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Memo to Boris: Bulk Medicine Purchases Could Save the NHS Millions Annually

by John Brian Shannon

The UK’s excellent National Health Service could save millions of pounds annually if the UK government were to bulk purchase all medicine for the entire country and thereby obtain huge discounts from pharmaceutical manufacturers.

The NHS can save itself millions of pounds sterling per year by simply purchasing a year’s worth of medicines in advance, similar to what is done in Canada where the government of Canada, using their mass-purchasing power, negotiates massive discounts on medicines from multinational pharmaceutical corporations.

In Canada, each province operates its own provincial health service and pays the entire cost of it via provincial income tax, sales tax and other fees — but they couldn’t succeed without the huge price discounts that the federal government of Canada obtains from its medicine suppliers. Not only do Canada’s healthcare systems benefit from lower drug costs, but the Canadian military and Coast Guard also benefit from those lower prices.

It’s not the whole answer to solve all NHS spending problems all the time but it could be a good part of the answer.

As the NHS constantly struggles to meet the demands placed on it by attempting to treat everyone, all the time, no matter the disease, ailment or injury; Saving millions annually on medicine costs could allow NHS funding to be better spent on treatment for patients, instead of it being consumed by drug costs.

It’s not about purchasing low quality medicines, nor is it about payoffs or patronage.

It’s about deciding how much medicine to purchase (a year in advance) and thereby obtain competitive pricing from the legitimate pharmaceutical corporations in America and Europe which appreciate knowing (in advance) how much of each medicine to manufacture and (in the case of some medicines) they are willing to offer deep discounts (usually about 50% off the listed prices, but in certain cases those discounts can reach 80% off the list price) which can help healthcare providers to lower their costs.


Using the Mass Purchasing Power of the UK Government to Lower Medicine Costs

Of course, the NHS has almost certainly looked at this model in the past.

But ‘timing is everything’ they say, and in the midst of recession, austerity, or during times of political upheaval, it isn’t practical to divert millions of pounds to prepay an entire year’s worth of medicines, nor is it likely to be done without prior approval of the UK government.

However, once we move out of the Coronavirus crisis (but while there’s still plenty of well-deserved focus on the heroic NHS workers) it might be time to have a national conversation about bulk purchasing the UK’s entire annual medicinal requirements — including purchasing on behalf of all devolved territory NHS units and the UK military. The UK government would thereby become the sole wholesale purchaser and wholesale seller of medicines in the UK, even acting as the sole supplier to every wholesale medicinal distributor in the country.

It might take a bit of UK legislation for this to happen and some money, because for all it’s merits, you must still pay for an entire year’s worth of medicine in advance in order to qualify for those quite wonderful discounts.

Also, every NHS unit including NHS Scotland, NHS Wales, NHS Northern Ireland and NHS England, and the UK military and every pharmacy supplier would need to provide a list of medicines to the UK government a year in advance so they could form an accurate picture of the pending mass purchase and consequent deep discount.

Yes, it would take some work to calculate that list and perfect it over time. But if Canada (and certain other countries and militaries) can do it; Why not the UK?

The truth is that certain global healthcare systems benefit massively from volume discount medicine purchases and the UK government needs to act now to create the requisite legislation so each NHS unit can save millions, allow the UK military to save hundreds of thousands of pounds sterling, and allow pharmacies to lower their retail prices via significant cost saving on the wholesale price they pay their suppliers.

But other than the price — as everything else would remain the same — the UK must get organized so it can obtain those astonishing discounts and benefit as other healthcare systems benefit from bulk purchasing.


The NHS Will Save Multi-Millions on Medicine Costs

You’ve got to like that.

Ditto for the UK military and for retail pharmacies.

Therefore, I respectfully submit that the UK government pass legislation to create a National Medicines Purchasing Agency (or ministry) that should thenceforth operate as the sole purchaser for all (non-homeopathic) medicines for the entire UK, including on behalf of all NHS units, the UK military, and for suppliers to pharmacies UK-wide, and provide it with generous funding to accomplish the task.

The legislation should require the agency or ministry to create a continuously updated website that is robust enough that the public and medical professionals could find relevant information on every medicine sold in the country — including general information, dosages, contraindications, along with high quality images of each pill or tablet to help counter possible fraudulent imitation pills or tablets.

Further, I believe that such an agency should be set-up — not to earn a profit from reselling medicines, but to simply recover the cost of each medicine — and that should remain true whether the agency is selling to any NHS unit, to the UK military, or to pharmacy suppliers across the UK.

However, if other national healthcare systems wish to purchase surplus UK medicines, then perhaps that UK agency could offer them to other healthcare systems at cost-plus-ten-per-cent for example, or whatever seems reasonable. No favouritism, please. Just enough to maintain a zero deficit/zero profit annual budget within the national medicines purchasing agency.


Selling Medicine that is ‘Near To Expiry Date’ & Selling Other Surplus Medicine to the UK Foreign Aid Office in Lieu of Monetary Donations to Developing Nations

The UK is highly regarded globally for its foreign aid commitment of .7% of GDP. It’s one of the most generous foreign aid budgets in the world by percentage and compares well with larger countries even when measured in total currency amounts.

However, more can always be done.

And instead of dumping ‘near to expiry date’ medicines or other surplus medicine in a landfill or incinerator; By staying current with the expiry dates, the UK could boost its foreign aid spending by sending such surpluses to developing nations once those medications are down to 6-months remaining on their batch number expiry date.

Therefore, whatever those drugs have cost the UK government, by simply reallocating them to the Foreign Aid Office for transshipment to a developing nation along with a note to the Foreign Aid Office explaining how much the National Medicines Purchasing Agency (or ministry) paid for that pallet of medications, it’s a just way to increase the UK’s foreign aid budget by that exact amount. Or to top it up  to .7% during lean years.

In either case, it won’t hurt to send a truckload or two of nearly outdated medicine (annually) to the developing nations that need them and include those donations as part of the UK’s foreign aid spending.

It’s a ‘Win-Win’ when you bulk purchase an entire country’s worth of pills annually and thereby receive astonishing discounts from multinational pharmaceuticals, it’s ‘Win-Win’ when each NHS unit never again runs short of medicine and only ever pays the deeply discounted wholesale price, it’s ‘Win-Win’ for pharmacy suppliers that benefit from a much lower wholesale price than they could ever hope to negotiate themselves, the UK military wins by having lower cost medicine for its personnel, and it’s a ‘Win-Win’ for the UK foreign aid budget/developing nations.

And all that, just by getting the UK organized on its total annual medicine purchase.
Who knew?

Brexit: Well, That Only Took 1317 Days!

by John Brian Shannon

 

After a gestation period that would’ve impressed a Brontosaurus (44-months, or 188-weeks if you prefer to measure time by the week, or 1317-days, or 31,608-hours) the UK government finally kept its promise to Britons who voted for Brexit on June 23, 2016.

So, after bobbling the ball for 3.5-years, the UK government finally got it right (Thanks, Boris!) and at 11:00pm GMT on January 31, 2020, the UK left the European Union. And not a moment too soon, as if the dithering on the UK side had continued much longer the UK would’ve been thrown out of the EU  — instead of leaving of its own accord! Yes, the frustration with successive UK governments grew to record highs over the past 3.5-years…

Anyway, that was then, and this is now, as they say.


What Next for the UK?

According to the terms of the Brexit agreement with the EU, the parties have 11-months to agree a trade deal to govern the future trading relationship, unless the parties decide to extend the trade deal negotiating period for another year, or longer.

I feel positive about getting a trade deal with the EU as it’s so obviously in the interests of both parties to arrange a fair-to-both-sides trade agreement, that there will be a signing ceremony before the end of 2020. Let’s hope!

Of course, the EU isn’t the UK’s only trading partner, so a trade deal with the Americans is important for the UK, And that too, must be concluded in a reasonable timeframe if the UK is to capitalize on its economic prospects following its departure from the European Union.

Let’s hope that Boris Johnson’s team sees the value of signing onto the CPTPP agreement — to become a member of the Trans Pacific Trade Partnership agreement — which is a huge trading region headed by Japan as the leading economy in the bloc.

Subsequent deals with Commonwealth of Nations countries — I’m hoping for a massive agreement between all Commonwealth nations, on par with the excellent CPTPP trade agreement. And, why not? The UK has ignored the Commonwealth for far too long now and huge opportunities await UK companies within that 2.5 billion member bloc (2.5 billion citizens/consumers in the Commonwealth of Nations countries by 2022) and further, the economy of that bloc consists of rapidly developing economies whose citizens are now beginning to enjoy real growth in their disposable income. Disposable income that could be used to purchase UK goods and services if you take my meaning.

Yes, huge trade opportunities await the UK, and not a moment to lose going after it. Because if the UK doesn’t go after that business, some other country or bloc will snap-up all of it and could completely displace UK trade in each country. That’s the punishment for taking too long to agree a trade deal.

Former UK Prime Minister Theresa May and her government found out what happens when it takes too long to accomplish something really important to the UK people, and those excessive delays are the only reason that Boris Johnson is now the Prime Minister of the United Kingdom. So… fast, fast, Boris, on the trade file!

And thanks for getting Brexit done.


Putting the UK – EU Relationship in Context

All in all, the UK – European relationship has been a good one when measured over the past 107-years.

In that time, the UK fought to bring peace to the continent in WWI and WWII, it was a solid contributor to the NATO alliance during the Cold War, the UK participated in operations like the Berlin Airlift, the fall of the Wall/reunification of Germany, and in missions in the Balkans to try to prevent genocide and enforce International Court of Justice rulings against non-state actors there, and it invested trillions of pounds sterling in the continent in the 20th-century.

The UK helped to bring peace and prosperity to Europe and was an early supporter of a unified Europe from the time of former UK Prime Minister Sir Winston Churchill — although Winston often said that the UK did not belong “in” continental Europe, but rather, that it should support a unified continent from “outside” continental politics.

Having played a pivotal role in the creation of a peaceful and prosperous European continent, the UK can now leave with its head held high, having accomplished all of its long-term objectives there, knowing that the ongoing peace and prosperity on the continent will continue for decades to come, due in part to the UK’s huge commitment to continental Europe since 1913, or thereabout.

Although the Brexit process might have frazzled nerves on both sides, there’s no doubt that the United Kingdom and the European Union will continue to be allies sharing a similar worldview and will continue trading with each other on an epic scale. While some tears have been shed over Brexit, the special relationship with our continental friends will endure for centuries to come, of that there’s no doubt.

Now, let’s make it easy on ourselves and quickly agree a fair and comprehensive trade agreement, so that both parties can continue to build on the successes of the previous century — as befits true neighbours, friends, families, and allies — thereby setting the bar for how countries can and should work together to create a better world.

And I wouldn’t expect anything less from Prime Minister Boris Johnson or from EU President Ursula von der Layen. In fact, we’ve only just begun!


Thumbnail image courtesy of www.ft.com

Will 2020 Be the Year that Britain Shines?

by John Brian Shannon

It has been an eventful 2019, hasn’t it?

I can hear you saying, ‘Please don’t go there!’, and I don’t blame you a bit for saying it.

In 2019, the UK lurched from one disaster to another; From weak Brexit politics and its concomitant economic uncertainty, to floods, to troubles within the major political parties and miss-steps with Britain’s allies. It has been a mess.

Consequently, 2020 can only be better. YAY!

Still, UK Prime Minister Boris Johnson united the formerly disunited Conservative and Unionist Party, which is now sitting at 365-seats strong — strong enough to pass almost any bill it wants — including a Brexit bill allowing the UK to leave the European Union on January 31, 2020, and a requirement for the UK and the EU to agree a trade deal by December 31, 2020 (or a so-called ‘No Deal’ Brexit will occur, which isn’t the worst thing in the world as WTO rules would automatically kick-in until a trade deal between the two parties is signed) that will set the rules and regulations (and the tone) for all future trade between the UK and the EU.

So, yeah, it’s important. To both sides. Try not to screw it up!


What We’d Like to See in 2020

Here’s a short list of some of the non-Brexit legislation that LetterToBritain.com would like to see passed in 2020 (legislation that would actually be passed into law in 2020) that would make the UK stronger economically, environmentally, and militarily.

  1. Legislation requiring one tree planted in the UK per each new vehicle sold in the UK by 2021. For cars and trucks that get over 50-miles per gallon automakers should fund the planting of 1-tree per new vehicle sold — but cars and trucks that get worse mileage than that should be required to plant 2-trees per new vehicle sold. The thinking is this: One giant sequoia tree can remove and store as much as 1400 metric tons of CO2 — which, astonishingly, is equal to the lifetime CO2 footprint of the average American citizen. Check out that claim here. Sequoia trees are the largest trees on planet Earth but even a mature Douglas fir or Oak tree can capture and hold hundreds of tons of CO2 in their trunks, branches and roots.
  2. Legislation requiring all ships to use clean power while in UK waters by 2021. Ships should be connected to cleaner ‘shore power’ instead of idling their engines while tied-up at port, and legislation requiring all ships over 20-tons displacement to use hydrogen fuel or battery power anytime they’re inside the UK’s 12-mile marine zone, and legislation requiring Royal Navy ships to use biofuels (as is already done in the US Navy) or better, to use natural gas, or even cleaner hydrogen fuel, or sail on 100% battery power like the US Navy’s newest and best destroyer, USS Zumwalt. Shipping represents just over 2% of global CO2 emissions, which could be cut in half by merely substituting biodiesel instead of bunker fuel. (Older ships may not easily transition from bunker or diesel fuel to biodiesel as biofuel tends to degrade low-quality rubber seals and gaskets, therefore, some small amount of subsidy should be offered to shipbuilders and yachtbuilders in the UK to ensure that all new ships are biofuel compatible)
  3. Legislation requiring 50/50 biofuel blended UK civil aviation fuel and UK military aircraft fuel by 2021. Like shipping, civil aviation contributes just over 2% of global CO2 emissions, which could be cut to 1% of global CO2 emissions via the use of biofuels. Today’s jet aircraft can burn biofuel with only minimal upgrades to rubber seals and gaskets. In fact, Boeing reports that because biofuels burn cleaner, engine maintenance costs fall due to less soot build-up and CO2 emissions can fall by up to 80% on civilian aircraft flights. And for the military, clean burning biofuels leave no smoke contrails behind the aircraft which is an important consideration to military aircraft survivability in combat zones! Sourcing biofuel is a little more challenging, because at the moment almost every drop of biofuel produced in the world is sold in Brazil and South Africa where cars burn a 50/50 biofuel blend and consequently, car emissions are 45% lower when compared to conventional petrol. Biofuel burns much cleaner than the best grades of petroleum-based fuels as… wait for it… there’s absolutely no sulphur in biofuel! And as you may know, cobalt removes most of the sulphur from petroleum-based petrol and diesel fuel and so much of it is used in the petroleum refining process that most of the world’s annual cobalt production is used for this purpose. All battery manufacturing on Earth utilizes only a fraction of total cobalt production, yet this fascinating point remains below the radar of the mainstream media.
  4. Legislation requiring all low-income senior citizens’ monthly income to be topped-up to £1200. per month via the reverse-income tax method and they should also receive free medical, free dental and free prescription medications (if their private or government pension plan doesn’t already include these three benefits). Any senior trying to survive on less than that amount plus those three benefits will simply cost the healthcare system, food banks, or their families hundreds or even thousands of pounds annually. How the UK treats its low-income seniors is a national disgrace! Seniors built the great UK we see today and they did it without the internet, smartphones, air conditioning, the social safety net (which still needs improvement) and they did it with lower labour standards. And worse than that. Toss in a couple of world wars, the Cold War, a few recessions, an overburdened NHS a scale of change they lived through unlike anything since the Industrial Revolution and it’s safe to say they’ve earned it. So let’s show our respect to UK seniors by helping them to live out their remaining years a little more comfortably.

Here’s a family doing a great thing for the UK: Prince William launches ‘Earthshot Prize’ to help speed climate solutions


Wishing All of You a Safe, Happy and Prosperous New Year!

No matter which side of Brexit you were on, regardless of which political party you favoured in the 2019 election, and regardless of age, gender, race, religion, or anything that could be construed by Britain’s critics as a way to divide us… there is simply much more that unites us than divides us. May that ever be the case.

Wishing all of you an enjoyable New Years’ celebration and a happy and prosperous 2020!