The integrated role: a universal win-win
The Foster review may threaten the future scope of the Royal Pharmaceutical
Society's roles. Graham Phillips, chairman of the Council's Public Affairs
Planning Group, believes that the Government should recognise just how
well the Society delivers for patients, the public and the profession
Over recent years, one of the big issues for pharmacists has been balancing
the integrated roles (representation and regulation) undertaken by the
Royal Pharmaceutical Society. Some members, myself included, have been
critical of what we saw as too much emphasis on the Society’s role
as a regulator at the expense of the Society’s role in supporting
members in all aspects of their professional practice and development.
As a result, the profession engaged in long and often painful debate
about how the Society should fulfil all its roles effectively in a modern
environment.
The end result, our new Royal Charter (2004), provides a robust framework
which nicely balances the professional leadership and development roles
with the Society’s role as regulator. Once the Government puts
an end to the inexcusable delay to the Society’s Section 60 Order
under the Health Act 1999, we shall have the solid legislative foundation
we need to complete our reforms. These historic reforms represent a massive
investment of time and energy by the profession, the hard-working staff
at Lambeth and the Department of Health.
They also represent the specific acknowledgement by the Government that
the Society should continue to fulfil the full range of its integrated
present roles. Good faith requires that, before any further change is
imposed, these major changes should be allowed to embed and deliver.
That said, the Society is clearly delivering as a demonstrably effective,
influential organisation that both robustly protects patients and serves
the professional needs of members in all sectors of practice. Our newly
reconstituted Council, with 10 lay members and two technicians, is also
delivering — for patients, public and profession alike.
But there is a new and worrying challenge on the horizon. The Society’s
future may be at the mercy of a political agenda that demands that all
professional health regulation follows a one-size-fits-all model. This
could mean that the Society’s continued existence depends not on
how successful it is but on the extent to which the Government believes
it needs to deliver change for change’s sake in response to Andrew
Foster’s recently completed review of the non-medical regulators
and the chief medical officer for England’s review of the General
Medical Council. This is especially frustrating since the Society has
an exemplary record as a regulator.
As has been reported in these pages, the unique nature of the Society’s
integrated roles as professional body and regulator has been questioned
repeatedly by Mr Foster in the course of his review. This has led to
speculation about whether, behind all this, there is a Government agenda
somehow to separate the strands of the Society’s work as a regulatory
body from those of a professional body. The question then arises: how
much of a wrecking agenda would this be?
I have always believed that the integrated role was a unique strength,
and my short time on the Council has convinced me beyond doubt. Yes,
there is compromise inherent in our position but it confers upon us a
level of influence over government thinking and our own destiny that
would be unachievable as a “trade union” type organisation.
The Society’s professional development and leadership roles are
indubitably strengthened by the fact that the Society has the entire
profession in membership. In other words only the Society can claim to
speak for all pharmacists. If the roles were separated, the professional
body role could well lose the 100 per cent involvement of all pharmacists.
The Society gets the ear of Government precisely because it is the profession.
It is the “must-consult” organisation on everything that
affects the future of pharmacy. Its ideas get taken seriously because
they have the weight of the profession behind them: almost all the developments
that were put forward through Pharmacy in a New Age
are now government policy across all three countries of Britain. Indeed, “PIANA” thinking
was a critical influence on the new community pharmacy contracts.
The regulatory functions lend authority and credibility to the Society
as the voice of the profession, while the professional development and
leadership roles help ensure that regulation is consensual, workable
and continually improving. To try to separate these roles would certainly
weaken all of them and fatally undermine the organisation’s careful
balance.
When the health minister with responsibility for pharmacy, Jane Kennedy,
spoke at a recent meeting of the All-Party Pharmacy Group, I raised the
Society’s concerns about this. The minister stressed that the Government’s
main focus would be on the handling of complaints, investigations and
adjudication. As far as it goes, this could be a reassuring response
because the Society is already proactively engaging with taking forward
best practice in all these regulatory processes. But the minister stopped
short of saying that the Society need have no concerns about the Foster
review. She would not be drawn on whether she shares the views of the
deputy director of the Council for Healthcare Regulatory Excellence,
Julie Stone, that the Society manages to discharge all its roles in a
way that is compatible with the public interest. In other words, we still
need to be vigilant; we still need to work to ensure that Government
and others recognise that our successful integration of functions is
a win-win model that others might usefully emulate.
I believe that the Society still has a lot of work to do to strengthen
its influence and be a still more effective advocate for the profession.
Action is being taken — for instance, the Society is currently
reviewing its
communications and influencing strategy (PJ, 4 February,
p149). But I also believe that the integrated roles offer the best vehicle
for going forward. Members should take every opportunity to be heard
by their MPs and other opinion formers on this crucial issue.
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