A sorry tale
Although the Government expects public health to be a priority, the signs are that funds earmarked for public health initiatives in England are not reaching their destination. Earlier this week the Association of Directors of Public
Health declared that only about 15 per cent of the money allocated in London
this year was being used to improve public health. Instead it has been used
by cash-strapped primary care trusts to plug holes in their budgets. Developments
that are being curtailed in particular, according to the association, are initiatives
to tackle obesity, smoking cessation and sexual health, such as testing for
chlamydia — all areas in which pharmacists can have a direct input.
The association’s anxiety has been echoed by the Royal Pharmaceutical Society.
David Pruce, director of practice and quality improvement, said in a statement: “The
concern is that without adequate funding the vision outlined [in the Department
of Health’s 2005 public health strategy ‘Choosing health through
pharmacy’] will not be fully realised.”
Everyone involved in public health will be disappointed by this lack of progress,
but possibly not surprised. Public health — whether we like it or not — is
at the soft end of health care and resources will always be plundered if a more
pressing need presents itself. It is also notoriously difficult to ensure that
funds are used for new therapies or services when existing services are crying
out for more cash.
The Society intends to write to the minister in charge of public health to seek
reassurance about the Government’s continued support for developing the
public health role of pharmacy. However, unless there are guarantees that allocated
funds are ring-fenced, we are likely to hear the same sorry tale year after year.
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Professional self-protectionism
In an interview in The Times this week (13 September, p33), the president of the General Medical Council, Sir Graeme Catto, laid into the plans for reform of medical regulation put forward in the chief medical officer's report “Good doctors, safer patients”. He claimed that fragmentation
of regulatory responsibilities would put patient care at risk.
The GMC also does not like the possibility of lowering the burden of
proof in fitness-to-practise cases from the current level of beyond reasonable
doubt (criminal standard) to a balance of probabilities (civil standard)
if a doctor were facing erasure from the register. The Royal Pharmaceutical
Society’s Statutory Committee embraces the civil standard of proof
and has not attracted the level of criticism that the GMC has done in
recent years. Sir Graeme’s remarks smack of professional self-protectionism
of the worst kind; retaining the “criminal standard” may
be interpreted as protecting doctors more than patients.
However, the fact that the GMC is clearly prepared to fight the Government
over the reforms is something for the Society’s Council at least
to note.
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The
Pharmaceutical Journal