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The Pharmaceutical Journal
Vol 269 No 7209 p175-176
3 August 2002


Pharmacists' views on the Council structure of the future

This article, including reponse to questions (PDF 140K)
Response to questions in the first half of the survey (PDF 25K)

"What will the Council look like in the future?" was the title of a survey distributed with The Journal on 29 June. This week we analyse the first half of the survey; the analysis of the second half will be published at the beginning of September

Regular readers of the Letters pages of The Journal might expect that few pharmacists would accept that modernising the Council of the Royal Pharmaceutical Society would mean that more lay members will join it. However, results from the survey distributed with The Journal of 29 June tell a different story.

In total 1,760 completed surveys were returned. In answer to the question: "The Council should change its composition to fulfil the requirements for a modern regulator", 25 per cent strongly agreed, 52.5 per cent agreed and 21.5 per cent either disagreed or strongly disagreed. In other words, over 75 per cent of the profession believe that changes to the composition of the Council must be made.

Further analysis revealed that those pharmacists in agreement encompassed both those who believed that changing the composition of the Council means that the pharmacy element should increase to 100 per cent, as well as those who accept that there should be a larger lay input to the Council. A breakdown of those agreeing that the composition should change revealed that 931 respondents (53 per cent) accepted that more lay members will join the Council and 443 (25 per cent) did not (Figure 1).

Figure 1: Respondents' views on whether the Council composition should change to fulfil requirements for a modern regulatory body

A close look at the proportion of lay members that respondents would find acceptable is also revealing (Figure 2). A total of 136 pharmacists (8 per cent) accept the pharmacy element could be 54 per cent or less, and a further 616 (35 per cent) accept the pharmacy element could be no more than 60 per cent. As the pharmacy element increases 158 (9 per cent) would accept a pharmacy element of 70 or 75 per cent; and 267 (15 per cent) would like to see a pharmacy element of between 80 and 95 per cent (roughly reflecting the way the Council is constituted at the moment).

A total of 493 respondents would like the Council to be only made up of pharmacists (28 per cent) — broadly reflecting the proposal put forward by the Young Pharmacists Group. Typical responses in favour of the YPG proposal were: "Regulatory machinery should be set up within the Society — it should have a separate board with almost half lay membership." And: "I strongly believe the Society should maintain its 'membership' role and should administer on behalf of the Government a reformed regulatory body, as indeed it does at the moment." Another respondent said: "Devolve regulatory function to a new committee as described by the Young Pharmacists Group." Yet another said: "I agree with the Young Pharmacists Group's proposal, ie, changing the structure of the Society rather than the Council." Another said: "One organisation cannot be expected to act in the members' best interests and to police those members unless a specific subdivision of responsibilities is made." And from one retired respondent: "Allow the Young Pharmacists Group to run the Society; it is their future."

This group of pharmacists also tended to be more disillusioned with the Society and Council in general: "The Council of the Society should not be concerned with commercial matters. The present arrangements mean that the Society's focus is on retail pharmacy issues to far too great an extent. Pharmacy is a broad-based profession and the aim should be to broaden its base and gain strength intellectually through diversity." And another pharmacist said: "Nothing I can write here, any of the answers I've given, no letters I could write, no opinions I give any way at all will make one jot of difference to what the Society does." "If Government requires a regulatory body let them set it up at a minimal cost to the membership. I am quite happy with external regulation if it is necessary but the [Modernisation Steering Group] seems to have made up its mind already. If we go down the route they have decided, then the Society is of no practical use to the membership."

What about the views of pharmacists who either accept the status quo or accept greater lay input? At the moment, there are three lay members on the Council giving a pharmacy element of 87.5 per cent. Doubling that to six lay members would reduce the pharmacy element to 75 per cent. Looking at Figure 2, the Society's Modernisation Steering Group should be able to take some comfort from the fact that a total of 53 per cent of respondents would accept at least a doubling of the lay input on the Council.

Figure 2: Respondents’ views on what should be the proportion of pharmacist members on the Council

In addition, 43 per cent of pharmacists would accept the proportions of professional and lay members seen in other regulatory bodies (60 per cent professional representation or less). A typical response in favour of 60 per cent of pharmacists is: "The system should allow for the best people to come through, but also have professionals to help with the running of Council." Another said: "It should be emphasised that it is essential to retain the unique regulatory/professional role of the Council in order to present the levels of transparency, accountability and governance standards that are seen to be in the public interest." A different view was: "The Council needs to radically change its vision to become more proactive, and have Council members who reflect and understand the 'new NHS' and can help pharmacists from all sections to deliver on that agenda." Another respondent said: "The future of the profession depends on the credibility and hence on the quality of the Council. Neither Council nor the Society will have credibility unless lay representation approaches 50 per cent and pharmacist members are clearly and consistently seen to act in the public interest — anything less will be seen as a fudge."

On a slightly different tack, a further respondent said: "If the Council continues to be predominantly made up of pharmacist businessmen/women, the profession will continue to be sees as a profession run by shopkeepers, rather than as a true health care profession."

Over 1,000 respondents (1,077; 61 per cent) accept that the Council should have between 20 and 30 members (as at the moment). However, 536 pharmacists (30.5 per cent) would like to see a much smaller Council at work (under 20) although far fewer (71; 4.0 per cent) wanted to see the Council increase to over 30 members.

In response to the statement: "The Council's constitution should allow for the inclusion of pharmacy technicians within its non-pharmacists membership", respondents were in favour. Nearly 1,000 respondents (972; 56 per cent) strongly agreed or agreed with the statement and 770 (44 per cent) disagreed or strongly disagreed.

An overwhelming majority of respondents would welcome the chief pharmaceutical officers of the Department of Health, the Scottish Executive and the National Assembly for Wales at Council meetings: 335 (19 per cent) would wish them to be there as observers; 1,007 (57 per cent) would be happy for them to debate, provided they did not vote; 216 (12.5 per cent) would accept them as full voting members; and only 176 (10 per cent) did not want them to be there at all (Figure 3).

Figure 3: Respondents’ views on whether the chief pharmacists for England, Scotland and Wales should have a role on the Council

A more radical proposal came from one respondent: "We should be looking to an EU [European Union] Pharmaceutical Council — then perhaps pharmacists would enjoy the status their colleagues in Europe seem to have."

The vast majority of respondents worked in the community (55 per cent); 15.5 per cent came from the hospital sector and 6 per cent worked in primary care, with 3 per cent from academia, 6 per cent in industry and a further 16 per cent specifying "Other".


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