The Pharmaceutical Journal
Vol 269 No 7211 p231
17 August 2002

Society summary

Modernisation programme:
Much common ground on Society's future

The joint statement refers to the "proposed structure for the Society's governing body". No proposal has yet been produced. What is clear is that the Society will need an identifiable governing body that can be held accountable for the entire range of its functions. That body will be the new Council of the Society. It will have to meet the Government's requirements for modern regulators, including increased lay membership.

Summary of the PSNC, NPA and YPG view The PSNC, NPA and YPG fail to see how the proposed Council structure will achieve an appropriate balance between the Society's regulatory and professional roles. They want the Society's professional representational roles to be accommodated in a reformed structure, distinct from and with equal prominence to the functions of a modern regulator. They want the Council structure to give the Society enough independence to allow it to oppose Government policies affecting non-regulatory issues. The PSNC, NPA and YPG want lay Council members barred from involvement in policy on professional issues. They say that, to maintain adequate representation of the broad spectrum of interests across the profession, the number of pharmacists on the Council should be similar to the current number. They say that the Society must be accountable to its members for promoting the profession and developing professional roles and opportunities. It must also be accountable to pharmacists, Government and the public for regulating the profession. Because the Society has a duty to safeguard and promote the interests of its members, it must consult its members fully and openly on alternative proposals that ensure that the professional and regulatory functions are properly balanced.

The Council cannot abdicate its responsibilities by delegating them. To do so would mean that it would be believed to be, and presented to be, accountable for aspects of the Society's functions over which it would have no direct control. This would be the worst of all worlds.

The only alternative to increased lay membership is for the Society to give up its role as the regulatory body for pharmacy. The likely consequence of going down that route would be that pharmacy would be added to the 12 professions already regulated by the Health Professions Council (formerly the Council for Professions Supplementary to Medicine). Pharmacy would then have only one seat on the council of its regulatory body and a one in 26 chance of that pharmacist being elected as president of the council. In addition, pharmacy in Britain would have no seat on the new overarching Council for the Regulation of Health Care Professionals (CRHP). In contrast, the Pharmaceutical Society of Northern Ireland, by retaining its regulatory role, would continue to have a pharmacist majority on its council and a place on the CRHP.

The way to retain a pharmacist majority on the regulatory body for pharmacy is to modernise the Society. No one is suggesting that pharmacists should not be in the majority on the new Council. We need professional self-regulation to have some meaning, both in terms of a professional majority on the Council and of the balance between Government controls and those developed within the profession. It is important for the profession to retain ownership of the regulatory process. It must be seen collectively to create and defend its standards of practice. Without this, commitment and responsibility could disappear and vocations could become jobs.

In the past, the Society's regulatory functions have been identified largely with registration, the Code of Ethics and discipline. The new, much broader scope of modern regulation encompasses much of what were previously considered "professional" functions. Together with essential underpinning activities such as research and communications and supporting functions such as finance, information technology and facilities management, it represents the large majority of the Society's activities. The regulatory functions cannot realistically be separated from the Society's "royal college" functions, which make up its professional role. Both include supporting and fostering good practice by, for example, providing information and advice. The developing knowledge base in science and practice is needed to inform both regulatory activities, such as ethical issues in genetics, and professional functions, such as developing the profession. The Society's duty to "safeguard and promote the interests of the members in their exercise of the profession of pharmacy" is fulfilled through its professional and its regulatory functions.

Functions such as publications and benevolence, although not falling neatly into either the regulatory or the "royal college" category, do not conflict with either. The Council's decision that the Society should retain its integrated regulatory and professional roles gives us the flexibility to be able to carry out this broader range of functions.

Another activity that does not fall neatly within a "regulatory" or "professional" category is the Society's representational work. The statement says that the Society must be able to oppose Government policies affecting non-regulatory issues. We would go further. The Society must retain the ability, where necessary, to make representations against Government policy on any issue within its remit, including regulatory issues. The Society is currently working with other regulators to oppose proposals on the free movement of health professionals within Europe which it believes would not be in the interest of the public or the profession. Having more lay members of Council should not impede this work: it would be much more likely to strengthen it and give it greater credibility.

The Council serves both public and profession and it is important that its arrangements for accountability reflect this. The public is represented by Parliament, to which the Council will be accountable for the exercise of its regulatory functions. Accountability to pharmacists is expressed primarily through the election of pharmacists to the Council.

We recognise the importance of developing robust, transparent mechanisms to ensure that professional advice and expertise is fed into the new Council and its committees, to inform their decisions. This is essential, as it could never be possible for these structures to include all the specialisms within pharmacy. We will also need to look for better ways to engage the profession and others in the Society's work in the future.

There is much we can agree on:

• that the Society should retain its regulatory and professional roles

• that there should be an overall pharmacist majority on the Council

• that we will need robust, transparent mechanisms to feed advice and expertise into the Council

• that the Society must be, and be seen to be, independent of the Government

• that the Society should be able to continue or even increase its existing representational function.

The consensus in the profession outweighs the areas where views differ. We need to build on this consensus to create a Society equipped to meet its responsibilities to both public and profession well into the future.