The question of whether the Royal Pharmaceutical Society should regulate pharmacy technicians was one of several dilemmas facing pharmacy at the moment, the Society's Secretary and Registrar, Miss ANN LEWIS, told the conference.
Miss Lewis said that she had come to the conference with an open mind on the subject, which the Council had not yet debated. However, in her view it was unlikely that there would not in the future be a requirement for some form of regulation and the Society needed to start thinking about whether it wanted to be in control of it or not.
Miss Lewis went on to say that the question of regulation of pharmacy support staff was a far reaching one, involving education and training, standards of practice, discipline and regulation itself. She felt that while one could easily agree on the training aspect and the need for standard operating procedures it was the issue of regulation that proved controversial.
Among the questions that needed to be answered to resolve the dilemma were what exactly was meant by "regulation" - was it that, or was it registration, accreditation of qualifications or simply a list of people with certain qualifications.
Another important question was who should regulate. There was no question that the Society had the power to extend its regulatory role to pharmacy support staff, if it chose to. "Under its charter the Society provides for the interest of its members. It could be argued that members include their support staff, or it could be argued, controversially, that it does not", Ms Lewis said.
More importantly, the new Health Act 1999 made two special provisions which, in her opinion, did change things in terms of the Government's and the public's expectations. One provision enabled professional bodies to modify their regulatory mechanisms by Order in Council without a need for primary legislation (Part III, Section 60). Another provision allowed them to extend their regulatory powers to activities carried out by a member's support staff (Schedule 3.11 [2] [b]). "Power [to regulate] is not really the question. . . it is certainly controversial and people are worried what hat we are going to wear", she said.
Miss Lewis conceded that there could be a conflict of interest if the Society was to regulate both pharmacists and pharmacy technicians, but said that there could be an even greater conflict of interest if staff working under a pharmacist's control and supervision were to be regulated elsewhere. The Society of Apothecaries had been named as one alternative, as had the nurses' body, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, and its successor.
It was, however, this point of conflict of interest that her fellow speaker on the subject, the National Pharmaceutical Association's director, Mr JOHN D'ARCY, felt strongly about. "This is a big issue and a real concern for the NPA", he told participants, explaining that the big question was about supervision and accountability. In his opinion, the pharmacist being responsible for everything that went on in the dispensary was a crucial point, since there was very little else left otherwise.
Mr D'Arcy admitted to a certain degree of protectionism but insisted that fuelling the question of supervision could be disastrous. He could envisage a scenario where technicians might ask for a relaxation of supervision while the pharmacists quite naturally wanted to hold on to what they had. Which way would the Society fall?
Mr D'Arcy also pointed out that finding a precedent or comparison was very difficult since the General Medical Council and other bodies, while having a similar regulatory function, did not promote the profession they represented in the same way that the Society did.
Mr D'Arcy added that he could understand the argument, so far as it went, that it might be better to have pharmacy technicians in rather than out, but he felt it was arrogant if the only reason to want them "in our camp" was to control them. Could technicians be happy under those circumstances, he asked. "They are happy because they want to come under any umbrella. . . . The fact of the matter is that technicians are struggling to get themselves registered, otherwise one would assume they would have done it long ago."
Miss LEWIS accepted that the task would not be an easy one, but she repeated her view that the conflict was not as big as it might be. She felt that pharmacy technicians were too small in number to pose a serious threat to pharmacists.
" I think we do have a choice - do we want to have the power to define what the content of the role and the training, the career linkages are likely to be and will be in the future for the whole of pharmacy and its support staff or do we want to be a supervisory spectator who does not want to get involved with their staff because they might be a threat", Miss Lewis asked. She added that the supervisory model might not prove to be the right one in the end.
The audience seemed to agree with her, with contributions from the floor largely in favour of the Society registering and regulating pharmacy technicians. There was also a feeling that the two should go together. As one participant put it, "How can you authorise someone without ensuring that they maintain standards?"