Can the Royal Pharmaceutical Society and The Pharmaceutical Journal make it a millennium resolution to adopt a new concept, and choose a new way to discuss the "manpower" issue? Can pharmacy move into a New Age and still use old language? Or will it continue to be the last bastion of unreconstructed thought?
Most UK institutions, especially those that interact with the public, took the decision in the 1980s to change their image to reflect a modern society. Thus anti-sexist and anti-racist awareness became a common feature in their journals, papers, spoken presentations at conferences and so on. This was because sexist or racist language, in addition to being offensive to many people, is often ambiguous and consequently misleading. It therefore came as a shock to hear the leaders of the profession continue to use the outdated term of "manpower" at the recent British Pharmaceutical Conference in Cardiff and to see its repetition in the PJ, the official journal of the Society. This is not just a personal opinion. All Government departments use the term "workforce" when discussing labour market issues.
We recognise that for many years the Society has adopted a universalist concept of equality, ie, that everyone is treated equally (in pharmacy, by pharmacy). Thus, when the Nuffield report recommended that "the majority of teaching staff in the schools of pharmacy should be registered pharmacists and more encouragement should be given to women to consider an academic career", the Council of the time responded: The "Council takes issue with the wording. It believes that encouragement towards an academic career should be applied equally to men and women pharmacists. There should be no positive discrimination in favour of either sex. However, employers who recruit women pharmacists should have regard to their special problems in relation to career development." To hold this view in 1986 was forgivable. It appears that the same view is still held today and that is not acceptable.
The argument against the use of the old fashioned word and concept of manpower is not just an irritating feminist, politically correct or possibly social scientist argument, where the use of "man" to describe people is proscribed. We believe that it raises two major concerns. The first is that insistence on using an outdated concept reflects a backward looking image of the profession and sets the profession outside the mainstream. How can anyone expect the Government or other professions to take such a body seriously? The second is that as a profession we should be using modern language or terminology in order to ensure precision and accuracy. During the last half of the 20th century, social thought has moved the agenda of the inequalities debate in the labour market away from old social class differences. The post-war boom in employment revealed significant structural differences in the vertical and horizontal patterns of employment between male and female, and between white and ethnic minority workers. Thus manpower as a concept to describe the profile of the UK workforce is redundant. Within pharmacy this is underlined by the majority female intake to the profession.
There is another more fundamental aspect to this debate and that is the relevance of the "manpower" debate as it is currently articulated. After consulting the dictionaries that we happen to have, therefore not a scientific review, we can begin to see the limitations of the modern use of the concept in the way in which the Society wants to use it. The 1959 edition of the Chambers dictionary defines manpower as "resources available in able bodied men" while in the 1969 Penguin dictionary it is similarly a quantitative descriptor of the number of people available for work. The Concise Oxford dictionary (9th ed, electronic form) provides a broader, non-quantitative definition of workforce as the "workers engaged or available in an industry" while retaining the quantitive definition of manpower. This reflects the definition in the Fontana dictionary of modern thought, which allows us to include qualitative characteristics - so we can begin to draw up a profile of the nature of the people involved. These broader definitions of workforce map on to its current general usage.
To be fair to the speakers at the BPC and the reported write-up in the PJ, their debate was about manpower. The approach to the "manpower problem" was a quantitative one and the problem was seen in terms of two distinct elements, recruitment and retention. The norm was presented as a man who used to be willing to work over 45 hours a week in one shop for 40 years - a norm against which women who are not willing to do that were measured. There also appears to be little consideration of the huge change in the nature of employment within pharmacy. We now have a situation where a majority of pharmacists are employees. This changes perceptions, values and attitudes to work. What we really need in the debate is to think about the employee perspective in terms of the working environment and working conditions.
The use of the concept of workforce, or even human resources, allows consideration of these related issues. Looked at objectively (one of us is an outside observer of the profession), the working conditions of many community pharmacists do not look particularly attractive. When asked about their work, pharmacists often describe dispensing factories, production line task work to meet the demands placed on them by the speed and numbers. That is piecework prescription dispensing, product focused, broken by attending to all the other tasks which have to be fitted around dispensing, such as patients who need advice. It can be even worse in some health centre pharmacies where there are no OTC products to sell and patients have just spoken to the doctor. Equally the working environment for many pharmacists is not attractive. In the dispensary there is rarely anywhere to sit comfortably to take a break, unless the shop closes for lunch, nowhere to go to escape, to relax for half an hour. Every inch in a pharmacy or dispensary is given over to products and storage —often even stairs and the WC have boxes.
Pharmacy in a New Age claims to promote healthy lifestyles. But a healthy lifestyle is not just about smoking, alcohol, exercise and healthy diet. This is to limit attention to a medical model of health. It is also about achieving a balance in life between work and family and leisure. Today's young people want the best of all worlds. Unlike the pharmacists of the alleged "golden age" they are very unlikely to be prepared to devote 40 years to the commitment of a 45-hour-plus pharmacy management job. Both men and women want a family life, a professional working life and to maintain independent pursuits. A topical modern term for today's labour market is flexibility. Women and men want to work part-time, to be locums and work as and when they want, to work for different employers, to move in and out of the market, as their lifestyle needs change. The profession needs to widen its thinking if it is seriously to confront these workforce issues. We believe that the Pharmaceutical Services Negotiating Committee is wrong: money is not the main motivator for employee pharmacists; lifestyle is.
This debate has been running in pharmacy for many years. It tends to be an introverted and limited discussion. Yet there are similar workforce issues in medicine, nursing, teaching and other professional groups. If the Council is serious about debating the workforce crisis it could do no better than to weigh up the work environment and conditions it offers graduates. A key question is who represents the interests of the employee pharmacist? Certainly the PSNC and the National Pharmaceutical Association does not. Where does the Society stand? Is it not time to begin a real debate with the employee pharmacists as to where the pharmacy workforce wants to go in the future?
The authors are from the pharmacy practice group at Aston university, Birmingham