The Pharmaceutical Journal
Vol 271 No 7277 p755-757
29 November 2003

Society summary

Listening to pharmacists: report on the second consultation on a new Charter

Marcus Longley summarises the key issues raised in the consultation on the second draft of a new Royal Charter for the Royal Pharmaceutical Society

The second consultation on a draft new Royal Charter for the Royal Pharmaceutical Society was announced in The Pharmaceutical Journal of 11 October and closed on 14 November. Responses were received from 225 individuals, the Scottish and Welsh Executives, four of the Society’s branches and regions, 11 other pharmacy organisations and three non-pharmacy organisations. The total number of responses was 245, which compares with 430 responses to the consultation on the first draft.

The report highlights the key themes to emerge, each of which was contained in a substantial number of responses. They are presented here in such a way as to facilitate understanding, and without specific commentary.

As with the previous consultation, an approximate indication is given of the frequency with which particular issues were raised — most frequent, and less frequent. It is not possible to be more precise than this, however, because some responses are from individuals, and others on behalf of groups (for whom there is often no indication of the number of people in the group). It is also not possible to establish how representative the respondents are of the totality of the profession.

Most frequent issues

This section summarises the issues raised most frequently in the responses to the consultation.

General support Many respondents expressed their support for the revised draft. They variously applauded the changes relating to devolution, the amended wording of the Objects (particularly the third), the specific provision for annual general meetings, and the balance between regulation and professional matters, among other matters. One respondent in particular made the point succinctly: “Get on with it. You will never have a consensus where one and all agree.”

Some respondents recognised the significance of the changes made between the first and second drafts and, while not entirely content with the latest version, were prepared to accept that it was probably good enough: “The new draft seems to answer most of the concerns I had with the original. It’s still a bit wishy-washy on supporting members’ interests but at least now it permits the Society to do so. What the Council does with the Charter once it’s got it is, of course, the key.”

Third Object: Removal of “members” There were, however, many more critical than supportive responses overall. As with the first consultation, the issue which attracted the most adverse comment was the Object which, in the second draft, read “to safeguard, maintain the honour and promote the effectiveness and interests of the profession of pharmacy” (emphasis added). Most of the respondents who raised this issue strongly preferred the use of the phrase in the current Charter: “... the interests of the members in their exercise of the profession of pharmacy” (emphasis added). Their concern was that in the future the effect of this wording might be that the Society could represent the interests of anyone working within pharmacy — including technicians — and not just pharmacists. They believed this might prejudice the interests of the current members, given the likelihood that on some issues their interests would not be identical to those of technicians or others.

Many argued that there was no need to change the wording and rejected the notion that the current wording was ambiguous: “I cannot ... understand there is any ambiguity and am unable to accept that a professional body cannot support its members.”

Others said that the change actually might have the effect of creating ambiguity, since the “members” was a defined category, whereas the “profession” was not: “Members are a physical entity, whereas the profession is an abstract concept and as such it is debatable [whether] ... it has any real meaning.”

It was also suggested that persisting in rejecting the current wording, despite the clear wishes of the special general meeting, was either perverse or a deliberate attempt to shift the Society from being an effective champion of the interests of pharmacists: “If there is no intention to change the way the Society operates in this area, why change the wording?”

Potential inclusion of non-pharmacists as members A related, but separate concern focused on Article 5 of the second draft. This establishes the mechanisms for admitting non-pharmacists to categories of membership of the Society. It replaces Article 6 of the current Charter, which unambiguously states that “members” are “registered pharmacists”. There was concern that this could result in technicians and others in time becoming members of the Society. The risk was thought to be compounded by the fact that this might happen solely as the result of an agreement between the Society’s Council and the Privy Council — there would be no requirement for the specific endorsement of the Society’s current membership: “It therefore raises the possibility of non-pharmacists conferring membership to non-pharmacists without the need to refer the matter to pharmacists for consideration.”

Linking with the previous issue (the rewording of the Object), the concern therefore was that the Society might lose its exclusive focus on the interests of pharmacists, and that in time pharmacists might even lose their control over the Society as other categories of membership were created: “Under the revised charter I cannot see how the members (pharmacists) will differ from registrants (technicians). What is enshrined in the Charter to differentiate between members and registrants?”

Composition of the Council Two issues were raised in relation to the composition of the Society’s Council. The first concerned the number of lay members on the Council. Some respondents objected to the presence of lay members per se (as being antithetical to the interests of the profession), although others argued that the proportion of lay members was too high. Both were concerned at the possibility that, on some close issues, an alliance of lay and technician members together with a few pharmacists could counteract the overall pharmacist majority.

A second concern focused on the mechanisms for determining the future composition of the Council, and the arrangements for the removal and replacement of Council members. Although the current Charter clearly fixes the composition of the Council, the draft Article 7 allows for the Privy Council to alter its composition, within an enlarged total of 35. It was argued that this could have a fundamental impact on the balance of interests on the Council (even putting pharmacists in a minority) and, given the close relationship between the Privy Council and the government of the day, would give the latter unnecessary scope to interfere in the workings of the Society.

Taken together, these measures appeared to give considerable (and unnecessary) power to the Privy Council, and to dominant majorities within the Council itself, undemocratically to alter the balance of the Council: “As written, the Privy Council has unlimited powers to alter the composition of the Council. Clearly this is an error and I would suggest that anything less than ‘the Council shall at all times consist of a majority of elected pharmacists’ (ie, not pharmacists + technicians) would not be acceptable to members.”

Checks on the powers of the new Council There was concern that adequate mechanisms for corporate governance should be clearly set out in the Charter. In this context, some respondents were critical of the second draft, which appeared to reduce the constraints on the Council. Criticism focused on four issues: the reduction of the majority required at a general meeting to endorse proposed changes to the Charter — from the current three-quarters, to the proposed-two thirds (draft Article 10); the absence of any requirement to seek the approval of the Privy Council for changes to the “governance, management, affairs or functions of the Council or of the Society” (draft Article 7(2)) — a change from the requirements of the current Charter; the power given to the Council under Article 7 to suspend or remove any of its members, and to fill any casual vacancies thereby created; and the fact that the Council itself could determine (through regulations) the procedures by which Council members were elected.

Without the inclusion of appropriate checks and balances there was concern that the (re-)election of pharmacist members of Council would be the only way in which members could express their dissatisfaction with Council’s decisions. This was seen as an insufficient level of control because of the infrequency of such elections, and the fact that 12 Council members would not anyway be subject to re-election by pharmacists. This was more than a procedural point for many respondents: “This is an especially sensitive area in light of actions of the Society over the last few years.”

Disposal of the Society’s assets Article 11 of the draft Charter describes the process for the distribution of the Society’s assets, should the Society wind up its business in the future. This caused some unease among many respondents. Most troublesome was the assertion that the assets would not be distributed among the members, but instead would go “to some other body with objects deemed to be sufficiently similar to those of the Society”. Some respondents believed that this “other body” might easily be a regulator, and could therefore envisage a scenario in which the Society’s assets, accumulated over 160 years by pharmacists for their professional and regulatory body, would be handed over to a government-controlled regulator. It was argued that any such move should require the specific prior approval of the membership.

Devolution The changes made in the second draft to reflect the importance of the devolution of health policy to Scotland and Wales, notably Article 6(1), were welcomed by those countries’ executives and other respondents.

The response from Wales was unqualified: “The Welsh Executive welcomes and endorses wholeheartedly the new draft charter.”

The responses from Scotland, however, identified some remaining issues. In particular, it was argued: (a) that members in Scotland should have a clearer role to play in determining and advancing policy within Scotland — the Scottish Executive, for example, suggesting that Article 6(1) be reworded as follows: “Shall by regulation and in agreement with the elected representatives of the members resident in Scotland and Wales, establish appropriate structures to reflect devolved powers and responsibilities for health, professional leadership and development, and other relevant matters, in these countries”, and that the chairman of the executive should be a full member of the Council; (b) that the Scottish Department should be specifically mentioned in the Charter; and (c) that any property sales or purchases in Scotland must initially be approved by the Scottish Executive, and any SGM relating to the sale be held in Scotland.

In addition, the Scottish Executive argued that Scottish representatives should be fully involved in the future development of any byelaws and regulations that might have an impact on the devolution of powers and responsibilities.

Less frequent issues

Relief for distressed persons Some respondents were concerned at the apparent “relegation” of the Object in the current Charter — to “provide relief for distressed persons” (members and others) to a similar Power (Article 3(2) in the draft). They wished to ensure that this element of the Society’s work was mandatory, not discretionary, and therefore believed that it should remain as an Object.

Inclusion of all sections of the profession of pharmacy Concern had been expressed during the consultation on the first draft that the different perspectives and needs of some parts of the profession — notably “non-dispensing” pharmacists working in industry, and in some of the newer professional roles — were not specifically addressed in the Charter. They felt that the existence of such a diversity of perspectives should be explicitly acknowledged in the Charter, such that it could not be ignored by future Councils. This was important, given their current impression of being somewhat marginalised within the Society: “I remain concerned that no attempt is made to clearly define/delineate pharmacy as a discipline . ... Apart from the word science there is little to indicate the wider fields of practice of the profession, that is to say beyond hospital and community.”

And: “The work of a mature democratic institution is not only to reflect the views of the majority, but also to safeguard the interests of minorities.”

“Public benefit” The use of the phrase “for the public benefit” in the Charter was rejected by some respondents. They argued that it unduly constrained the Objects, and that the key issue was not that the Society exists solely for the public benefit, but rather that it should not do anything against the public interest: “Making all of the objects conditional on being ‘for the public benefit’ would strengthen the hand of those who would argue that the Society should not seek to represent the interests of pharmacists per se. Public benefit would be an important condition of anything the Society would seek to do. This would put the interests of the public ahead of the interests of the profession. Although the Society, in its role as a professional association, should not seek to do anything that was against the public interest, but that is not the same as saying that everything the Society does should primarily be for the public benefit.”

Some believed that this phrase was only still included to allow for a future application for charitable status.

Separation of regulation from “professional representation” Some respondents were concerned that the SGM motion in favour of a “two board” structure (one for regulation, one for professional “representation”) did not appear to be reflected in the draft. They argued that this was too important an issue to be left for the decision of future Councils: it should be stipulated from the outset.

A smaller group of respondents argued that it would actually be in the interests of the profession for the two roles to be entirely separated, with the Society retaining responsibility only for representation.

Definitions There was some concern that key terms within the Charter were not defined. One example was the reference to “students of the Society”: “... but there is no explanation who falls within this category. Is it just preregistration trainees or also pharmacy undergraduates?”

There was also some concern about the position of retired pharmacists: “The revised draft charter is perfectly acceptable to me. My sole concern ... as a wholly retired pharmacist, is whether I shall be able to remain on the register. Further clarification on this point is needed.”

Other issues

Some issues were raised by several respondents which, although not strictly related to the content of the draft Charter, are nevertheless significant, and perhaps relevant to the general discussion.

Referendum Many respondents argued that the full membership of the Society should have the opportunity to vote on the final proposed wording of the Charter in a referendum. They maintained that the issue was sufficiently important to justify such a measure, and that there was no other way of assessing the views of pharmacists, given the relatively low participation in the various consultation methods so far employed: “It seems to me that the current Society Council regards itself as being on a plane above the members and that it can do whatever it thinks fit ‘in the interest’ of the members. If this is true, the Council should think again. I for one will not accept it.”

Consultation process There was some criticism of two particular aspects of the consultation process itself. First, it was argued that the time allowed was insufficient. Second, some respondents maintained that it was not advisable to consider the draft without also having sight of the proposed wording of the Section 60 Order, since the two were closely linked and, to some extent, mutually dependent