The Pharmaceutical Journal
Vol 269 No 7219 p545-548
12 October 2002

October Council meeting

Use of STV in Council elections to end

The Council of the Royal Pharmaceutical Society has agreed to discontinue the use of the single transferable vote system in Council elections from next year, against the advice of its modernisation steering group. It agreed that elections to the reformed Council shall be by the "first past the post" system (meaning the system under which voters have one vote for each vacant place). All pharmacist members of the Council would be chosen by election.

The Council also agreed that the reformed Council should not have reserved places for specific fields of practice or for experts in pharmaceutical education or science, although there would be reserved places for representatives from England, Scotland and Wales.

In the absence of reserved places for specific fields of practice or areas of expertise, the Council agreed that the modernisation programme should recognise "the need for robust, flexible, efficient, effective and transparent mechanisms to ensure that specialist advice and expertise is fed into the Council, and that the Council is kept aware of the circumstances and concerns within sectors of the profession".

The Council made those decisions after considering a paper produced by the modernisation steering group following consultation on getting the balance right on the future Council.

Introducing the paper, the PRESIDENT stated that the items and recommendations in it had been part of the consultation process. The information had been supplied to pharmacists and other organisations (PJ, 22 June, p883) and they had responded (PJ, 14 September, p375). The matter had been discussed by the Council at a policy development day on 30 July. No particular consensus had been arrived on that date at because there had been differences of views and therefore there would be debate on some if not all the points. There were seven recommendations in all, which the Council could accept, reject or refer back.

LINDA STONE said that the document was based on informal Council discussions that had been held before the discussions that had resulted in the decisions minuted and it seemed that the order was wrong. Was this document based on a discussion after the decisions taken by the Council on 18 September?

ALISON EWING said that she had grave concerns about some of the recommendations. She had been slightly dismayed to see the recommendation about reserved places and in particular a paragraph which included the sentence: "Only in the fields of education and pharmaceutical science is the need for specific expertise within the pharmacist membership of the Council sufficiently strong to make the case for securing this expertise through appointment." She felt strongly that these were not the only areas.

With regard to devolution, she said that she was a member of the devolution subgroup, which was to hold its next meeting on 31 October. Bringing recommendations to the Council today could not preclude that group's discussion.

Mrs STONE said that some good decisions had been reached on 18 September that were overwhelmingly supported by the Council. Some of the recommendations and text in the document before the Council did not take into account the decisions taken at that meeting. The decisions taken on that day were based on the understanding that there would be a body that supported a forum or a senate of experts who would be brought together for their expertise within the profession and allied areas, which was needed to inform the Council and underpin its work.

She had difficulty in seeing how one could combine an elected body on which there were reserved places with a body on which places were allotted to ensure levels of expertise. The Council should be discussing these questions in the light of the decisions taken on 18 September because those decisions were used as a basis for the well-received presentation made by the President at the British Pharmaceutical Conference.

The PRESIDENT said that the Council could refer the options back to the steering group or agree some other options. What Council members had in front of them were comments on the basis of what had been discussed at the end of July. It had then gone back to the steering group, which had taken into account those discussion. The recommendations were largely based on the views that had been expressed, bearing in mind that there was not a clear consensus, subject to some comments from the steering group, which had looked at some of the issues from a different perspective. The Council now had the opportunity to discuss the recommendations individually and sequentially without prejudice .

Mrs STONE moved that the matter should be discussed informally later, when everybody had had time to absorb it.

HEMANT PATEL said that he would be happy to second a referral back of the matter.

ASHWIN TANNA said that the seven recommendations should be taken one by one on a show of hands and the matter could proceed from there.

ANDREW BURR said that it would not send a good message to the membership if the Council kept referring things back. He had been at the 18 September meeting and he would not be supporting some of the recommendations, but he wished to have the opportunity to debate them.

PETER CURPHEY said that Council members were confused because they were leapfrogging their own decisions. He would prefer to debate the matter in private and then have some reasoned decision-making in public. He supported referring the matter back, but pointed out that the Council was losing time.

The SECRETARY AND REGISTRAR said that the Council had had a number of discussion days. This was the second stage and it was now taking further issues forward. If the Council wanted more lengthy informal discussions before taking its decision then it could decide to do so.

Dr GORDON APPELBE felt that the Council was rushing the whole modernisation programme.

The SECRETARY AND REGISTRAR said that the branch representatives had been urging the Council to consider the single transferable vote and that this could be dealt with separately. However, the Council would have to make a decision on this item before November or December if it were to be implemented from next year.

DIGBY EMSON said that he did not think he would benefit from more discussion on the matter and he would support voting on it now.

Dr NICOLA GRAY said that she would be happy to take a vote on the recommendations but members would need to debate each point and say why they were not happy.

WALLY DOVE said that the Council had had sufficient exposure on these issues to be able to vote on them.

The PRESIDENT said he did not feel that there was any new information which could be produced on these topics and that sending it back for further debate would not take the matter any further forward because they had gone as far as they could.

The motion to refer the matter back was lost. The Council then agreed to consider the recommendations in open business.

Opening discussion on Recommendation 1 — "that two places be reserved within the pharmacist membership of the reformed Council for appointment of a senior pharmacist with expertise in education and an eminent pharmaceutical scientist" — Professor MICHAEL SCHOFIELD proposed that the recommendation should be deleted.

The SECRETARY AND REGISTRAR said that the steering group had proposed the recommendation to ensure that those particular skills and knowledge were available to the Council to enable to discharge its role and duties.

Mr BURR asked the Council to reject the recommendation because he was sure there was another way of getting the expertise required.

Dr GRAY said that there had been concern among pharmaceutical scientists about the future of science within the Society. They would feel reassured by having executive input into the Council. Eminent pharmaceutical scientists had tried to get elected to the Council in the past but they had not been able to do so.

HASSAN ARGOMANDKHAH said that he supported Mr Burr. The whole recommendation should be deleted.

Professor SCHOFIELD said that his suggestion that the recommendation be deleted had been based on it being overtaken by the discussion on the Council "awayday", when the Council had talked about a forum on which such people would sit. He wanted input from scientists and academics, but he thought the Council had designed a better mechanism for doing that on its awayday.

HEMANT PATEL felt that the Council should make a clear decision to get rid of the proposal once and for all.

Mrs STONE said that she wished to see a Council that was democratically elected supported by a forum that was strong and robust, because then they would have the best of both worlds.

CLIVE JACKSON said that his main concern was that he was not in favour of appointments to the Council. There would be fewer pharmacists on the new Council and he felt that there would be a perceived reduction in the democratic process. He did not see that the argument for these particular two carried more weight than any other areas.

The SECRETARY AND REGISTRAR stated that in the response from the membership 42 per cent favoured a mix of elected and appointed members, and the recommendation was trying to reflect the responses.

Mr EMSON said that if the Council made this decision it should be careful in the way it was communicated because it should not diminish the need to work on the representation of these groups.

Mr DOVE said that it was politically insensitive to bring this motion back to Council and he believed that they should delete it.

Mr CURPHEY said that the Council should explain that it wanted to ensure that expertise was properly brought to it but that it did not believe it helped the Council in its decision making to have factions that might be perceived as representing certain groups of people.

Mrs HOARE said that if the Society needed an expert opinion it could go to the Academy of Pharmaceutical Scientists and many eminent people, including its own chief scientist.

Recommendation 1 was then put to the meeting and was lost.

Recommendation 2 was "that all other pharmacist members of the reformed Council be elected." The PRESIDENT put this recommendation to a vote, with the removal by agreement of Council of the word "other". The motion was carried.

Recommendation 3 was that "the constitution of the reformed Council include no reserved places for fields of practice, beyond the two place reserved for appointment of a senior pharmacist with expertise in education and an eminent pharmaceutical scientist".

Mrs STONE proposed that a full stop should be inserted after "practice" and the rest of the sentence deleted. The proposal was agreed and the amended recommendation was approved.

Recommendation 4 was that "the need for robust, flexible, efficient, effective and transparent mechanisms to ensure that specialist advice and expertise is fed into the Council, and that the Council is kept aware of the circumstances and concerns within sectors of the profession, be recognised within the modernisation programme".

Professor SCHOFIELD said that if this was agreed as being the first recommendation it would set the tone for the rest of the decisions and would deal with the concern that had been expressed about the message being sent out to the scientific communities about inclusivity.

The PRESIDENT said that that was a splendid suggestion. The Council approved the recommendation and agreed that it should be placed first.

On Recommendation 5 — that the reformed Council should include not less than one pharmacist members and one lay member from each of England, Scotland and Wales — Mr BURR asked whether the wording meant being resident in a particular country or working there.

The SECRETARY AND REGISTRAR replied that in normal circumstances it would be resident, but if the Council wished to clarify the matter it needed to be taken as part of the devolution discussions.

The PRESIDENT said that Hemant Patel was to chair a meeting on 21 September that would look at the implications of devolution. He had received a proposition from Miss Ewing that the recommendation should be deferred and considered at that meeting.

Mrs STONE seconded this proposition, which was agreed.

The SECRETARY AND REGISTRAR accepted that the item should be deferred but she thought that the principle of representation for England, Scotland and Wales should be accepted.

Miss EWING felt it would be better to come back with a firm and robust proposal.

Mrs HOARE suggested it might be helpful to agree in principle that there would be representation from Wales and Scotland but leave the details to the working group. (Agreed)

Turning to Recommendation 6 — that recommendations on the process for filling the reserved places for pharmacists be brought to a future Council meeting — the PRESIDENT asked the Council to agree that this recommendation no longer applied. (Agreed)

Commenting on Recommendation 7 — that the single transferable vote system be used to elect pharmacist members of the reformed Council — Mr TANNA suggested that the 2003 Council election should use the "first-past-the-post" system.

The PRESIDENT said that although the single transferable vote system was more complicated and difficult to understand it was apparently fairer to minority groups, and the Council did have to be concerned about diversity. Other bodies were pursuing the STV on the basis that it was in everyone's interest.

Mr BURR encouraged the Council to adopt the first-past-the-post system. They had to carry with them the membership for the modernisation programme and not ignore them. The members had continually asked for this particular system and it was time people listened to them.

Professor SCHOFIELD said that he had been involved with another professional body that used STV and was perfectly happy with it. If the other professional bodies used STV then that should be taken into account.

Mr CURPHEY said that the present system had been a thorn in the flesh of the membership ever since it was introduced 26 years ago.

Mr TANNA added that if the Council did not reject the present proposal it would antagonise the members more.

HEMANT PATEL agreed with the previous speakers because he said that pharmacy was becoming a much more diverse profession and he urged his colleagues to think about the longer term rather than the past.

Mrs STONE said that she did not think it made much different overall; the difference would come at the margins. If all the other health professions were using STV it showed that it was understood and it did work.

Dr GRAY said that the comments from the membership over the past 26 years far outweighed any advantages that STV had.

The PRESIDENT put recommendation 7 to the meeting. It was lost by six votes to 14 votes, with two abstentions.

Mr TANNA proposed that the first-past-the-post system should be used to elect pharmacist members of the reformed Council.

Mr BURR felt that the word "reformed" should be replaced by "future".

The SECRETARY AND REGISTRAR believed that what the Council wished to do was, first, to say that the first-past-the-post system be used to elect pharmacist members of the reformed Council and, secondly, to put forward a separate proposal to say that the first-past-the-post system be used to elect pharmacist members of future Councils and that this be implemented as soon as practicable.

GERALD ALEXANDER said that he would be happy to second both propositions formally.

The PRESIDENT put the motion: "That the first-past-the-post system be used to elect pharmacist members of the reformed Council." The motion was carried.

The President also put the motion: "That the first-past-the-post system be used to elect pharmacist members for future Councils, to be implemented as soon as practicable." The motion was carried.

The SECRETARY AND REGISTRAR stated for the record that the paper they had been debating represented the Council discussion in July and the feedback from the consultation. Despite some comments that had been made, the paper tried to represent that discussion and feedback and it had been fairly produced.

Dr EVANS said that the process had been started by the Government, which required the Society to modernise its arrangements. The end purpose of a series of similar discussions would be to present a package proposal to the Government and hope that it would accept it. The decisions were being brought to the Council by the President and by the modernisation steering group a few at a time to try to get agreement stage by stage as they went along. All these decisions were in a sense interim decisions because the end process had to be to wrap them all into one package to see if there were any inconsistencies or contradictions and to produce something that could be put to the Government as something that the pharmacy profession was united behind. Therefore the Council should not get too hung up on the individual decisions as they went along.

Professor SCHOFIELD asked when the procedures for the election of officers of the new Society would come before the Council for discussion. If the future Council consisted of 28 people of whom 16 were pharmacists, and if the President was elected only from among Council members, there would be a substantially increased lay input to the election of the President and a substantially reduced number of pharmacists from who they would choose. The Society needed to consider whether in future the President should be elected by the whole of the membership and not just by the Council. That also threw up the issue of whether the roles of President and the Council chairman should necessarily be filled by the same person. When would the Council have an opportunity to discuss those questions?

The PRESIDENT replied that he was not sure when the modernisation steering group planned to discuss that issue. It was an important point that needed to be considered and brought to the Council.

Pharmacy workforce

The Council welcomed the Department of Health's recently published discussion paper on skill mix in pharmacy, "Pharmacy workforce in the new NHS" (PJ, 5 October, pp469 and 480) and agreed to hold a full debate on it in time to submit a response before the 31 December closing date.

The President said, because the document had been published only at the end of the previous week, there had not yet been an opportunity to digest it in detail and to come forward with a paper that might form the basis for policy development for the Society. The intention was that a document would be produced for discussion at a later meeting. Adequate time was needed to involve other people and to consider a detailed response.

In answer to a question, the President said that the Society would be consulting other pharmacy bodies but each body would have the opportunity to respond individually. However, they would seek to highlight areas of common purpose.

During a brief preliminary debate, Council members welcomed the opportunities presented in the report and made some initial observations. The President thanked them for their contributions and said that, if the profession was to fulfil the roles identified for it in various documents, there had to be adequate and appropriate support. He believed that the skill mix document would give the profession the mechanism for such developments.

Future Council composition

ASHWIN TANNA asked for clarification about the mechanism for reducing the number of elected pharmacists on the Council following the decision that the new Council would have 24 to 30 members, with lay members accounting for up to 40 per cent. The elected pharmacist members would be no more than 16 or 18. To reduce the elected membership from the current 21 members would require ratification by a two-thirds majority in the Council followed by a special general meeting at which a 75 per cent majority would be required of those present and voting.

The SECRETARY AND REGISTRAR said that the Council had not yet decided on the detailed composition of a future Council, nor had it yet determined the way in which that might be achieved. She therefore could not say when a special general meeting would be held — if one had to be held. The Pharmacy Act allowed the composition of the Council to be altered, and the Council would have to look at the impact of the Section 60 Order and its relationship with the Charter as it proceeded.

The PRESIDENT said that the issue was an important one that would need to be addressed at the appropriate time.

Practice without registration

The President said that on 1 October a letter had appeared in the Daily Telegraph from the presidents and chairmen of the United Kingdom health regulatory bodies, urging the European Commission to drop a proposal that individuals from a member state could practise in another member state for up to 16 weeks a year without registration. The President had been among the signatories, representing the Society.

The President said that the Commission's proposal would be contrary to the Treaty of Rome and would run counter to the principles of health protection. It was therefore in conflict with the Government's policy of safeguarding the health and well-being of patients.

The proposal was of particular concern in the light of the probable expansion of the European Union. It would mean that a practitioner from a country where standards and practice were different would be able to come to Britain without the Society knowing anything about it. There would be no requirement for such a person to register for up to 16 weeks a year.

The President emphasised that what the health regulatory bodies were seeking was to ensure that patients and users of health services were safeguarded. They were not seeking to put barriers or impediments in the way of people who were qualified in their own countries and who legitimately wished to work in the UK. Free movement of health professionals was enshrined in the Treaty. But it was essential was that such individuals should be registered and should come to the attention of the Society.

The article had been referred to in the BBC Radio 4 Today programme, with an interview with the president of the General Medical Council, who had responded on behalf of all the health regulators. The matter would be raised in the European Parliament, and the health regulators, in concert, would be calling upon MEPs to reconsider the proposals.