Review group members

The members of the devolution review group are:

Lord Fraser of Carmyllie
Ann Lewis, Secretary and Registrar
David Thomson, immediate past chairman, Scottish Executive
Angela Timoney, chairman, Scottish Executive
Andrea Robinson, immediate past chairman, Welsh Executive
Mair Davies, chairman, Welsh Executive
Alison Ewing, member of Council
Digby Emson, member of Council
Maurice Hickey, member of Council (resigned from Council, December 2004)
Gillian Hawksworth, immediate past president of the Society
Colin Ranshaw, member of Welsh Executive
Paul Jervis, honorary senior research fellow, constitution unit, University College London.

Conclusions and recommendations of the devolution review

The group took the view after considerable discussion that the Society had no option but to follow the political devolution of power to the Scottish Parliament and the Welsh Assembly in view of the fact that both were assuming responsibility for important NHS functions in their respective countries and if the Society did not mirror these changes, then the profession would lose out in the proper representation of its views to those having the responsibility for the delivery of the NHS in the respective countries.

Where the group would propose to go further than the present asymmetrical devolution of political power to Edinburgh and Cardiff is with the recommendation that a new English executive or board should be established under the Society’s Council.

The reasoning behind this is that most of the work now being undertaken within the Department of Health in Whitehall is concerned exclusively with the delivery of NHS services in England. Only a minority of its time is taken up with those reserved matters of GB application. In such circumstances where there are exclusively English matters to be considered this should be done under the direction of a body exclusively comprising practitioners in England together with English lay representatives. This body should work collaboratively with the other national boards as appropriate.

This is not to suggest a new raft of employees will be necessary, since those already within the Society at Lambeth could undertake this work. What will be necessary, however is a mindshift: staff must clearly appreciate when they are working on a GB-wide issue and when they are addressing country-specific issues. The cultures of each of the constituent countries needs to be recognised.

One of the resentments encountered in both Edinburgh and Cardiff was that all English pharmacy issues are equiparated with GB ones. It was the clear view of the group that if, within Lambeth High Street, there was a much clearer separation of exclusively English issues from GB ones, and there was a clear recognition that some issues were exclusively Scottish or Welsh, much of that sense of resentment would fall away.

Professional bodies have found that responding to political devolution has increased their costs somewhat, and the smaller bodies have found this increase hardest to accommodate. The increases have come particularly when the bodies concerned previously had not had any form of devolved administrative/representative structures.

The Society already has representative structures in the devolved administrations in Scotland and Wales. Therefore the only new structural element is whatever is needed to address the English question. The cost of this need not be prohibitive.

The group had little difficulty in concluding that the Society should be devolving power where the issue was exclusive to one country within GB. The more difficult problem is where an issue first arises, possibly uniquely, in one country, which clearly has GB implications. The most prominent example of that to date has been the proposed abolition of prescription charges in Wales. There are others looming and it must be anticipated that this will continue to be the case.

The group discussed the approach taken by the Westminster Government on the introduction of political devolution, in agreeing “concordats” with the new devolved administrations. Concordats are neither contracts nor sets of rules. Rather they are statements of intention about the ways the different parties will work together. As such they are aspirational.

Concordats cannot be drafted until the allocation of responsibilities between the parties involved has been agreed. The group believes that, if its recommendations are implemented, potential difficulties between Lambeth, Edinburgh and Cardiff might be alleviated by the development of appropriate Concordats to describe how the three boards and Lambeth will work together. While it was not part of the group’s task to try to draft such Concordats, the group would recommend that Concordat(s) be developed between the three boards and Lambeth and suggest that the following points be included:
(i) that the Council should be informed as soon as possible of any issue with GB implications
(ii) that in the absence of a timely response from the Council, the national board responds as it sees appropriate notwithstanding its acknowledgement that the issue has GB implications
(iii) that in that event the decision of the national board will be the policy of Society for the time being
but (iv) that the Council after consultation reserves the right to adopt or amend the national board policy and if it does amend that decision the national board will be bound to follow Council policy.

The national boards would have five prime functions:

(1) provide strategic leadership and support for pharmacy practice development in [country]
(2) assist development of Council policy and its implementation in [country], and develop and implement policy specific to [country]
(3) promote pharmacy and its contribution to health
(4) provide professional advice to government and its agencies, NHS bodies, and other health and social care organisations in [country]
(5) support the Society’s branches in [country].

The group was surprised at the strength of feeling that disciplinary regulation should remain a GB issue to ensure consistency of decision making and that the Statutory Committee or its successor body should continue to sit in Society rooms in Lambeth High Street and agrees with that widespread view.

It was considered that some relatively modest modification might be necessary. The Statutory Committee or its successor should be prepared in an appropriate case to sit outside London where there was good reason to do, eg, where a Welsh pharmacist or patient requested that proceedings be held in Welsh under the Welsh Language Act. Another example might be where there was some feature of a case from Scotland which made it more appropriate to hear the case within the separate jurisdiction of Scotland, or where it was in the public interest to do so.

The Welsh language and the obligations of a public body under the Welsh Language Act was looked at in much detail by the group and evidence was heard from the Court Service of Wales. The group agreed that it should be recommended to Council that a Welsh language scheme is developed by the Society. The Council agreed this on 2 December 2004.

The group agreed with the representations to it that the common core of undergraduate and preregistration education should remain a GB function but that there could be variations in postgraduate education and training. It is not suggested that postgraduate education should be wholly devolved to the national boards but that it should be a joint function.

As the UK is the member state of the EU, it is important that the views of Scotland, Wales (and Northern Ireland) are fully represented at European level. The UK Government addresses this problem by ensuring that the delegation has representative members from each of the affected devolved governments. These members can lead the debate on particular issues where European legislation may have greater consequences for one of the devolved governments. The group considered this would be a suitable model for the Society to adopt. This would ensure that when dealing with European issues the national boards were fully represented. The group recommends that a representative from each of the affected national boards be included in any European delegation and should the matter have a more significant implication for one country, the national board of that country should lead on the matter, although the ultimate decision would be for the Society’s Council.

The group discussed the matter of the chairman of the national board sitting on the Council as a matter of right or, conversely, the elected national member of the Council chairing the national board. The group, although being aware that the Council had taken decisions on this previously felt that under the terms of reference the Council should revisit this issue as it warranted further discussion. The group was unable to reach a consensus, with Scotland and Wales having very different views. It was agreed that both arguments should be put forward to the Council and that the Council should be asked to look again at this important issue at some point in the future.

The Government of the Scottish Parliament is called the Scottish Executive; this has caused much confusion with the Society in Scotland also having a Scottish Executive. The group agreed that the Executive should be renamed, as this will avoid any further confusion. Many suggestions were made including “colleges”, “boards” and “councils”. The group, although recommending that the executives should be renamed, is not making a recommendation as to what they should be called. It has, however, earlier in this report referred to national boards in the hope that this clarifies the situation at least as far as Scottish readers are concerned.

Key to the engagement of the national boards with the Council and the Directorates at Lambeth is the relationship with the director of the Scottish Department and secretary to the Welsh Executive. Recently the director of the Scottish Department and secretary to the Welsh Executive have been invited on an ad hoc basis to attend the regular meeting of the Society’s directors. The group agreed that it is important they now become formal members of the executive directors’ meetings. This would ensure that there is a formalised two-way communication between the executives and the other directorates on a regular basis. This is particularly important in the areas of policy development and the representational role that the national boards will play as a result of these recommendations. The group recommends that the director of the Scottish Department and the secretary to the Welsh Executive become formal members of the executive group with immediate effect and have common titles and equivalent roles.

Although the administrative functions of the Society are currently discharged from London, the group discussed whether they could be better discharged from elsewhere, as this would help reduce the perceived Lambeth dominance of the Society but could also have a reduced cost implication for the Society. The group agreed that this was not something that could be achieved in the short term but should be considered as part of the long-term strategy of the Society. The group recommends that the Society should review what administrative functions are currently discharged from Lambeth, that could in the fullness of time be discharged from either Scotland, Wales or elsewhere in GB.

If the Council accepts the essential change recommended of establishing national boards under the Council, it is suggested that there would be a value in having these meet regularly during the course of the year. Key principles of the boards would be Kennedy governance, elected local leadership, access to expertise, transparency, equivalence of respect and relevance to members.

The full report, including appendices, is available online