Nurses have questioned whether privacy and confidentiality could be given in a supermarket chemist or pharmacy environment. This is an ill-founded comment because the fact is - it can. A study of supply of EHC from community pharmacies in Lambeth Southwark and Lewisham showed that 90% of women felt comfortable or very comfortable discussing their request with the pharmacist. We recognise that there is room for improvement with privacy as only 77% of women felt that there was enough privacy to talk to the pharmacist comfortably but this should be addressed in a positive way. Women really valued the service, which they found to be very accessible and convenient. We accept that a service offered by a clinic with a closed door facility will provide a higher level of privacy and confidentiality but what is the use of that if the service is difficult to access?

Regarding assessment of women requesting the service, the NHS supply of EHC from community pharmacies is highly structured. A recent audit of EHC services in GP surgeries, A and E departments, family planning clinics and pharmacies showed that pharmacies supplying under PGDs had the highest standard of record keeping.

Regarding the supply of EHC over the counter, practice guidelines in pharmacists' code of ethics, require them to assess the request for EHC and to give appropriate advice about regular contraception, disease prevention and sources of help. Studies have shown that purchasing EHC over the counter is not the preferred option for teenagers because of the cost of the product. The majority of women who purchase EHC from pharmacies are over 20. We refute on, clinical grounds, the RCN's proposal that, when pharmacists supply EHC over the counter they should take a full medical history including a family history of heart disease and blood clots. This was required for the earlier EHC product (PC4) which contained oestrogen. It is not clinically necessary for the product that is available for sale - Levonelle. Indeed, this was one of the safety factors that enabled the Medicines Control Agency to allow the product to be made available for sale from pharmacies.

The real issue is not what nurses think about the supply of EHC from pharmacies but what the public thinks. Currently women have a choice. They can use a highly structured, but easily accessible, service from a community pharmacy (if that is offered locally by the NHS); they can choose a clinic or doctors' surgery if they wish to have a consultation behind closed doors, or they can choose a more informal, but equally ethical way, by purchasing the product from their local pharmacy.