GP's fight from penalty corner

We chat in the basement office of one of his family’s pharmacies on the corner of Guildhall Walk and Guildhall Square in the heart of Portsmouth city centre.

It opened four years ago after the Laly family was ‘encouraged’ to expand its 30-year-old pharmacy chain in the city to serve the needs of patients issued with prescriptions from the open-all-hours Guildhall Walk Healthcare Centre 100 yards down the road.

He says the family bought the building from the University of Portsmouth, employed 12 new staff members and started opening from 7am until 10pm Monday to Friday and until 9pm and 8pm at weekends.

Then last year, as Raj puts it, ‘the rug was pulled from under us’ when the Portsmouth Clinical Commissioning Group (CCG), which funds the walk-in centre, announced plans to close it and move it across the city to the St Mary’s Treatment Centre.

That was the penalty decision he has been contesting ever since and this week Raj submitted his family’s response to the CCG’s public consultation exercise.

Raj believes the decision is fundamentally wrong. There are those who say ‘well, he would wouldn’t he? He has a vested interest’.

He’s the first to admit it. ‘Of course the pharmacy will lose money if the walk-in centre down the road closes, but that’s not the point. This decision makes no sense in terms of modern healthcare and the way patients are treated.

‘The CCG has never been to our pharmacy to see how busy we are, how many come to us from the healthcare centre and how often we deal with things like emergency contraception and needle exchange.’

He adds: ‘What you’ll end up with if this goes ahead is patients from this corner of the city, who have the only out-of-hours GP surgery in the city centre, traipsing across to the eastern side of the city to St Mary’s, where there is no pharmacy, being issued with a prescription which they then have to bring back here to be dispensed.’

He speaks from the unusual position of being both a GP (he practises in Petersfield) and a pharmacist. He is also Portsmouth born-and-bred and knows the city, its geography and its demography like the back of his stethoscope.

Public consultation, organised by the CCG, ends on February 19. There has been a welter of protest by thousands of signatories on online petitions.

Raj, 31, qualified in 2007 from St Bartholomew’s Hospital, London, and the London School of Medicine and Dentistry.

‘Even when I was a junior doctor on hospital wards I remember thinking, yes, the NHS is amazing and you wouldn’t ever want it to go, but it’s under enormous pressure and we’re only papering over the cracks. It’s got much worse since then.’

Which was why he and his parents, who founded the Lalys pharmacy brand in Portsmouth, decided to take a chance on the Guildhall Walk building to serve the needs of the flourishing open-all-hours, walk-in centre just down the street.

‘Of course it was a business risk, but we’d been encouraged to go for it by the CCG’s predecessor, the primary care trust, and we signed a contract to open 100 hours a week because there was a need for it. Until then we had no intention of opening in the city centre.’

The shop’s catchment area – and that of the health centre – caters for some of the most deprived areas of Portsmouth. In addition, it’s in the heart of studentland, a hotel has just opened on the other side of Guildhall Square and in the summer the area is thronged with tourists.

‘If, as a city, we’re doing our utmost to attract visitors, surely we have a duty to care for them too?’ asks Raj.

Primary care is in transition in Britain, he says. ‘Everyone’s agreed that pharmacists have an important role to play in alleviating the pressure on hospitals and GPS.

‘They are perfectly placed to deal with someone who has a sore throat, a chest infection or earache. There is a new generation of pharmacists who are geared up for this and are more than happy to deal with these cases.

‘You also get prescribing pharmacists now. This is where the future lies, especially as health is becoming more complicated for GPs who are dealing with more and more chronic illnesses where a 10-minute consultation in the surgery is not enough. We need more time to deal with patients and this is one way to go.’

He continues: ‘We all know the healthcare system is cracking at the seams. Hospitals can’t cope and GPs are under increasing pressure, so how removing the city centre walk-in surgery will help beats me. What will happen is that more people will go straight to A&E – the last thing Queen Alexandra Hospital wants.’

Raj, whose parents left east Africa in the 1970s and ’80s respectively but whose grandparents were born in India, went to Portsmouth Grammar School after prep school at Boundary Oak, Fareham.

‘According to my mum I was talking about becoming a doctor at the age of two,’ he laughs. ‘Yes, like most youngsters, I played around with toy stethoscopes when I was a kid, but it wasn’t a fad. I’ve always wanted to do it.’

Perhaps it was a kind of rebellion against his parents? ‘I knew I could always fall back on going into the family pharmacy business, but I wanted to do my own thing.

‘But I’ve always been motivated by business too. I remember going straight to one of our shops after school and doing the paperwork for the business in the back when I was 14 or 15.’

As a director of Lalys, a full-time GP and married with two small children, Dr Raj Laly has little time for pursuits away from family and business life – apart from his passion, hockey.

It’s in the blood. ‘One of my uncles played for Kenya in a World Cup when he was only 16 or 17,’ he says.

Raj adds: ‘I’ve got cousins and nephews who play,’ and then almost as an afterthought he says: ‘And I played for England under-16s and was involved with the under-18s too.’

That was while he was at Portsmouth Grammar School working hard to get to medical school and also working behind the scenes in his family’s pharmacy business.

He played for various London clubs while studying medicine, but he was forced to make a life-changing choice.

‘I was involved with the 2012 Olympics hockey training camp, but I was in medicine and on an A&E rota at a hospital.

‘I needed time off at weekends to attend the camps.

‘When I asked my boss he said the policy was that only current internationals could attend. I wasn’t one, so I’d reached the fork in my road where I had to decide between medicine and hockey.’

But he is now captain of Havant’s first team, one of the south’s most prestigious clubs, and also spends much of his time trying to entice new players to join.

‘I seem to be devoting a lot of time to being a scout these days, bringing in players from Pakistan, India and Poland.

‘But I love the sport and it’s the perfect antidote to my life in medicine,’ he adds.