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A need to take a fresh look at the profession's systems for preventing, detecting and remedying poor performance was identified at the February meeting of the Royal Pharmaceutical Society's Council.
Discussing a draft response to a Government consultation document entitled "Supporting doctors, protecting patients", which raised issues in relation to the tackling of poor performance in the medical profession, the Council noted that the document had implications for all other health professions, and the Society would need to ensure that its own systems were consistent with the proposals in the document.
The document said that the two methods for the prevention and early detection of poor performance were revalidation and clinical governance. It saw appraisal as an essential part of revalidation and proposed giving health authorities, primary care groups and primary care trusts the capacity to support appraisal of general medical practitioners. Part of the appraisal process would look at a doctor's participation in local clinical governance activities. In relation to poor performance, the document also examined locum practice and the supervision of doctors in training posts.
The document proposed a three-step process for handling doctors with problems of poor performance (other than those who clearly needed to be dealt with under disciplinary procedures). The first step would be referral to a new body called an assessment and support centre, of which there would be a number spread around Britain. The second step would be the provision of impartial support to the doctor and the local employer or health authority by advising on the action required. Possible actions would include monitoring of practice, a period of retraining, referral to the General Medical Council and referral for medical treatment. The third step would be for the employer or health authority to take responsibility for implementing the centre's findings.
Among other things, the document also set out a list of principles of professional self-regulation in the health field, covering matter such as the maintenance of standards of practice and education, the maintenance of professional competence and conduct, the transparency of procedures, freedom from bias or discrimination, regulatory activities, disputes procedures, objectivity in judging performance, the protection of the patient, the retention of high public confidence, and partnership working with the National Health Service and other health care organisations.
The SECRETARY AND REGISTRAR said that many of the issues raised in the document would affect pharmacy and it could be used as a checklist for the work that the Society was already doing both in clinical governance and by the Health Act working party.
Mr DARLING said that the Secretary of State for Health (Mr Alan Milburn) had, when Minister of Health, written to all health care professions saying that he wanted to see the evidence of the professionals keeping up to date. Furthermore, the news media were looking at the behaviour and the failures of the health care professions.
With that backcloth, the Society's response would be a fundamental document. It would be looked at by Ministers and by the Department of Health when they were drawing up their philosophy and their policies for the next election. He was convinced that the regulation of health care professionals would feature in the manifestoes of all three major political parties.
Mr Darling emphasised that the Society's response needed to take into account the current climate, making Ministers and civil servants aware of the work the Society was undertaking in the proposed revised Code of Ethics, where there was emphasis on competence and on revalidation, and also the work of the Health Act working party. The document needed to set out the facts of what the Society was doing.
Dr HAWKSWORTH said that her concern was with regard to clinical governance. Perhaps the Society should be looking at the relationship of pharmacists with GPs in the changing climate and how they worked together so that the response made some input that was constructive and was not seen to be damning what was going on. That relationship should be highlighted.
The VICE-PRESIDENT said that the huge level of public concern in the wake of the murders by Dr Harold Shipman highlighted the issues underlined in the consultation document. Those events would have a profound effect. In the light of that, the response should demonstrate that the profession took extremely seriously the issues and potential issues which faced it in playing its part in managing the health of the public. The response had to be positive, direct, forceful and concise on the part that the Society and its members would play in the future.
The SECRETARY AND REGISTRAR said that, since "Supporting doctors, protecting patients" was primarily about doctors, the response should concentrate on that issue but be amplified by an attached paper in the light of comments made by Mr Darling and others.
Mrs REMINGTON supported Dr Hawksworth's remarks. There would be useful material in the paper that was being produced on clinical governance in the hospital sector. Its perspective was very much about clinical governance on medicines management and not on hospital pharmacy practice. It described well a whole raft of clinical governance issues and practices in the hospital sector.
Mr PATEL said that the Council should be looking at the question of whether the Society should be accrediting postgraduate education courses. The document said that regulatory bodies involved in education had to produce clearly stated standards for professional education and training by which the providers of education and training could be monitored and held to account.
Dr EVANS hoped that it would be made clear that pharmacy took the matter very seriously and that there was also a great deal of work for the Council and the profession to do to ensure that they could deliver continuing competence just as the other professions were required to do.
The Council agreed that its provisional timetable for implementing the proposed new code of ethics should be amended to allow time to deal properly with all the issues raised during the consultation process on the document produced by the ethics working party (PJ Supplement, September 18, 1999). That meant that it would not be possible to submit the proposed new code in full for the approval of the Society's annual general meeting in May.
It was hoped that at the Council's April meeting it would be possible for the working party to present a final text of parts 1 and 2 of the code, which set out general principles and philosophy. The Council might then adopt those parts and decide whether it was appropriate to present them to the AGM for approval. But the working party would continue to look at part 3, which set out service specifications, taking into account changes in practice and legislation, with the aim of taking a composite document to the 2001 AGM.
Mr DARLING (chairman of the working party) said that he had given an assurance during the British Pharmaceutical Conference in September, 1999, that the comments received would be taken seriously. But it would not be possible to do so properly within the planned timetable. While he was saddened that he could not achieve the timetable, it would be wrong for the working party to bring to the Council a document with which it was not totally satisfied. Nor would it be right for the Council to go to the AGM with a document that was, in the light of the current situation, substandard.
It was for that overall reason that delay was being proposed. The working party felt strongly that the philosophy and principles incorporated in parts 1 and 2 of the code should receive support and assent from the Council as quickly as possible in the light of the small number of comments made within the consultation period. But so far as part 3 was concerned, there was a great deal of work to be done to ensure that they got it right and that they were in tune with the regulations and principles of the Government.
Presenting an outline of work undertaken to support the aims of the Society's policy on sexual health, the Society's director of public affairs (Ms Beverley Parkin) said that since July, 1999, when a discussion paper had been published, a programme of stakeholder contact had been undertaken to promote the Society's position. There was now wide acceptance that pharmacists had a role to play in helping reduce the numbers of unwanted pregnancies by supplying emergency hormonal contraception.
An ongoing pilot scheme in Manchester used a protocol to allow pharmacists to supply the PC4 product within a health action zone. This had been well received and other pilots were to follow. Now, the licensing as a prescription-only medicine of a new progestogen-only product presented the real possibility of a pharmacy product for emergency hormonal contraception at some future time.
Work was in hand across the Society's directorates and committees to identify and address the support that the profession would need should such a product come on to the market. When an emergency product had been introduced in France, the profession had expressed concern that its support needs had not been effectively addressed. The Society would plan now to ensure that appropriate support would be available.
The Council approved a new mechanism for the election of the Society's President, Vice-President and Treasurer. It was agreed that any member of Council should be able to put themselves forward for election to any of the three posts, doing away with the need for a nominator and seconder.
For the Presidency, the closing date for nominations would be the Friday 11 days before the June Council meeting. For the other Officer posts, nominations would close after the election of the President had been announced.
All candidates for the Presidency would be required to produce a 1,000-word address to demonstrate how they measured up to the job specification and to set out their policies. The statements would be distributed to Council members along with data about candidates' previous performance as Council members, and would be put in the public domain after the election.
It was also agreed that job specifications should be formulated for each of the Officers' roles and made public to the membership.
The Council's decision followed consideration of a series of options in a paper produced by a working group after the Council's previous meeting, at which the Council had also decided that the election of the President should be held entirely in open business, with the voting recorded.
The Council made a number of decisions in principle that were designed to improve the procedure for the selection of chairmen and members of Council committees and working parties.
The Council agreed that the decision on which committees a Council member should sit on would be made by a selection panel consisting of the Officers, together with a Privy Council nominee member of Council as an external assessor. Committee chairmen would be selected by the same panel - as would deputy chairmen, new posts. Job and person specifications would be drawn up for each committee chairmanship.
It was agreed that the criteria for a good selection process should be that it should achieve the best outcomes for the Society, be transparent, demonstrate equity and fairness, be objective in assessing individual Council member' potential contributions, provide the requisite skills and experience for the committee to discharge its function, provide training and development roles for Council members, and meet the wishes of individual Council members as far as possible.
To assist the selection process, Council members would be able to draw up lists showing which committees they would like to sit on, in order of preference. These lists would be published on a Council notice board, along with such information as details of current working parties and their membership. In special circumstances, the panel would be able to make appointments to committees outside Council members' expressed preferences.
The Council also agreed in principle several other proposals, including appeals processes and training and development plans for Council members. As part of that plan, a Council member would be allowed to sit in on specified committees as a silent observer and criteria would be developed so members could evaluate their progress.
It was agreed that special consideration should be given during the selection process to issues arising from the lack of continuity between the Council election in May and the appointment of the new committees and committee chairmen in June. It was also agreed that further consideration should be given to clarifying the issue of length of tenure on a committee.
On working parties, the Council agreed in principal that membership of any working party should be open to all Council members with expertise to offer. When a committee decided to form a working party, details regarding remit, number of places, nominees and date of final report would be published openly to invite applications from other Council members, provided that this process caused no inappropriate delay.
The Council agreed that at its April meeting it should consider a paper setting out options for a Society policy on the promotion and sale of goods via the internet.
The Council's decision followed the presentation of an outline paper on the impact of e-commerce on pharmacy, prepared for the policy support unit with assistance from Mr Andrew Tucker (head of policy development, health affairs, GJW Government Relations Ltd).
Introducing the paper, Ms EILEEN NEILSON (head of the PSU) said that pharmacy needed to be well informed about the likely effects of e-commerce in pharmaceuticals so that it could plan strategies to meet the challenges ahead, form strategic alliances with other interested bodies and position itself appropriately. Within the next two to three years most of the United Kingdom population was likely to have internet access and its use would expand into a wide range of goods and services, including pharmaceuticals. Pharmacy needed to explore how it could participate in that development in ways that preserved the professionalism and public esteem of pharmacy and protected the public.
Mr TUCKER suggested that the internet and e-commerce raised five main issues for pharmacy. The first was the supply of pharmacy medicines. The Society had a specific role to do with how its members actually worked in day-to-day practice. Specific guidance had been brought out in the Society's new standards for the provision of on-line pharmacy services (PJ, January 1, p9).
The second issue was the supply of prescription medicines. The important question was how pharmacists could relate to their customers when they had no face-to-face contact.
The third issue was the supply of general sale list medicines and toiletries. That would probably be the major economic driver of whether internet pharmacy worked. Would people log on to buy vast quantities of slightly reduced price toiletries and GSL products?
The fourth issue was the quality of information given electronically. Politicians and other stakeholders paid a lot of lip service to quality of information. That was one of the key factors in whether people got the right medicines or the wrong ones.
The fifth issue was the method of delivering the product to the customer. At the moment, internet pharmacy was a glorified mail order service. If it were to go beyond that area, it would have to establish special delivery networks.
A Bill going through Parliament, the E-commerce Bill, which touched on internet pharmacy, was expected to be on the statute book in April. The key point was that it was about voluntary rather than legislative regulation. The Society would have a key role. The European Parliament was also debating draft e-commerce legislation that it was keen to have on the statute book by the end of the year.
United Kingdom pharmacists would have to face the challenge of working with the new technologies and other professional groups in order to provide a better service, making sure that they harnessed the available opportunities while all the time making sure that the regulatory approach and professional standards remained intact.
Ms NEILSON, summing up the presentation, said she would like to return in April with fully worked up options for the Council to consider. She invited members to join a "virtual" monitoring and analysis group, which would communicate electronically and by telephone. She said that she would contact all members of Council setting out the areas that the PSU would be taking forward.
The Council approved a proposal from the Industrial Pharmacists Group Committee to extend the group's membership criteria.
Membership of the group is currently open to any pharmacist who is engaged in industrial practice, who acts as a consultant to industry or whose work is concerned substantially with questions of industrial pharmaceutical practice. The membership criteria would be extended to include pharmacists whose work concerned, or who had an interest in, industrial, regulatory or technical matters affecting pharmacists.
The Council accepted a proposal from the Agricultural and Veterinary Pharmacists Group Committee that the group's name should change to the Veterinary Pharmacists Group.
The group committee asked for the change as part of a drive to encourage more community pharmacists to become involved in the sale of companion animal veterinary medicines. The committee felt that adopting the change would remove an implied preference for large animal activity. The new name was expected to help the group in developing partnerships with companion animal medicine manufacturers without prejudicing its relationship with large animal practitioners.
The Council agreed that a meeting should be arranged between the Industrial Pharmacists Group Committee and the Preregistration Advisory Group to consider the way in which preregistration experience in the pharmaceutical industry could fit into the new preregistration performance standards agreed by the Council in December, 1999. At that meeting, the Council had postponed its decision on the maximum length of preregistration training possible in the industry while it considered the views of the Industrial Pharmacists Group.
The Council approved a proposal from the Preregistration Advisory Group for a flexible approach to shared preregistration training to meet the new performance standards (PJ, October 16, 1999, p632).
The Council was reminded that in October and December, 1999, it had provisionally decided to require trainees normally to undertake a period of six weeks out of their 52 weeks' preregistration training in a second sector of practice, in order to develop knowledge and skills to meet the new preregistration performance standards. In coming to its decision, the Council expressed its wish to be kept informed of implementation issues as they arose.
The Preregistration Advisory Group, whose members represented training providers, had informed the Society that the training decision had not been well received by the large training providers, in particular the community multiples, which had communicated their unease. Their arguments had been that a stipulated time period was philosophically unsound within an outcome-based training programme, that a six-week period would be logistically difficult to arrange, that there was insufficient time to set up and evaluate programmes containing secondary periods ahead of the recruitment round for 2001-02, and that the expected nature of the secondary period was unclear.
The group felt that a new approach was needed in order to make positive progress and had proposed a compromise. The proposal was that training providers should be trusted to arrange suitable secondary placements for the first year of the new performance standards, with a requirement for a set period being introduced in the following year if necessary. Providers would be told that a time period would be prescribed if there was evidence in the first year that joint experience was not being provided. Training providers would have the flexibility to arrange placements to suit their trainees but would forfeit this to a prescribed time period if the flexible approach was found to result in training programmes with inadequate joint experience.
The Council noted that the Preregistration Advisory Group was drawing up guidelines for the secondary periods, to include indicative content and an indicative time period. These guidelines would be available from the late spring for training providers to use in the development of their new training programmes.
The Council agreed to refer back for further consideration and advice a document setting out draft new arrangements for the reimbursement of expenses and the payment of attendance fees for Council members. The decision to refer back arose from disquiet among Council members about the lack of any facility for the reimbursement of locum expenses incurred by proprietor pharmacists who served on the Council.
Introducing the document, the TREASURER said that as far back as July, 1998, it had been agreed that the present system of remuneration was unsatisfactory in many ways. A resolution had been passed to increase the ceiling for the attendance fee allowed under the Byelaws from £50 to a maximum of £200 in order to introduce for the first time a payment for members' time in the preparation for and attendance at meetings. The Byelaw change had been made in autumn, 1999. At the same time there had been a paragraph introduced which said that members of Council would also be entitled to be reimbursed for expenditure on travel incurred on business of the Society and for costs of accommodation and subsistence up to limits to be determined by resolution of the Council and reported to the annual general meeting each year.
The document proposed that members of the Council should be entitled to be reimbursed for expenditure incurred. There was a ceiling of £136 per night for bed and breakfast and evening meal which might be charged for overnight accommodation, but Council members would only be reimbursed for expenses actually incurred.
An attendance fee of £160 per day would cover attendance at all meetings by Council members. It was taxable and had to be declared to the Inland Revenue. There was nothing in the document with regard to reimbursement for loss of earnings or covering remuneration of any locum expenditure. It was estimated that the changes as set out would increase costs by in the region of £60,000 a year.
The Treasurer added that the proposals should be seen as a package and that if the Council wanted to change anything, the document would probably have to go back for reassessment.
It was also reported to the Council that the level of expenses and fees would also be available to members of the Statutory Committee, the Adjudicating Committee, the Panel of Fellows and the Joint Formulary Committee of the British National Formulary.
Mr DAJANI said that the document was discriminatory. It disadvantaged Council members who had to pay for locums while on Council business. Not only was the system unfair, but it would further discourage potential candidates running for Council because they would not be able to afford locums.
Mr CURPHEY asked: (1) whether the £136 could be split; (2) whether his dinner would be paid for after meetings at Lambeth, since when he left the building he did not expect to reach home until 10pm; (3) whether the package had been checked with the Joint Formulary Committee, which had consistently run on the higher British Medical Association level of expenses; and (4) what the £160 was for?
The TREASURER replied: (1) that it was possible to split the £136; (2) that there was no provision in the document for paying for Mr Curphey's dinner on the way home; (3) that the information he had about the Joint Formulary Committee was not as given by Mr Curphey; and (4) that the £160 was an attendance allowance, which covered preparation for meetings as well as attendance.
Mrs BANKS thought it would be helpful if she made two points of principle. They were general to the public sector. One was that one only claimed expenses actually and necessarily incurred. The other was that one could not be paid twice for one's time. A locum allowance would be to allow somebody else to do a job and to free time to do something else. An attendance allowance would be a direct payment for the time. It was not possible to have both.
Mr CURPHEY said that he did not accept what Mrs Banks had said.
The VICE-PRESIDENT said that the Council had to work within the Byelaws, and the Byelaw in effect rehearsed what Mrs Banks had said, although expressing it in different words.
The TREASURER said that the Byelaw said that members would be entitled to be reimbursed for expenditure on travel incurred on the business of the Society and for costs for accommodation and subsistence up to the limits to be determined by the resolution of Council and reported to the annual general meeting each year. That dealt with accommodation, subsistence costs and travel. A new paragraph had been put in the Byelaws to ensure that only these expenses should be claimed.
Mrs BANKS said that it was absolutely clear from its size and from comparisons with other organisations that the attendance allowance was for the time spent preparing for the meeting and for attending the meeting. If a locum did a pharmacist's job, that freed the pharmacist's time. The general principle was that a person could not be paid twice for his time: once for somebody else to do the job that the person would normally be doing, and all over again to do the job that the person was actually doing.
Mr ALLEN said that he did not accept that argument. He suggested that the Council had to make an allowance for pharmacy proprietors who had by law to employ a locum. Loss of earnings was a strong issue for many Council members. In general, they accepted that there was a loss of earnings issue when they attended meetings. A fee of £160 for preparation and attendance at meetings was, in the view of some, derisory. He himself would not comment, being ambivalent regarding the figure. He felt that one inequitable system was being replaced by another. The whole thing should be reworked.
The SECRETARY AND REGISTRAR said that the figure for the attendance allowance was comparable to that paid by the Department of Health for Section 4 committees which had currently a tremendous amount of work. It was not out of line with other bodies.
Dr EVANS confirmed that the payment was in line with what happened elsewhere. Locum fees so far as he knew were not payable. The tax point was relevant. If he received £160 for attendance and preparation, he was taxed on £160. If someone was paid £160 but paid £140 of that to a locum, he would be charged only on the balance between £140 and £160. That was where the tax point came in.
The TREASURER said that the tax issue was important. The previous system talked about allowances - something that was not looked upon favourably today. That was why they had the wording in the paper.
Mr CURPHEY said that if, as the Treasurer had said, the £160 was for attendance and preparation, then it was not, whatever anyone else said, for paying a locum fee. He did not accept that he had to pay a locum fee out of that and then the balance would be for attendance and preparation. The locum payment was not just an intellectual exercise. It was about the government of the profession. Some had a statutory requirement to pay a locum expense, as had been recognised by the Council years ago when a contribution towards locum expenses had been put into the expenses framework. They were now removing that at a time when the profession believed that its governing body had lost complete touch with the problems of its contractors. Five members of Council were being told that their problems of locum expenses were of no interest, but the others were all going to take £160. That was a strange signal to send.
Mr Curphey said that his business suffered every time he was not there. That was a fact of life of the small independent pharmacy.
Mr Curphey said that he did not accept the paper. However, he did not want those who had just been given the £160 that they had long deserved to have to wait because the document was sent back. They needed some sort of compromise arrangement which dealt with the implementation of that which was fair and right for those people who had been suffering for years but which also looked at the position of independent proprietor pharmacists, because it was their profession and they were the people who should be sitting round the table.
Mr Curphey said he could not sit at the table in an unfair and inequitable situation for much longer. The reason he had asked about his dinner and getting home at 10pm was because in future he would not attend in the afternoons if he was not going to be paid for his dinner at night.
The SECRETARY AND REGISTRAR said that there had been a number of discussion with the Department, and she understood that loss of earnings was excluded.
Mrs HOARE said that the document specified that no fees were payable for attendance at the British Pharmaceutical Conference. She wanted to explore the possibility of paying an attendance fee for those who did a tremendous amount of work, not least in chairing meetings, and who did a lot of preparation time. There were also those who, in their official Council member capacity, were appointed to deal with specific items of work at the conference.
Turning to a reference to fees for attending regional committees and regional meetings, Mrs Hoare said that some of the regions had more than one Council member who lived locally and who attended. Did that mean that more than one Council member could claim £160 for an evening meeting? Was there a sliding scale? Perhaps there might be a regional committee which was attended but the member was not an official representative. In those circumstances could there be a claim of something other than the £160?
The PRESIDENT felt sure that the Treasurer would wish to take those matters back.
Mrs STONE said that the paper was an overdue move towards a transparent and proper method of reimbursing Council members and from that point of view none would wish to delay it. She supported some form of reimbursement for proprietors who had to employ a locum directly in order to satisfy their statutory obligation. She also wanted the bed and breakfast reimbursement separated from the evening meal reimbursement. She hoped that matters could be dealt with as quickly as possible so that they could all behave in a far more proper way than their system currently allowed them to do.
Dr HAWKSWORTH felt that the situation was surreal. The Council was talking about legitimate expenses, and so far as she was concerned her locum expenditure was a legitimate expense. She agreed with Mrs Hoare and Mr Curphey. As a community pharmacist she felt she was undervalued by the Government and now she felt that the Council were undervaluing her contribution and the contribution of others.
Reference had been made to the Conference. To attend for four days Dr Hawksworth would pay locum fees of well over £600. The lack of attendance of independent proprietors to the Council was because the Council did not pay for locums. The Society would be poorer for that in the future. A most terrible message was being sent out from the Society.
Mrs REMINGTON said that she would welcome the redrafting of the paper, which was unclear and ambiguous. She agreed with Mrs Stone's suggestion for dividing the accommodation and dinner reimbursement. The situation with the attendance fee was ambiguous and messy.
Mr NATHAN hoped that the discussion, when reported, would not come across as mercenary and self-interested. It should be clear to readers that, even with an enhanced reimbursement, whatever the fee, many Council members would still be out of pocket.
On the other hand, Council members did not attend in order to make a profit out of the Council. Most were prepared to make some financial sacrifice in order to serve the profession. Some unquantifiable losses were made by people who owned businesses. Several Council members in the past had actually had to resign in order to rescue their businesses from disaster. Matters such as those should be taken into account in the report of the Council's discussion.
The PRESIDENT added that consideration should be given to the length of time members served on Council. A business became very damaged over a period of time.
Mr KOZIOL said that the Government had used a phrase called social exclusion and he felt that members needed to consider something called Council exclusion. The point had been made that Council members were prepared to accept a loss of earnings. But most of the profession could not afford to accept such a loss. A situation where only those at the fringes of enthusiasm could stand for Council would not serve the long-term interest of the profession.
Mr Koziol said that he had heard of other organisations where elected representatives were paid a fixed sum per annum and expenses which totally eclipsed what Council members were being paid. Fundamental changes were needed. In the medium term the Council should give consideration to some kind of contract that its members would sign. He realised that there would be tax implications. There could be a contract linked to a fee payment. The Council needed to be more imaginative. The sums of money that they were talking about were absolutely derisory.
The TREASURER replied that he took on board the point about legitimate expenses of a business. The figure of £160 was based on the fact that it equated to a great extent to payments made to members of S4 committees, for Department of Health meetings and to non-executive members of trusts.
Professor MACKIE agreed that people should not be paid twice for something. At the same time she agreed that they should encourage people to come on Council but that should not be at personal cost. Perhaps the attendance fee could be split and properly defined, a preparation fee and an attendance fee, and perhaps members could claim either an attendance fee or a locum fee. Legitimate expenses were not loss of earnings. They were something completely different.
Mr DARLING suggested that the document had not been thought through as well as it could have been. He had total sympathy with a proprietor pharmacist who, in order to come to Council, would find himself out of pocket because the locum allowance did not cover the costs of the required legal cover. He accepted totally that in the current financial and taxation environment the present system could not continue. But equally it was wrong for the proprietor pharmacist to be put at a disadvantage in serving on the Council. That in effect was what the document had done.
The VICE-PRESIDENT said as someone who was involved in the discussions in producing the paper he wanted to highlight the principles. The criteria considered had been whether it was in accordance with the policy agreed by Council in June, 1998, whether it was transparent, simple to understand and easy to comprehend, whether it met the Inland Revenue requirements, and whether it was equitable? Having considered all those issues, the Council was in agreement that expenses for overnight stay, bed, breakfast and evening meal should be reimbursed and that there should be a daily allowance. The nub of the issue was the payment of a locum allowance. But the conclusion he had drawn was that it was not allowable to make such payment and also to make payments for a member's time.
The PRESIDENT said it was clear that the paper had to go back.
The Council agreed.
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Those present at the meeting, which was held on February 2 and 3 at 1 Lambeth High Street, London SE1, were the President (Mrs Christine Glover), the Vice-President (Mr Marshall Davies), the Treasurer (Dr Gordon Appelbe), Mr David Allen, Mrs Terri Banks, Mr Andrew Burr, Mr Peter Curphey, Mr Sultan Dajani, Mr William Darling, Professor William Dawson, Mr Digby Emson, Dr John Evans, Dr Gillian Hawksworth, Mrs Patricia Hoare, Mr Mark Koziol, Professor Clare Mackie, Mr Alan Nathan, Mr Hemant Patel, Mrs Helen Remington, Mrs Linda Stone and the Secretary and Registrar (Miss Ann Lewis). Also present was the chairman of the Welsh Executive (Mr Colin Ranshaw). Apologies for absence were received from Mr Hassan Argomandkhah, Professor Michael Schofield, Mr Ted Smith and Miss Joanne West. Present by invitation were Mr John Bourke (president, Pharmaceutical Society of Ireland), Mr Matthew Lynch (assistant registrar, PSI), Mrs Margaret Hemingway (chairman of the Society's North Staffordshire branch), Mr David Ellerby (former secretary of the Society's Moray and Banff branch) and Mr Alan Tobias (secretary of the Society's Yorkshire region). Among the guests of the Council at dinner on February 1 were Professor Sir Charles George (chairman, Joint Formulary Committee) and Professor Hugh Edmondson (chairman, Dental Formulary Subcommittee); Dr Katherine Orton (president, section of general practice, Royal Society of Medicine); Professor Brian Edwards and Mr Mike Hall (chairman and registrar, respectively, Council for Professions Supplementary to Medicine); Ms Donna Covey (director, Association of Community Health Councils for England and Wales); Professor Michael Richards (national cancer director, St Thomas's hospital, London); Lord Newton of Braintree (vice-chairman, All-Party Pharmacy Group, and parliamentary adviser to the Society); Mr David Heath, MP (treasurer, All-Party Pharmacy Group); Dr Jenny Tonge, MP (vice-chairman, All-Party Pharmacy Group) and Dr Keith Tonge (hospital consultant); Sir Graham Hart and Sir Gordon Hourston (chairman and member, respectively, Pharmacy Practice Research Trust); Mr Ray Jobling (chairman, Community Pharmacy Research Consortium); Commander Andrew Hayman (head, drugs directorate, Metropolitan Police, and director, complaints investigation bureau); Mr Jeremy Clitherow, Dr Emily Finch, Dr Jane Pettifer, Mrs Kay Roberts and Dr Patricia Shorrock (members of the Society's working party on pharmaceutical services for drug misusers); Dr John Smart (head, school of pharmacy and biomedical sciences, University of Portsmouth); Dr David Temple (director, Welsh Centre for Postgraduate Pharmacy Education); Mrs Veronica Wray (head of public affairs, National Pharmaceutical Association); and Dr James Le Fanu (medical columnist, Daily Telegraph); along with Mr Bourke, Mr Lynch, Mr Ranshaw, Mrs Hemingway, Mr Ellerby and Mr Tobias. |