Christopher Icha
How might the Society’s roles be split? |
What will the Royal Pharmaceutical Society look like in five
years’ time?
This is the question that many members may be pondering following publication
of the so-called Foster review last week (PJ, 22 July, p91).
The Department of Health wants to introduce greater consistency between
the non-medical regulators, as well as the General Medical Council, and
increase public confidence in their activities. The Foster review proposes
a number of changes to their structures and practices in order to achieve
this. One of the proposals for the Society is that “any necessary
changes can be made to clarify the separation of the Society’s
regulatory and professional lead functions”. The position will
be reviewed by the Government in 2011. So, how might the Society go about
separating its dual roles of regulator and professional lead?
Status quo not sustainable
Anthony Cox, a former honorary auditor at the Society, believes that
there are three main options: first, to carry on arguing for the status
quo; secondly, to strengthen the “Chinese wall” between
functions; and, thirdly, to put forward a new plan based on a separation
of functions. He believes that the status quo is not sustainable in
the long term.
The Society’s submission to the Foster review (PJ, 3 September
2005, p273) suggested its combined role provides a mechanism for mediating
between regulatory and professional perspectives. However, Mr Cox argues
that this fails to allow a space for a creative dialogue to improve both
regulation and professional practice. He adds that, as the boundaries
between the professions merge, for example, in the area of prescribing,
it is not clear why pharmacy deserves unique treatment.
“The Council should have the confidence to take this opportunity to extricate
the representative body, and its membership assets, from the regulatory
role and develop a plan that would attempt to preserve the best aspects
of those roles. For example, the Society’s inspectorate could fit
into the increasing emphasis on local aspects of regulation, within primary
care trusts, of fitness to practise. With regulation becoming a partnership
between the professions and the Government, a representative professional
body cannot, in any real sense, continue to be an independent voice if
tied to regulation,” Mr Cox says.
John D’Arcy, chief executive of the National Pharmacy Association,
believes that a likely way forward, if the Society stays together, is
that it will have two councils — one for regulatory matters and
one for professional matters. The two councils would need to act independently
from one another, he says.
Regarding membership of the regulatory council, Mr D’Arcy believes
that it should have a balance of people rather than excluding elected
members or those who are representatives on other associations and defence
bodies, as suggested by Foster. “A problem with that is you are
almost predetermining the look and shape and feel of it. I would suggest
that having a limited number of people from other bodies would add colour
to it. It seems to me inherently wrong not to want to take on board people
who have a view from the grass roots.”
Mr D’Arcy believes that the two roles of the Society would take
on an increasingly autonomous identity. If the Society were eventually
to split, he believes that it would keep regulation and hive off its
professional roles.
Similarly, Mark Koziol, one of the four pharmacists involved in the Save
Our Society court case two years ago (PJ, 31 January 2004, p109), envisages
that the Society might keep its regulatory and professional roles in
the short term. However, this is with a view to splitting eventually
and giving up regulation. “The only way that [keeping both roles]
could work is if the Society’s national boards for England, Wales,
Scotland and Northern Ireland were developed to represent pharmacists,” he
says. However, he believes this could only work in the short term since
a tension would develop as funds are drawn away from membership functions
to feed more regulation as specified by Foster. The effects of this heightened
regulation could also create dissatisfaction among members, he adds.
The most likely scenario in the medium term, he believes, is that the
Society will split and the members will vote for its assets to be applied
to a representative body, similar to some of the medical royal colleges,
with the responsibility for regulation taken by the Government.
If the Society were to split and retain its regulatory function — something
that, some might say, the Foster review hints at — which organisation,
or organisations, might adopt its professional leadership functions?
Ian Simpson, chief executive of the College of Pharmacy Practice, suggests
that the college would be well placed to take on this role, perhaps working
with others. “Promoting excellence in practice was one of the objectives
in the Society setting up the college 25 years ago,” he explains.
Mr Simpson says that the CPP is keen to work with the Society to take
forward the professional role. Even before the Foster review was published,
the college was in discussions with the Society on how the two organisations
could work together more closely. “These discussions are continuing
and obviously will be given added impetus by the Foster review,” Mr
Simpson adds. Single body best way forward
Howard McNulty, visiting professor at the University of Strathclyde
and general secretary of the Institute of Pharmacy Management International,
believes that clarifying the separation between the Society’s professional
and regulatory functions while retaining a single organisation is the
best way forward.
“Separation is not divorce. In fact, the Donaldson review [of the
General Medical Council] suggests closer working between the GMC and the
royal
colleges, and Foster makes similar comments,” he adds.
He suggests that the role of Secretary and Registrar would need to be
separated. The professional directorates and the directors of the national
boards would report to the secretary, and directorates dealing with regulatory
matters and the regulatory committees would report to the registrar,
he says. Common services, such as human resources, finance and publications,
could serve both functions.
Professor McNulty hopes that the new national boards for England, Scotland,
Wales — and, potentially, Northern Ireland — will be empowered
to better represent the professional interests of pharmacists.
The Council, he believes should still have elected members if it is to
be fit for purpose for a professional body. “If the new regulatory
committees act independently of Council, as the current Statutory Committee
does, and have appointed pharmacist and lay members, then this largely
meets Foster’s requirements,” he argues.
Several options for the future of the Society have been highlighted here
but many more permutations are possible. The Society’s Council
will be considering its response to the Foster review at its August meeting. |
The
Pharmaceutical Journal