But what about Britain?
Since publication of the Foster review, pharmacists have been debating
whether or not the Royal Pharmaceutical Society of Great Britain
should split into two bodies: one for regulation and one for representation.
Fear of the unknown is a barrier to such a division, with even
those in favour of change wary of unforeseen consequences. So there
is
much to learn from recent events in New Zealand.
Since the split of the Pharmaceutical
Society of New Zealand has clearly been a success, it is perhaps
surprising that Chris Budgen, president of the PSNZ, has reservations
about a
similar division of the Society in Britain. “My concern is securing
the financial future. The Society already offers a lot of professional
resources and these would have to be slimmed down if its financial
position was put in jeopardy,” he says.
If the Society were to lose its regulatory role and thus depend on
its membership numbers for income then this could threaten financial
security. But if the Society could achieve financial independence
through another means, for example through its publications, then
it could
confidently continue to provide professional services. “The Society
currently needs the security of its regulatory role, particularly because
the National Pharmacy Association is so strong. But if, and only if,
the Society could achieve a guaranteed income then a split would be
good thing for pharmacy,” Mr Budgen concludes. |
In September 2004, the NZ government legislated against self
regulation of health professionals. It perceived self regulation to involve
a conflict
of interest. The consequences for the Pharmaceutical Society of New Zealand
were stark. Its dual
role of regulation and representation could no longer
continue (PJ, 16 October 2004, p555–6).
So, from the old PSNZ came two new organisations: the Pharmacy Council,
which regulates the country’s 4,000 pharmacists, and the new PSNZ,
which has both representative and professional roles. (Although the new
organisation is called the Pharmaceutical Society of New Zealand Incorporated,
it is still commonly abbreviated to PSNZ.)
Chris Budgen is president of the PSNZ. He says the split has been a good
thing for pharmacy in New Zealand. “The PSNZ has become a stronger
voice for pharmacy, unshackled from the regulatory function. It is a
body now strongly focused on advocacy and, in a changing primary health
care environment, the profession needs it more than ever,” he explains.
Cynics might argue that these are the words one might expect from the
new organisation’s president. But the evidence is unquestionable:
90 per cent of NZ pharmacists have voluntarily become PSNZ members.
New organisation roles
Dividing an organisation presents significant challenges. So, which
organisation does what? The Pharmacy Council’s roles are to: · Register pharmacists
· Ensure pharmacists are fit to practise
· Set standards for pharmacy education and competence
· Protect the public
Ensuring pharmacists are fit to practise encompasses a number of functions.
These include checking that pharmacists maintain competence, accrediting
programmes for ongoing competence and considering the cases of pharmacists
unable to perform the required functions. Should disciplinary action
be required, the pharmacist is referred to the Health Practitioners Disciplinary
Tribunal, which acts as a disciplinary body for all health professionals.
The PSNZ’s roles are to:
· Provide professional advice and support
· Provide education and training
· Represent the interests of pharmacy to government and other organisations
To be a practising pharmacist in New Zealand, there is a requirement
to hold an annual practising certificate. In order to get one, pharmacists
have to be enrolled in an accredited recertification (or continuing professional
development) programme. This is where the PSNZ has been particularly
adroit. One of its flagship schemes is its CPD programme “Enhance”.
It is currently the only CPD programme accredited by the Pharmacy Council
and, as such, participation is in effect compulsory for any pharmacist
who wants to remain on the practising register.
Mr Budgen admits the importance of Enhance in securing members of PSNZ.
He comments: “The need to sign up for CPD was probably a significant
factor but I think there is an expectation now that the society will
do more for pharmacists and show more leadership now that it is not the
policeman.”
In fact, he thinks pharmacists were unaware of how restrictive it is
to be a regulator. “It is a funny situation to be in, you want
to do what is best for the profession but you have to take the professional
high ground even if you would prefer to take a more practical approach,” he
explains. “The society can do so much more now we are no longer
inhibited by the regulatory role.”
So what is it that the PSNZ can do now that it could not do before? “Pharmacy
in New Zealand is changing, with a move towards pharmacists being paid
for professional services rather than labelling bottles,” says
Mr Budgen. “It is a huge departure from the past so a major theme
of the new PSNZ is to encourage and support pharmacists to get moving
on new services.” He explains that pharmacists are already busy
and that this is compounded by a shortage of pharmacists. “Many
pharmacists think they haven’t got the time to provide new services.
My aim, through PSNZ, is to make it as easy as possible.” A series
of seminars and provision of practical advice are already offered, and
possible ideas for the future include a mobile support team to visit
pharmacies. “All this is possible because the professional role
is the entire focus of the new society,” Mr Budgen adds.
Not without problems
But such a massive organisational change has not been without problems.
Setting up the Pharmacy Council was resourced from the assets of the
old PSNZ, which put a financial strain on the new PSNZ in its first
year. This meant a cultural change for PSNZ staff and pharmacists alike. “Some
pharmacists had expectations of generosity in terms of things like
expenses from the society, which we had to tighten up on,” he
explains.
One thing the PSNZ was keen to ensure was that costs were not passed
on to pharmacists in fees. Before the split, the 2004 PSNZ retention
fee was NZ$695 (about £260) plus tax. This year, pharmacists paid
NZ$365 (inclusive of tax) to the Pharmacy Council and NZ$340 (inclusive
of tax) to the PSNZ.
Another change for the PSNZ is the need to compete for members. “We
simply have to meet members’ needs otherwise they will vote with
their feet,” comments Mr Budgen. That is probably why some tension
exists between the PSNZ and the Pharmacy Guild, the organisation that
represents the interests of community pharmacy.
Although the two bodies now meet regularly through the establishment
of a pharmacy co-ordinating committee, Mr Budgen says that there is an
overlap of interests which results in competition for membership. “There
is strong feeling within the profession that there should be one representative
body formed from the guild and the society. Extensive work on a merger
took place in the past but it was put on hold, although the subject is
still live at the pharmacy co-ordinating committee meetings.” |
The
Pharmaceutical Journal