How refreshing and apposite to see the article "Split and merge" by Anthony Cox and Howard Fox (PJ, August 19, p263). How encouraging to see how it generally mirrored a view expressed by me over the 35 years since I joined the staff of the Pharmaceutical Society's in 1965. To be alone in the wilderness is never a comfortable experience, but the light has dawned for two younger pharmacists. I noted the expected reply from John Ferguson (PJ, August 26, p293), who has long known of my views.
I agree with John Ferguson that the Royal Pharmaceutical Society is unique in having three major roles and that it is this combination that gives the Society its strength. I agree that this should not lightly be cast aside because of concerns relating to other regulatory bodies and the way that they discharge their responsibilities. However, I do not agree that the Government will wait until the public loses its confidence in the pharmacy profession before it intervenes to exert greater control or greater public input.
I accept that our codes and standards have teeth only because the Society is a statutory body with an enforcement role. Many would argue that it is an anachronism for a professional body to have such a role. Indeed, if the Society were to split, it would be this statutory/enforcement role which would go, together with the control of accreditation of pharmacy degrees. John Ferguson implies that our consultative role, which I agree is an important element in establishing the public status of the Society (particularly with the Government), would diminish. As a statutory body, the Society has to be consulted, but I have seen no decline in the consultation that the Government has with other health professions, eg, the British Medical Association, the Royal College of Nursing, the British Veterinary Association, none of which is a statutory body.
As was stated by Cox and Fox, the desire by a profession to be self-regulating is perceived by the public to be one of self-interest. One of the Society's chartered objectives is to "maintain the honour and safeguard the interests of the members in the exercise of the profession of pharmacy" - arguably, a self-interest motive. However, many members allege that the Society does nothing to further the interests of its members, particularly in the area of remuneration.
The role of the Society's staff and its Council is to pursue this objective against the background that it has a statutory, quasi-judicial role to act in the interest of the public. In my election statement to the membership in 1991, I said: "It is a question of balance, a balance which has shifted too far in favour of the membership and needs redress before the Government questions the Society's future statutory and self-regulatory role." That balance is getting more and more difficult to sustain. Most European and Commonwealth countries have a pharmacy board or a combined health professions board - which is their statutory body for registration, discipline and degree accreditation - and a separate professional body, as do most of the health professions in the United Kingdom.
Let me now turn to the role of the Council. Whereas it makes the final decision to proceed with a prosecution, it is the staff who decide whether there is a prima facie case to be put to the courts. Looking at the Society's history, it is interesting to note that, whereas all its codes of conduct have been finally agreed by the Council and the membership at various annual general meetings, the initiatives have generally emanated from the membership (the original code in 1937) or the staff (1979 and 1984). It is also of note, historically, that the Society's original charter of 1843 had as one of its objectives "the protection of those carrying on the business [my italics] of chemists and druggists". That took 110 years to change!
Let us learn from our history, see how far we have come, but always be looking forward. Be a traditionalist by all means, not a dinosaur. But why not be a reformer?
If the profession was given a plain sheet of paper today, how would it constitute itself? How best could it be done? Could it be done better? It is not a question of whether it should be done, but of how. It is recognised that one of the considerations would be how to fund the Society after it had lost its captive audience - through the loss of its statutory registration role - and had become a voluntary body.
Should the status quo be maintained, with the Society existing alongside such bodies as the Guild of Healthcare Pharmacists, the Pharmaceutical Services Negotiating Committee, and the National Pharmaceutical Association - numerous bodies "representing" pharmacy yet being fragmented by others on the "divide and rule" principle? Or should there be one powerful pharmaceutical body fighting the profession of pharmacy's corner, rather like the BMA does for medicine and the RCN does for nursing? Who appears on television to comment on medical or nursing matters? The BMA and the RCN. Both of these are strong professional bodies that forcefully represent their professions unencumbered by the restraints of a regulatory and enforcement role. It would be a rapprochement if all the major pharmaceutical organisations sat down together and debated this subject.
May I exhort pharmacists to attend the British Pharmaceutical Conference in Birmingham on Wednesday, September 13, and take part in the debate "Putting our house in order - professional performance and self-regulation", and then, after lunch, to join the open meeting of the Pharmacy Law and Ethics Association and debate the topic of "Closing ranks or protecting the public"?
Pharmacists who have not yet completed the consultation document on the Society's constitution should do it now. It is important.
I congratulate Anthony Cox, Howard Fox and John Ferguson for bringing this topic to the fore for debate at such an important time in pharmacy's history. Everyone should join in the debate. It is their profession's future that is at stake.