled up. It is, in its modest way, one of the great quiet successes of British healthcare over the last decade. Nobody voted for it, nobody legislated it into being with a grand ten-year plan, and yet it works. It exists because Boots and Superdrug and the local independents worked out that people would pay a small sum for convenience, speed, and the absence of a three-week wait.
I propose that we should extend this principle, and put a doctor in there as well.
Not permanently, and not the chemist's own staff. What I have in mind is a retired GP, of whom there is no shortage, many still spry, competent, and mildly bored, coming in for two or three sessions a week to occupy that same little booth, or one very like it, and offering fifteen-minute consultations to people who have booked ahead. Say £25 a time. Something ails you, something needs a look, a prescription needs renewing or a referral needs writing, and you would rather not spend half a day achieving it. You book a slot, you turn up, you are seen, you leave with either reassurance or a prescription that the pharmacist two feet away can fill on the spot. The whole transaction might take fifteen minutes at most.
This is not a wildly novel idea. SameDayDoctor and its cousins already do something like it, charging rather more for the privilege. What I am suggesting is the same service stripped down and priced for the mass market, riding on infrastructure that already exists. The chemist already has the booth. It already has trained staff next door. It already has the footfall because people walk past pharmacies on their way to do something else, in a way that they rarely walk past a doctor's surgery. All that is missing is the doctor, and Britain currently has rather a large number of doctors who have retired from full-time practice but not from the wish to be useful, nor from the wish for a slice of extra income that does not involve nights and weekends.
The objections write themselves, and are worth taking in turn. The first is that it will undermine the NHS. It will do nothing of the sort. Nobody with a broken leg or a suspicious lump is going to a chemist's booth instead of A&E. What they might do is get a repeat prescription sorted, or an ear looked at, or a rash diagnosed, without occupying a GP appointment that someone with a more pressing need could otherwise have had. Every visit diverted from an overstretched surgery to a booth in Boots is a small gift to the NHS, not a theft from it.
Will it create a two-tier system? It already exists, and is called having money for taxis, or living near a good surgery, or being the sort of person confident enough to demand a same-day appointment. What a £25 booth adds is a cheaper tier, available to people who currently have no tier at all except the queue. The critics of two-tier medicine are curiously unbothered by the tier that consists of waiting three weeks and then being fobbed off with a phone call.
Could quality and regulation be assured? A retired GP remains a doctor, subject to the same GMC oversight as any other, and no one is proposing they should operate outside clinical governance. The pharmacy chains already run rigorous compliance regimes for vaccination and minor ailment schemes; extending them to cover consulting sessions is an administrative task, not a moral hazard.
Will retired doctors actually want to do this? Some will, some won't, and the market will sort that out without help from a committee. The attraction is precisely that it is part-time, low-stress, free of the paperwork architecture that drives GPs to retire early in the first place, and is pleasantly sociable. Fifteen-minute slots, three days a week, cash in hand and no on-call rota: for a retired GP who still enjoys the diagnostic puzzle but not the 7am staff meeting, this is not a bad life.
None of this requires new legislation, new funding, or a white paper. It requires a pharmacy chain, or better still several competing ones, to notice that they already have the booth, the pharmacist, and the customers, and that adding a doctor for a few sessions a week is a small experiment with an asymmetric payoff with modest cost and a service that people will visibly queue for. The NHS did not invent the vaccination booth either. Someone in a head office worked out that people wanted it enough to pay for it, and did it. There is no reason the same insight should not extend, quite naturally, to a doctor at the next table along.
Madsen Pirie