The Pharmaceutical Journal
Vol 268 No 7181 p54
19 January 2002

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New year, new resolutions from us all

By Barry Simner

The start of a new year is a time for reflection and reinvention; it may also be an appropriate time for the Royal Pharmaceutical Society to make some constructive resolutions regarding Council elections, career satisfaction, education of pharmacy undergraduates and professional representation.

The Society is both our regulatory body and our representative to the outside world. Every pharmacist in Britain is a member (although recent statements have put a question mark over what "membership organisation" means) and therefore has a duty to ensure the Society is both effective and acting in the profession's best interest.

Council elections

Let us therefore look at the basics and see how we can ensure this, starting with the election of members to the Council. From the numbers of members who cast their votes, pharmacists would appear to be as apathetic as the general population at general elections. Why is this, when pharmacy is currently undergoing a period of unprecedented change? Is it because members have become disenchanted with the membership of the Council and their lack of vision over recent years? Or are we all to blame for allowing the sorry situation we are in to develop by not being more proactive with successive Ministers of Health.

The system of election has not kept pace with the changing demands and opportunities offered by modern society. For example, we do not allow candidates actively to canvass and put their views forward in a modern and transparent manner, using all the media opportunities available to them. Do we really know and understand what their policies are and what they will fight to deliver for members during their period in office? Should we therefore be more demanding of elected members and hold them to account, with regular updates on what progress has been made compared against their policy statements?

In terms of the candidates, we need to ask whether it is really benefiting us to allow members to stay on the Council, if re-elected, for an indefinite period. Does this not inevitably stifle innovation and new ideas and lead to the problems we are experiencing due to the lack of vision and direction that has existed for the past 20 years? Why not set a maximum period of five years during a member's lifetime or six years if elected to the position of President?

The Society must modernise: it needs to be more open and accountable if younger people are to be encouraged to stand for election to the Council. More meetings are now being held in the open but it is too little too late. Why not broadcast all meetings on the web to encourage a wider sense of involvement, especially among those unable to travel to London.

In terms of the election process, has the single transferable vote brought any real benefits or has it just resulted in additional complexity and confusion? The current system seems incapable of delivering the innovative, out-of-the box thinking we need or the strong representation that today's professional and economic climate requires.

Career satisfaction

In spite of the significant increase in fees, we are still not required to hold, or are issued with as a matter of course, official photo-identity cards. With so many pharmacists undertaking locum duties, yet failing to attend with a certificate, do we really know whom we are employing? Do we turn away a locum if he arrives without a certificate? Anyone can go to a library and obtain names, addresses and registration numbers of pharmacists. Surely as a profession we need to put in place modern safeguards to protect ourselves as a profession as well as the patient.

We should be asking ourselves why are more and more pharmacists leaving the profession or becoming permanent locums? It cannot just be because of a lack of job satisfaction, because working as a locum with a day here and there cannot be all that satisfying.

Pharmacy is a profession that finds it difficult to embrace change and does not welcome those who attempt to challenge the orthodoxy, as I have found out to my cost.

My views on subjects such as control of entry are generally well known, in that I advocate total deregulation. This would encourage innovation, competition and encourage independents as well as multiples to offer new and innovative added value services, with the focus on quality. Inevitably some will find it a difficult environment to compete in, but the end result will be improved services as well as convenience for the patient. I do not expect the whole of the profession to agree with me, least of all those who already have the benefit of an NHS contract. But I am a pharmacist, it is my chosen profession and I hold these views because I believe it is in the interest of pharmacy. Whether others agree or disagree, we should as professionals be able to debate this issue rationally.

Clinging to the status quo has done the profession no favours: tens of thousands of pounds were wasted over trying to keep resale price maintenance. Now the Office of Fair trading is looking at entry controls. It appears short-sighted that no appropriate research has been carried out to find out what patients, consumers and other parts of the medical profession think. By this I mean quality, unbiased research, not scaremongering, allowing a balanced set of options and possibilities to be considered.

As a profession we are quick to claim we are exploited and undervalued, yet we are slow to respond to changing demands. We seem content to let others decide our fate without offering constructive alternatives. The Society should be leading this, yet over the past year the most hotly debated topics have been the appointment of the editor of The Pharmaceutical Journal and various other internal issues. The debate should not centre around protecting those in possession of an NHS contract. Rather it should centre on what we as pharmacists should be doing within a modern health service, using our existing skills and developing and acquiring new and more appropriate ones for the 21st century.

Undergraduate education

Are our schools of pharmacy equipping graduates for the new Milburn vision of pharmacy? Are they spending this new academic year on training students to deliver the services of tomorrow and not yesteryear?

How many graduates have the skill base to give an injection, take a blood sample, run an anticoagulation clinic, or carry out and interpret an electrocardiogram? Or are they more prepared to count tablets and specialise in label sticking? This may be an exaggeration, but it is intended to make us think about the future as well as the present, to think about what should be, rather than what is.

Professional representation

I am delighted that at long last the Council has decided on joint representation to the Department of Health with the Pharmaceutical Services Negotiating Committee, but I question whether we are being represented in the best possible way by having so many differing pharmaceutical bodies. Let us start the new year by amalgamating the PSNC, the National Pharmaceutical Association and the Company Chemists Association into one productive unit, speaking with a voice that truly represents the profession. Imagine what could have been achieved over the past 15 to 20 years if there had been such a powerful voice to speak for us. In the RPM case, different bodies providing a wide range of expertise and financial resource came together under the banner of the Community Pharmacy Action Group. But their argument was fundamentally flawed and, not surprisingly, the case was lost. However, if a similar body had such combined resources to address such issues as remuneration and payment for services, these matters could be expeditiously resolved.

Conclusion

Until the Society accepts that it needs to embrace change there is a void to be filled. As a profession we need to resolve that this cannot continue. So let us make our new year's resolutions now and agree to make our voices heard and expect a lot more of those whom we elect to represent us.

Barry Simner is pharmacy general manager at Woolworths General Stores