PJ Online | News: Society seeks clarity on NHS Bill

The Pharmaceutical Journal Vol 267 No 7175 p733-738
24 November 2001

Society seeks clarity on NHS Bill

A broad welcome has been given by the Royal Pharmaceutical Society to the National Health Service and Health Care Professions Bill published last week (PJ, 17 November, p701). However, it has called for much greater clarity on how some of the Bill's main provisions will work in practice. Other professions have also raised concerns about the Bill and the Council for the Regulation of Health Care Professions (CRHP) which it would establish (see below).

Independence of the CRHP

Eight other regulatory bodies have signed a joint statement voicing concern about the independence of the Council for the Regulation of Health Care Professions.

They say: "We believe that the principle of independence from Government is seriously undermined by the proposal in Clause 25(2) that a new council, which is a non-ministerial Government department, would be able to direct regulators to change their statutory rules on important matters, even where the regulator believed that doing so was against the public interest.

"This concern is even greater because it is also proposed that the new council will have an inbuilt majority of ministerial appointees. We believe that only Parliament should be able to direct regulators on fundamental matters."

The statement has been signed by the presidents or chairmen of the shadow Nursing and Midwifery Council, the shadow Health Professions Council, the General Osteopathic Council, the General Medical Council, the General Chiropractic Council, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, the General Optical Council and the General Dental Council.

In a briefing note sent to all Members of Parliament ahead of the Bill's second reading on 20 November, the Society notes that much of the Bill is intended to be implemented by means of subsequent Regulations. This allows for detailed discussion in time, the Society says, but means that it is difficult to see at this stage how far the Bill's powers will extend.

Some of the areas of concern surround the new overarching Council for the Regulation of Health Care Professions. These include its accountability to and independence from Government; the appointment of members of the CRHP and how this affects appointments to individual professional bodies; the power of the CRHP to delegate in areas relating to education, training and professional development; potentially sweeping powers of direction by the CRHP; the funding of the CRHP; and the mechanisms for complaints about regulatory bodies.

The Society also has concerns about powers for inspection of community pharmacies to be given to the Commission for Health Improvement and to new patients' forums, which are to replace community health councils. The new Bill extends the definition of the quality of NHS services to include the environment from which they are provided. Since pharmacies are already inspected by the Society, they should not be subject to multiple inspections that might affect the quality of service to patients, impinge on patient confidentiality or undermine the security of medicines stored on premises, the Society says.

In an opening speech during the Bill's second reading in the House of Commons on 20 November, the Secretary of State for Health (Alan Milburn) said: "The Bill marks a decisive shift in the centre of gravity of the National Health Service. It moves towards regulation that is in the hands of independent regulators rather than Ministers or the health service."

During the debate, Sandra Gidley (Lib Dem, Romsey), a pharmacist, highlighted the lack of pharmaceutical input to primary care trusts. "There is no direct requirement for that, which is short-sighted because problems with ineffective prescribing will not readily be tackled."

Dr Howard Stoate (Lab, Dartford) said that more efficient use needed to be made of pharmacists "who have enormous expertise and knowledge and could be used far more effectively than in the past".

The Bill was given a second reading and now moves to its committee stage.

The Pharmaceutical Services Negotiating Committee says that it will be studying the Bill carefully. It has issued guidance to local pharmaceutical committees on extending their terms of office and restructuring themselves in line with the new boundaries of primary care trusts and strategic health authorities in England.

In Wales, the Bill introduces a duty for each new local health board, and the equivalent local authority, to formulate health and wellbeing strategies for their areas.