How the UK's biggest pharmacy chain went from family-run public service to debt-laden hedge-fund disaster

Boots the Chemist started out as a family-run business whose Methodist founders believed in civic duty and public service, spreading across the country and providing front-line medical services to Britons, making 40% of their revenues from government compensation for NHS service.

In 2007, Boots was acquired by the giant hedge fund Kohlberg Kravis Roberts, who loaded up the company with debt, made massive cuts to staff, remade the stores as retailers first and health providers second, and used a system of punishing quotas to get pharmacists and other staff to extract maximum revenue from the public coffers by providing useless services.

The cuts to staffing often left pharmacists without a second set of eyes to review their prescription filling, putting patients at risk; while at the same time the reduced staffing left the pharmacists with less time to consult with patients and make sure they were getting the correct care. Pharmacists were required to conduct a 400 medication reviews with patients (the maximum the NHS would compensate), even when the patients had dementia or weren't interested, and the bill was sent to the public.

The company relocated its headquarters to an empty, small box in Switzerland, ducking £1B in taxes. The hedge fund that owns it tripled the value of its investment. The pharmacists working for the company rate their job satisfaction as significantly lower than their colleagues working for other chains or independents.

That fear comes wrapped in the corporate language of empowerment. Targets are "non-negotiable", and staff who beat them get graded as "legendary". A chemist advising a customer – "You know, like I've done my entire career," as one Boots lifer puts it – is now having a "Great Conversation". If the satisfied customer then compliments the chemist that is now a "Feel Good Moment" (although in performance plans they are unfortunately referred to as FGMs – so a chemist must notch up, say, five FGMs a week).

This is pure Apprentice-speak, an attempt to turn pharmacists into estate agents, career pedants with a duty of care into hustlers in labcoats. Tony played the game at first, but struggled to cope as the staff numbers in his section halved. When he complained, the manager classed him a "non-performer" and asked if he would move stores. His pay was frozen and he was subjected to regular performance reviews. (A spokesman from Boots stated: "the health and wellbeing of all our colleagues is, and always has been, a priority for the business.")

"There are a huge number of very good pharmacists at Boots," said Bill Scott, the former chief pharmaceutical officer for Scotland. "But if my bonus is dependent on the business targets I've been set, you are taking away from me my ability to practice my profession for the patient. And that's got to be wrong." And, he remarked, the sheer size of Boots meant that where it went, the other pharmacy chains and independents would follow.

How Boots went rogue
[Aditya Chakrabortty/The Guardian]

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(Image: Oxford Street Boots store Christmas decorations 2011, Editor5807, CC-BY)