If pharmacists are not following the government's best practice guidance on preventing medicine shortages, the Department of Health needs to know about them "double quick," and will "bear down on them" without delay, Health Minister Earl Howe told an industry meeting yesterday.

The Minister was speaking about progress made in dealing with medicines shortages since the best practice guidance was issued in February by the Department's supply chain working group, following on from the 2010 Ministerial summit held to discuss ways to tackle the continuing rise in shortages.

While there are still delays in supplies of around 50 medicines, "substantial progress" had been made since the summit, and the Pharmaceutical Services Negotiating Committee (PSNC) website now lists all products in short supply, "so no-one trading in these products can say they were unaware of the shortages," said Earl Howe, speaking yesterday at the annual conference of the British Association of Pharmaceutical Wholesalers (BAPW) in London.

The Minister acknowledged that there had been calls for regulatory moves to establish a public service obligation as a way of dealing with the problem. However, he said that while this is one way forward, the government feels it would not be necessary if all parts of the pharmaceutical supply chain adopted the best practice guidance document.

Ministers do not believe that increasing the regulatory burden on business in this way would prove to be a panacea unless there was actual patient harm and firm proof that this is the best way to progress, he said, adding that the Department is "closely monitoring" individual supply problems.

But the Minister was challenged on this by a conference delegate representing a major pharmaceutical manufacturer, who asked him how adherence to the guidance can be monitored, particularly its requirement for 24-hour delivery under normal circumstances, and told him that her company is aware of some pharmacists who are buying significant drugs included on the PSNC list of products in short supply and exporting them, perfectly legally, because they hold wholesale dealers' licences. "The guidance document can't stop this happening," she said.

Earl Howe responded by urging the company delegate, and any others at the BAPW meeting who had such information, to feed it into the Department as quickly as possible. If pharmacists are not following the guidance this way "we need to know about them double quick and we have the means to bear down on them without delay,” he said.

Other delegates pressed the Minister on the need for a public service obligation, pointing out that this is being implemented throughout Europe so why not in the UK. He responded that the government is certainly not ruling out such a move but is reluctant to restrict a free-market economy and believes that the best way to solve the problem is through "persuasion, guidance, information and inspections" rather than regulation.

Martin Sawer, executive director of the BAPW, said the Association welcomed the guidance but is concerned that "something tragic will happen" as a result of patients not being able to access their medicines. We need to know what they are experiencing, he said, and called for a national patient organisation to be added to the membership of the Department's supply chain working group.

Earl Howe agreed to speak to Department officials about Mr Sawer's proposal and again emphasised that he hoped it would be possible to find a way through the problem without regulation. However, he added that, if this was not the case, "we won't hesitate to act appropriately."