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Graham Southall-Edwards is a pharmacist and barrister-at-law
from Tyrol, Austria
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The Broad Spectrum feature is open to any reader.
Contributions of around 1,100 words commenting on topical issues
should be sent to graeme.smith@pharmj.org.uk for consideration
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In 1998, I wrote a Broad spectrum article entitled “Stand and be
counted” (PJ, 28 November 1998, p859). At that time I saw the enemy
against which I felt a stand should be taken as the rising power of the
multiple employers. However, over seven years on, I am now amazed that
my legal efforts on behalf of pharmacists are increasingly directed towards
defending their interests not against their employers, but against the
Royal Pharmaceutical Society’s investigations of them.
Mark Koziol (PJ, 15 April, p442) appears to think things are getting
bad for pharmacists caught up in many of the Society’s needless
and costly investigations or inquiries into pharmacists; he could not
be more right. But if he hopes that matters may in future improve and
that the Society may one day really start to “help pharmacists
achieve excellence”, I venture to suggest that he will have a long
wait.
Looking at some of this month’s Statutory Committee inquiries and
recent developments in the legislative pipeline, I can only see the plight
of the pharmacist and his or her individual rights getting worse and
being further eroded, respectively.
Look, for instance, at Part 5 of the Draft Statutory Instrument under
Section 60 of the Health Act 1999. Article 46(a)(i) and (ii) gives the
Society sweeping powers in respect of demanding and obtaining information
about pharmacists who are on the Register and effectively affords them
no privacy at all. In addition, Article 47 allows the Society in effect
to say what it wants to whom it wants and the provisions of Article 54
mean that at any time a pharmacist may see his or her employment and
(importantly) income brought to a sudden halt by reason of an allegation
against them which may subsequently prove quite groundless; and all this,
of course, is pleaded as being necessary by reason of the so-called “need
to protect the public”.
The Society already has powers which, in effect, exceed those of the
police; persons arrested by the police on suspicion of (or accused of)
serious crimes like, say, robbery are not obliged to make any statement
and, by reason of the “caution” under the Police and Criminal
Evidence Act 1984, the only effect of their silence is that a court may
later draw adverse or other inferences from that silence. Nowhere in
English law are the police entitled to charge the suspect who says “no
comment” with any offence for so doing. However, members of the
Society who take such a stance with investigators are liable to be referred
to the Statutory Committee for misconduct, by reason only of their exercise
of the rights that the inspectors read to them at the start of any Society
PACE interview.
I deal daily with pharmacists who have made dispensing errors and who
are seeking advice about what to do and I can say with certainty that
the current regulatory regime terrifies many of them. In cases involving
CD errors where the police and Society may have to be involved, it is
interesting to note that it is the thought of a Society inspector being
called in that worries members most, as against the possible involvement
of the police, who are seen as much the lesser body to worry about. It
seems that Society members are finally waking up to the reality that
calling the Society or an inspector for help in such situations is no
longer of any assistance at all; instead it is rather more like the bank
robbers telephoning the police after they have broken into the bank and
asking if they know the combination to the safe. Mr Koziol says that
pharmacists presently incur a disproportionately high level of stress
in their professional and personal lives by reason of investigations
and I can only say that he is right, but that this stress and worry is
going to get worse under the new powers proposed in the Section 60 Order.
Interestingly, however, the Society is, as Mr Koziol says, doing little
or nothing to address the staff levels and working environment that I
am certain often lead to or contribute to the errors, which then result
in the relentless persecution of those involved in them.
Mr Koziol also draws attention to the fact that an increasing number
of pharmacists are retiring or leaving the profession early and depriving
it of their experience. I would add to his concerns regarding this increasing
trend by asking how long it will be before the coming regulatory machinery
begins to act as a serious deterrent to entry into the profession in
the first place.
The present regulatory activities of the Society and the likely future
developments are worrying to me indeed, particularly since the proposed
legislation will be effected without any Parliamentary debate and that
legislation will, remember, include the complete repeal of previous primary
legislation, ie, the Pharmacy Act 1954.
It is interesting that nearly every pharmacist I talk to is against current
developments in the Society’s regulatory machinery and few can
see any real justification for the current developments based largely
on what I call “Shipman arguments”; nearly all are appalled
by the way the Society, which they once felt was there to support them,
is now increasingly like the Sweeney to the villains. But short of a
mass refusal by the majority of the membership to work under the present
and proposed regulatory frameworks, none of them can see any way in which
they are going to be prevented. Given the proposals for “remote
supervision”, such a refusal could see the beginning of the end
for the profession because any government threatened by such a move could,
of course, simply legislate to remove the need for the pharmacist
altogether.
I cannot help but draw contrasts with developments that have taken place
during the past century. Many notable changes in regimes or the rise
to power of persons and bodies have been unwanted generally by those
who have been affected by them. Sadly, though, the very persons whom
one might have thought would oppose and stop these developments have
not taken action. Sometimes that has been because of apathy, but more
often it has been through fear of the effects of protest — fear
of being singled out as a rebel and subsequently suffering the consequences
of their expressed dissent. Many pharmacists I currently advise and represent
are frightened to confront the Society under the present regulatory framework;
what will be their attitude, I wonder, when they know that they may be
removed from the Register without notice and effectively on a whim?
Finally, I wonder how long it will be before publicly opposing the Society,
or merely criticising it, is deemed to be misconduct, therefore effectively
stifling protest. |
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