Future far from clear
Julie Stone is visiting professor in health care ethics at the University of Lincoln and a barrister with an interest in complementary and alternative medicine. However, it is in her capacity as deputy director of the Council for Healthcare Regulatory Excellence that she is making health care professions, including pharmacy, nervous.
Professor Stone, even though writing in a personal capacity, has had
a paper published recently in Consumer Policy Review entitled “Reforming
healthcare regulation” (p97). She argues, among many other matters,
that reform is long overdue and that the current system of regulation
is inconsistent, particularly when it comes to dealing with shortcomings
in an individual’s fitness to practise.
The Royal Pharmaceutical Society is now awaiting the deliberations of
the Foster review and Sir Liam Donaldson’s examination of the General
Medical Council in the light of Dame Janet Smith’s inquiry into
the Shipman case.
What will all these reports have to say about pharmacy regulation? According
to Jane Kennedy, minister responsible for pharmacy, who was speaking
at an
All-Party Pharmacy Group meeting earlier this week, nothing will be said
in public about pharmacy until Sir Liam has finished his deliberations.
However, what the minister said in general terms should, in theory, bring
some comfort to pharmacy. She said that the aspect of health care regulation
that concerns the decision-makers most (and highlighted by Dame Janet)
is that investigation of complaints should not be undertaken by the same
body that goes on to judge that complaint and that there should be legal
input into the adjudication process.
Certainly, the GMC falls short in these respects. Moreover, doctors have
to be found guilty beyond reasonable doubt before they are disciplined — a
system, some argue, that favours the medical profession. Other regulators
are more concerned about the balance of probability in a particular case,
which may be fairer to patients.
In all respects, pharmacy can be proud of its record: fitness-to-practise
investigations are carried out by a committee of the Society’s
Council, the adjudication is completely independent of the Council and,
moreover, the chairman of the adjudication panel (the Statutory Committee)
is always an experienced lawyer.
So why does all this make pharmacy nervous? The fact is that the Society’s
dual role (as professional body and regulator) takes it out of line with
the majority of other bodies. Although the Society fulfils the need to
separate investigation and adjudication, it may not be enough for the
Government. However unpopular and politically explosive the move, the
Government may demand the two functions are separated more clearly (if
only to bring the Society into line with other regulators) or even establish
a single external adjudicating body for all health professions.
The future is far from clear.
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