Council members’ concerns about ensuring fee structure is equitable
Members of the Council of the Royal Pharmaceutical Society have expressed a number of concerns about the Society’s current fee structure and the process that led to the adoption last August of a structure that many see as flawed.
The concerns were expressed at the June
Council meeting during a long
discussion leading to a decision to set up a working group to carry out
an urgent review of the fee structure (see p769).
Opening the deliberations, Graham Phillips said that the membership had
expressed great unhappiness over the fees paid by part-time pharmacists.
Costed options were needed in terms of what could be done for those who
worked part-time. There was also the issue of being able to continue
to recognise people who had been on the Register for many years and had
made a contribution to the profession both professionally and financially.
Finally, there was a need for something for the students, who were the
future of the profession. Although the Society needed to win their hearts
and minds from day one, it was not particularly welcoming to them.
When the Council made its decision on the 2005 fees it had had its back
against the wall, Mr Phillips said. By the time the fee proposals came
to the Council it had little time to address the situation properly.
That was why it got it wrong, and it owed the members an apology.
There should be enough time into the process to allow for appropriate
soundings and appropriate measures. A Council-led working group could
explore the issues in a way that the Council itself could not do, develop
options and make recommendations. If a report and recommendations reached
the Council in August, it would have enough time to make better decisions
and have a better process than last year.
Mr Phillips added that it was not just the restructuring of the fees
that had upset members in 2005. There had also been the way in which
the introduction of continuing professional development was being introduced
and the declarations that members were required to make when they adopted
either practising or non-practising status.
The resignations of some 2 per cent of the membership might seem trivial
but had to
be set against the desperate shortage of
pharmacists. Every day some pharmacies were unable to open because of
the lack of a
pharmacist. Even more significant was that the Society had lost many
elder statesmen of the profession, including international leaders in
pharmacy practice. The effect on the profession was profound.
Mr Phillips said that he would like to see the various concerns addressed
by a group that did not consist only of Council members. The membership
needed to be drawn into the debate so that their concerns could be addressed.
Clearly the Society had to balance the budget, so any reduction in fees
for one sector of the profession would have to be met with an increase
elsewhere. The result might not satisfy everyone, but if the profession
saw a genuine attempt to address its worries it would accept the outcome.
Philip Green (director of education and registration) pointed out that
over 80 per cent of those who had retired from the Register were previously
in fee categories that did not allow them to work in the UK or at all.
Most were already retired from work. Only 292 of those who had retired
from the register were previously part-time — and they may well
have been planning to retire anyway.
Sue Ambler (head of practice research) said that the proportion retiring
in 2006 was almost identical to the proportion in 2003, the year of the
last workforce census.
Davan Eustace said that the ill-feeling and disenchantment within the
membership was illustrated by the recent branch representatives’ meeting,
which debated five motions on the fees and fee structure.
Dorothy Drury said that a full investigation into the structure of the
fees was essential. Some full-time pharmacists had their fees paid by
their employers and others could claim tax relief, but those who did
not work many hours had to pay the full fee. They should be allowed a
slightly reduced fee.
Lesley Morgan said that the Council needed to take into account technicians’ fees
as well as pharmacists’.
Marcia Saunders said that the Council was meant to be a strategic body.
It should use the existing machinery and refer the matter to the Resource
Managemetn Committee.
Colin Ranshaw said that it was the duty of the Council, as a high level
strategy-setting body, to set policy and that of the RMC to cost out
what the Council required. The RMC should review, assess and come back
with costed models. The matter should not be
broken down in detail in the Council chamber.
Sultan Dajani said that the RMC dealt with pounds and pence and was not
geared to deal with wide issues that impinged on matters such as the
public interest and competencies. What was needed was a working party
that could talk to people outside the Council — to hospital pharmacists
and pharmacy technicians, for example.
He added that it was not in the public interest to have highly competent
pharmacists being struck off or non-practising pharmacists not allowed
to advise.
Sylvia Hikins said that the matter should be referred back to the RMC,
but with a strong steer from the Council as to exactly what it wanted
the committee to look at.
Martin Astbury said that in August 2004 the Council, thinking that the
financial situation was under control, was told by the RMC that it had
to agree there and then to an enormous fee hike. There had been no time
to tinker with it. That situation should not be allowed to happen again.
That was why a process was needed to better inform the RMC. The Society’s
structures were not being used in the correct manner.
Lorna Jacobs said that, as a new Council member, she had gained the impression
that communication was an issue. If the Council was to take the members
with it, it had to listen to what they were saying and demonstrate that
it had heard. Perhaps what the working group or RMC needed to do was
to trust the members to generate creative solutions.
Ray Jobling said that the RMC could not work without seeing and hearing
what the Council saw and heard and taking it into account. The issue
was one for the RMC.
Stephen Denyer said that, although the RMC could look at models of how
to achieve the necessary income, it might not be appropriately comprised
to examine the issues of membership categories. A working party would
be able to take cognisance of the many communications received, plus
other consultative opportunities.
Seema Agha, supporting referral to the RMC, said that there was danger
in having talk shops that were not formally accountable.
Andrew McCoig said that a working group would be able to encompass disenfranchised
members and members who were still considering whether to jump ship.
The Vice-President suggested that Council members should make written
comments the RMC, but a small working group was probably still needed
to scope the outside world and seek the membership’s consent in
moving forward. The time frame might not allow a full consultation, but
there had already been enough letters to inform the working groups.
Summing up, Mr Phillips said that he was not trying to undermine regulation.
He was proud of the Society’s reputation as a modern regulator
and would do nothing to tarnish it. He did not want to give the impression
that the Council had to go into consultation mode every time an issue
came up, but when there had almost been a rebellion by the membership,
it would be foolhardy, arrogant and unhelpful not to listen to the members
and take their views into account.
The RMC had much else on its agenda and would not have the time to go
into the necessary detail. What he was talking about was bringing in
two or three additional members from the wider profession who have unique
expertise. It was not an abdication of leadership.
The Council then agreed that there was a need to review the fee structure
and to develop costed options that fitted into a yearly and five-yearly
plan. On a vote, it was agreed that the review should be carried out
by a working group with some external input. It was agreed that the Officers
should take the matter forward as soon as possible so that a report could
go to the RMC meeting on 8 July.
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