The Pharmaceutical Journal
Vol 269 No 7218 p497-498
5 October 2002

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Young pharmacists group

Old guard and young turks voice serious concerns about modernisation

The immediate past Secretary and Registrar of the Royal Pharmaceutical Society, JOHN FERGUSON, outlined to the meeting his serious concerns about the direction of the modernisation process. He said: "Ever since its formation the Royal Pharmaceutical Society has been continuously modernising to meet the challenges of the day. Looking one by one at the 13 roles proposed by the Kennedy report, the Society meets all but one of those roles. The remaining role, revalidation, was already being planned as an additional role prior to the Kennedy report."

Mr Ferguson considered a series of statements issued by members of the Modernisation Steering Group (MSG) and expressed a concern that they had misinformed the broader membership. For example, if the Royal Pharmaceutical Society cannot represent individual sectors, as claimed by the MSG, then how does one explain the special interest groups or the resources placed into defending resale price maintenance, and how had the Society in the past been able successfully to put the concerns of hospital pharmacists to the Government?

Dual role

At this year's annual general meeting the membership was told that the Society's dual role of representational and regulatory body would continue. However, since then, the proposals put forward by the MSG show that the representational role will inevitably be diminished because the Society is being forced by the Government to increase lay membership of its Council. It should be remembered that the lay representatives would be appointees of the Government.

Ultimately, members have elected members of Council to uphold the Charter of the Society, but the proposals by the MSG would change the very raison d'ętre of the Society.

Mr Ferguson told the meeting: "When I retired as Secretary and Registrar, I promised everyone that I would not be standing for Council or involving myself in pharmacy politics. However, there was one scenario which, if it emerged, would bring me back and that was the notion that the Society were to be weakened by any attempts to split the Society's dual role of representation and regulation. I believe that the Society must think again about its current proposals."

Following on, DAVID THOMSON, chairman of the Society's Scottish Executive, explained how there were a huge number of issues coming out of the woodwork with the changes that devolution have brought to Scotland. He was concerned that certain aspects of the modernisation debate were not being fully considered by the MSG. It is important that these concerns are aired before decisions are made, or they will fester and the profession will suffer from these decisions for years to come, he said.

Develop representation

BOB GARTSIDE, from the Society's Welsh Executive, explained that it was important for the representative role to be developed further. He explained how the Welsh Executive had been able, despite limited resources, to act as a representative driving force for the profession in Wales. He said: "Pharmacy as a whole suffers from a lack of resources being applied to representing the profession. Additionally, there has been a large increase in the amount of paperwork produced by civil servants to which pharmacy bodies have to respond. By being able to represent and act in the interests of members, the Welsh Executive is able to act in the interests of pharmacy."

ALASTAIR BUXTON, immediate past-chairman, Young Pharmacists' Group, explained why the YPG was so concerned about the way the Society was handling the modernisation agenda. He said: "It is clear that the process that the MSG undertook appeared very much to have a predetermined conclusion. The consultation process featured leading questions and a dismissal of alternative suggestions which bordered on arrogance. Above all there was the constant 'spinning' of this story in the pharmaceutical press by the MSG."

Although the YPG has had prior concerns about the ability of the Society to represent the profession, it is surely better to have some representation than a much diluted down version, which was what the MSG's proposal — if left unaltered — would represent. The MSG proposals, which are predominantly regulatory, mean that despite any assurances to the contrary there is a strong possibility of the prospect of reduced membership activities such as the loss of the branches and many other membership style activities, said Mr Buxton.

Following the publication (PDF 50K)of the YPG model (PJ, 29 June, p906), a lot of groups and individuals in pharmacy indicated their support as a better alternative to the MSG's proposal. This led to the joining of three major forces in pharmacy — the National Pharmaceutical Association, the Pharmaceutical Services Negotiating Committee and the YPG — to develop a set of modernisation principles (PJ, 10 August, p181).

An open debate followed the presentations. DAVID SHARPE was asked about the visit to Lambeth by nine of the 11 past-presidents who signed the letter supporting the YPG model (PJ, 6 July, p15). Despite the impression given by an article and smiling photograph appearing in The Journal (31 August, p299), the nine past presidents who were able to attend made it extremely clear that they all continued to disapprove strongly of the path that the Society was being steered down and that they would return to the issues if they were not resolved, said Mr Sharpe.

It was asked why the past presidents had been invited to Lambeth to discuss their opinions on modernisation, yet no other body had been similarly invited despite the clear and opposing stance of bodies such as the YPG, the NPA and the PSNC.

CHRISTINE GRAY, the Society's modernisation project manager, responded that there is a standing offer from the MSG and that any group could request a speaker from Lambeth to explain the position on modernisation.

Mr SHARPE explained that there was a large difference between having someone come from the MSG to talk at you about modernisation and someone from the MSG listening to why there was a difference of opinion on it.

YPG model shot down

Douglas Simpson, former editor of The Pharmaceutical Journal, said that the consultation process has been flawed by misinformation on such matters as the extent of regulation within the Society's activities (it is, in fact, a minority activity), the use of unreferenced assertions, and misrepresentation of the views of those who want the Society to take a different route to that favoured by the modernisation group.

For instance, the Society, in an article in Pharmacy Business (August), claimed that the YPG's proposal to set up a board within the Society to handle the regulatory agenda assumed that regulation only encompasses "conduct and discipline". The model, Mr Simpson said, does no such thing. The model takes full account of the Kennedy list.

The article was a symptom of a feature running through the so-called consultation process. Every time the YPG model was mentioned, the Society wasted no time in trying to shoot it down. The YPG plan does in fact have a good pedigree. A forerunner of it was put forward by the Society itself as proposals for changes in regulatory machinery under the Health Act 1999. No satisfactory explanation has been given for the Society dropping it.

Mr Simpson went on to say that the Secretary and Registrar recently claimed that there are those who oppose public intervention in pharmacy's institutions. That is not true. The opposition is to the loading of the Council with lay people, which would wreck the Society as a professional association of pharmacists. That is not the same as opposing lay participation per se. What the opponents of the "modernisers" are seeking is lay participation within a regulatory model that would leave the balance on the Council much as it is today.

Mr Simpson said that the Royal Pharmaceutical Society was set up as a professional association. The regulatory functions were added later. The regulatory cuckoo must not be allowed to push the representative and association functions out of the Society's nest.

A force force for patients

ANDREW BURR, member of the Society's Council, said that he does not personally support the YPG model. He stood for Council in order to act as a force for patients. The Society has lost substantial ground in the past decade because it, unlike other health profession regulators, has failed to grasp key issues in modern health care. Pharmacists should stand back and consider the implications of the Kennedy report, he said.

NICHOLAS WOOD, a past president of the Society, challenged Mr Burr to state one area of the Society's work that was not in the public's interest.

Mr BURR believed there were certain aspects of the resale price maintenance campaign that he would have handled differently.

Responding to Mr Burr, SUSAN SHARPE, chief executive of the PSNC, stated: "The PSNC is totally committed to the principles of the Kennedy report. What is important to understand is that while the YPG, PSNC and NPA refuse to accept the MSG's plan, the alternative proposal put forward by the three groups must not be misinterpreted as a position which does not support the Kennedy proposals because the joint proposals meet the Kennedy objectives."

Unacceptable statement

Collette McCready, from the NPA, said that she supported completely the sentiments expressed by Mrs Sharpe. She said: "The repeated statement made by the Society that certain things are what the Government wants and the Society has no choice is absolutely unacceptable. The Society should at least try to mould the modernisation proposals in a way that is acceptable to the membership. The principles in the joint statement by the YPG, the NPA and the PSNC have received a large amount of support from the Society's membership."

The issue of the overall legality of the Society's actions was discussed and concern was expressed that the Society would not follow the procedure specified in its Charter and would instead attempt to use Section 60 order legislation to attempt to make fundamental changes to the professional body. It was believed that only regulatory affairs of the Society could be covered by the Health Act (Section 60) whereas representative and professional activities are covered only by the Royal Charter. To make changes to issues covered by the Royal Charter would require a 75 per cent majority in a council vote and a 75 per cent majority of members at a special general meeting. The number of pharmacists on the Council is covered by the Royal Charter. Therefore, to change this, an SGM would be required.

MARK KOZIOL, a former Council member, said that he was struck by the absence of imaginative thought in the MSG's proposals. He said: "The Society's accounts show that the Society earns approximately £6.5m from registration fees. However, a significant amount of income came from non-regulatory sources. For example, profits from publications alone last year were in the region of £3.5m. Imagine if a structure could be found which not only preserved a meaningful representational role within the Society, but also ringfenced the non-regulatory income and devoted it to representative issues. Just think of the huge benefits that could accrue. The Society's proposals demonstrated a poverty of thinking and there appeared to be no fight for a solution which would be more beneficial to the members."

Past president of the Society and current Council member HEMANT PATEL told the meeting that he believes that a number of members of the Council would have preferred to have simply turned the Society into a regulatory only body, but they feared that there would be a riot in the profession if they had gone directly for this endpoint. He, therefore, believes that some Council members may be using the agreed joint role of regulatory and subjugated representative body as a staging post for later conversion into a regulatory only body. He also said that even as a member of the MSG himself, he was not always kept up to date with exactly what was going on.

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