Review group met in Scotland this week |
The Royal Pharmaceutical Society is not meeting the needs of
pharmacists in Scotland. This is the essence of the message that seven
groups — who
together represent the interests of nearly all pharmacists in Scotland — have
put forward to the Society’s devolution review. But the stakeholder
group is far from negative about the Society’s future. “We
very much want York Place to lead our profession in Scotland,” they
say. The trouble is that right now they believe that this is not happening.
The Society announced earlier this month that it is seeking members’ views
on how it should adapt to meet the political and social changes brought
about by devolution
in Scotland and Wales (PJ, 9 October, p541). As part
of the consultation process, the Society’s review group met key
stakeholders in Edinburgh on 26 October.
The seven stakeholders who came together to present a united front are:
the Association of Scottish Chief Pharmacists (Acute Care), the Association
of Scottish Chief Pharmacists (Primary Care), the Scottish Pharmaceutical
General Council, the Scottish Pharmaceutical Federation, the Scottish
Specialists in Pharmaceutical Public Health, and the two schools of pharmacy
in Scotland — at the Robert Gordon University, Aberdeen and at
the University of Strathclyde. They submitted their views in writing
before the meeting.
The cause of the Society’s problems
The root cause of the Society’s problems is the fact that responsibility
for health policy is devolved whereas health regulation is not. This
means that the Society, with its dual roles of professional representation
and
regulation, has found itself making UK-wide
decisions might not always be most appropriate for Scotland and Wales.
Since powers were devolved to the Scottish and Welsh administrations,
health policy has started to diverge. And this has
resulted in differences in the way that pharmacy is developing in England,
Scotland and Wales. The seven stakeholders point out that there are differences
between the values and cultures of Scottish and English society. “This
inevitably impacts on the population’s health and therefore it
would always be appropriate for health matters to be devolved,” they
say. On top of this, each country’s population has particular health
needs and devolution allows these needs to be met at a local level.
It is only five years since devolution. Yet
already many examples exist of different
approaches to health policy. Each country has its own pharmacy plan.
The Scottish and Welsh governments responded differently to Westminster
on the Office of Fair Trading’s report on control of entry. And
the Scottish community pharmacy contract is taking a different approach
to the contract drawn up for pharmacists in England and Wales.
The stakeholder group points to the different NHS management and clinical
structures in Scotland. “It is essential that the Royal Pharmaceutical
Society in Scotland is able to interact effectively with these structures.
The present arrangements within the Society do not accord to these principles,” they
comment. “For example, great attempts are being made to involve
the public in the redesign of health services in Scotland. This requirement
is now enshrined in Scots Law and therefore a statutory duty on health
boards. It would not be appropriate for the Society in Lambeth to dictate
how Scottish pharmacy services develop to meet the desires of the Scottish
public.”
Furthermore, they comment: “The Society in Scotland is not currently
empowered to interact autonomously with the Scottish Government. This
must be rectified soon otherwise the opportunity to participate fully
in the development and implementation of Scottish health policy will
be missed.” A view of the future
The stakeholder group is adamant that it wants the Society in Scotland
to lead the profession as a strong, well-regarded and well-received
professional body. It proposes that the Society takes a collegiate
structure: an English college, a Scottish college and a Welsh college
all reporting to an overarching UK-wide Society council. This model has
the benefit of allowing devolved matters to be addressed by the colleges
and UK-wide issues to be dealt with by the council.
Since health regulation is a power reserved to Westminster, it is perhaps
not surprising that the stakeholders recommend that
regulation should be managed centrally at Lambeth. “Rules and standards
for entry to the pharmaceutical register must be appropriate and applied
consistently across Great Britain,” they say. But within this,
they suggest that the Scottish context and practice should be taken into
account.
It is in professional representation that the stakeholders want a stronger
role for the proposed Scottish college. “An empowered York Place
should be the champion of the profession in Scotland and to do this the
Society must be active at the front line of Scottish politics, representing
the profession and influencing Scottish policy development and implementation,” they
say.
The group suggest that the Scottish college should have responsibility
for standards of practice, postgraduate education and training, advising
the government in Scotland, and promoting the profession in Scotland.
It would be led by a chief executive and have a council with representatives
from community pharmacy, hospital pharmacy and academia, and a technician
among its membership.
On policy formulation, the stakeholders want York Place to be given the
power to
interact with the Scottish government and be able to support the development
and implementation of policies in Scotland. Although some policies will
take a UK approach, Scotland must be able to make its own policy and
be able to choose how it implements UK-wide Society policy, they say.
Turning to pharmacy education, the stakeholders want an education committee
to be created at York Place. Undergraduate education should be tackled
by Lambeth but postgraduate education and practice development should
be dealt with in Scotland.
The consultation also asked where the Society should hear disciplinary
cases. The stakeholders say that, because regulation should be retained
by Lambeth, York Place should act as a host for hearings with Lambeth
managing the process. Debate and consultation
What it comes down to is this: pharmacists in Scotland want to be able
to respond to what is happening in Scotland. They believe that Lambeth
cannot carry out this function and they want a Scottish organisation
with the power to represent them.
When the Society launched the devolution consultation, it urged members
to put forward their views. The model proposed by the Scottish stakeholders
should certainly stimulate debate. Members still have three weeks to
make contributions. The Society’s devolution review group will
then make
its recommendations to the Council early next year. |
The
Pharmaceutical Journal