The Pharmaceutical Journal
Vol 277 No 7419 p364
23 September 2006

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One solution to the Foster conundrum

By Chijioke Agomo

The Royal Pharmaceutical Society has at various times made clear its desire to modernise. The recently published report of the Foster review of non-medical health professional regulation seems to make this desire a reality. It has called for the Society to separate its regulatory and representative roles and to merge with the Pharmaceutical Society of Northern Ireland.

In response to this report many concerned pharmacists have put forward their views, and many of them appear to support the continuation of the Society’s dual role. However, Laura O’Loan (PJ, 26 August, p249) reported that participants at a Northern Ireland Centre for Postgraduate Pharmaceutical Education and Training “Influencing and persuading” workshop held on 14 May were of the view that there is the need to have an “appropriate representative professional body” with a dedicated “communication spokesperson”. Interestingly, Keith Ridge and Bill Scott, chief pharmaceutical officers for England and Scotland (PJ, 9 September, 2006, p313) seem to agree with Mrs O’Loan that, for the profession to move forward, the separation of the dual roles within the Society will be necessary.

Many pharmacists will be wondering what indeed is the best way forward for the profession, especially in light of the fact that the other major health professions in the UK — medicine, dentistry and nursing — are regulated and represented by separate bodies.

Regulation and representation abroad

Not too long ago, the Pharmaceutical Society of New Zealand, which for 124 years has regulated and represented the pharmacy profession there, gave up its regulatory role (PJ, 2 October 2004, p457). The reorganisation followed the NZ government’s Health Practitioners’ Competence Assurance Act, which became law on 18 September 2004 and brought in a new regulatory framework for all health professionals. The outcome was that the various interest groups in the pharmacy profession in NZ came together to form a representative body, the Pharmaceutical Society of New Zealand (Incorporated). The Pharmacy Council of New Zealand now regulates the profession. The move reflects an increasing global trend among professional organisations to separate regulatory and registration duties from professional functions (PJ, 2 October 2004, p457).

In Australia, the pharmacy profession is regulated at the state level. However, a national professional organisation for pharmacists — the Pharmaceutical Society of Australia, which is a federation set up in 1977 by the state professional pharmaceutical societies, provides a national identity for the profession. The PSA is the leading advocacy organisation for pharmacists in Australia, influencing attitudes, opinions and policies through representation, networking, etc.

The pharmacy profession in the US is regulated by the National Association of Boards of Pharmacy, with the state boards overseeing directly the practice of pharmacy within the states. The implication of this is that the laws that govern the practice of pharmacy in the US tend to vary from state to state. When it comes to representation of pharmacists in the US, the main organisation that performs this function is the American Pharmacists Association, which was founded in 1852 as the American Pharmaceutical Association and protects not just the interests of the profession but also those of the individual pharmacist.

In Canada, the profession of pharmacy is regulated on a provincial level, while the main representative body for pharmacists is the Canadian Pharmacists Association, founded in 1907.

In South Africa, the profession is regulated by the South African Pharmacy Council, while the Pharmaceutical Society of South Africa represents the profession. The 25 members of the SAPC are composed of nine pharmacists elected by pharmacists, 11 nominated and appointed pharmacists (nine from the provinces and two from the schools of pharmacy), one representative of the department of health and four appointed non-pharmacists from the ministry of health.

The situation is not much different in Nigeria where the Pharmacists Council of Nigeria, regulates the profession. The organisation representing the interest of pharmacists is the Pharmaceutical Society of Nigeria. Operating under the umbrella of the PSN are interest groups or associations, such as the Nigerian Association of Lady Pharmacists, the Nigerian Association of Hospital Pharmacists and the Association of Community Pharmacists of Nigeria.

Standing diminished

The need for pharmacists in the UK to have an independent representative organisation spearheading the interests of pharmacists can no longer be ignored. This point is further strengthened by David Miller (PJ, 9 September, p307), who highlighted that “our profession has been commercialised and our standing in the community diminished. While doctors have moved to second in the earnings table we have been relegated to 42nd place.” Although, one can appreciate the concerns of those against the formation of a representative body for pharmacists, the benefits to the profession as a whole seems to outweigh any drawbacks. Representative organisations bring vibrancy and motivation to a profession. Creating a representative body for pharmacists will help to raise the profile of the pharmacy profession in the UK and, therefore, put the profession in a better position to complement the other health professions as a health care provider. Moreover, the Government and the public perception of the profession will change positively. The duties of a representative body for pharmacists will definitely complement the roles already performed by the Society, in terms of ensuring that employers, pharmacists and their support staff provide the best quality of service to the public. This will ultimately help the regulatory body to focus entirely on its regulatory duties, which are becoming a lot more complex and are interrupted many times by genuine demands by the membership for better representation.

New UK body needed

Several models of representation and regulation of the profession have been proposed by different groups and concerned individuals within the profession, However, the Society seems to be happy with the model that allows national boards to be formed for the three home countries of England, Scotland and Wales. It is hoped that these boards will take on some of the duties of the Society, particularly in the area of representation. If the boards are to be truly representative of pharmacists from the home countries, then they will need to be given the opportunity to function independently. An alternate model will be to adapt the national boards to function as regulatory bodies in the home countries (due to differences that exists in the home countries), with a central body, for example, the Society, unifying the functions of the boards. Another body will then be needed to represent the interest of the profession and pharmacists in the UK.

Although, as Alan Kershaw wrote, “having a split is no guarantee you will get a good result” (PJ, 9 September, p313), at the same time not having a split cannot guarantee a good result in the future either. Whatever happens, it is important that the debate for which model to follow is not a long one, because the process is not only time consuming but also expensive. Studying other professions both here and overseas to see how their two bodies are able to co-exist without “confrontation between two bodies with separate aims” (Alan Kershaw, PJ, 9 September, p313) will be the best way forward. Finally, embracing the Foster report could actually help the pharmacy profession to produce a profession that is fit for the 21st century and works in line with the other major health professions in the UK.