|
John Gentle and Graham
Phillips are members of the
Royal Pharmaceutical Society’s Council
|
On 15 April 1841, Jacob Bell resolved to form the Pharmaceutical Society and ever since it has existed primarily to promote the interests of pharmacists and pharmacy. In 1933, the Society took on the statutory role of regulating the profession and the 2004 Charter and the impending Pharmacists and Pharmacy Technicians Order (Section 60 Order), under the Health Act 1999, aim to modernise these roles. In 2005, the Government asked Andrew Foster
to review non-medical regulation in the UK and we now believe that the
ramifications of this review make the Society’s historic dual role
untenable. For the benefit of the profession and its patients, we want
the Society to revert to the original vision of Jacob Bell.
The composition of the current Council arose out of the 2004 Charter.
Before the debate concerning this new Charter was held, most pharmacists
would neither have known nor cared what a Charter was, and many probably
still do not. What they may remember about the Charter debate is that
it caused a lot of trouble and the recriminations continue to rumble
on. The mistakes of past Councils, particularly with regard to communications,
have been learnt and readers have our assurance that this time it will
be the members who decide the way forward.
Those who formed the Society’s Modernisation Steering Group several
years ago must be amazed that the S60 Order, originally to have been
introduced in parallel with the Charter, has yet to be laid before Parliament.
There has been change after change from the Government and it has hung
around the the current Council’s neck like an albatross, taking
up a great deal of our time and energy as we have gone through it line
by line to anticipate possible future scenarios. It was not meant to
be like this.
Over a three-year period the elected membership of the Council was almost
entirely changed with pharmacists making it clear by the way they voted
that they wanted new faces at Lambeth — and that is what they got.
But the current Council, too, has been all but obsessed with Government
legislation of various kinds and this has severely impaired our availability
to address professional issues. The Privy Council has blocked several
initiatives and it seems sometimes that someone somewhere does not want
us to succeed. No one said it was going to be easy, and there is a determination
to deliver, despite the politicians and lawyers who appear randomly to
change course and look for reasons not to do the best thing.
The Government has had to deal with the aftermath of the Shipman Inquiry
and has had to be seen to be acting “in the public interest”.
As with other areas of the NHS, the harder it looks, the more problems
it finds and it decided on two reviews of regulation: Liam Donaldson
reviewed medical regulation and Andrew Foster non-medical regulation.
Things changed under the Charter and again under the S60 Order and then,
before any of this is implemented and before the Council has had time
to draw breath, things are set to change again under Foster. And this
time, the changes being proposed strike at the heart of our professional
body. What is at stake in the Foster review is the future of the Royal
Pharmaceutical Society as we know it.
Foster appears to want to deal with things as he would have them, not
as they are. It would be nice if we could pigeonhole all of the regulators
with one set of rules and one set of principles and one set of everything
else: in other words, “one size fits all”. The real situation
is not that simple and the Society is fundamentally different from many
other professional bodies and regulators. To thrive and prosper into
the 21st century, the profession must be allowed to develop its ideas
with a freedom to think and push back the boundaries of practice, to
develop and modernise ways of working so pharmacists at the cutting edge
of health care delivery can achieve their potential. The Society should
concentrate its resources and its efforts on driving the profession forward
so that the dreams of today’s students and leading-edge practitioners
become the reality for tomorrow’s pharmacists.
The successful “Save Our Society” candidates at three consecutive
elections did not get elected to give the Society away, nor did they
get elected to roll over and accept a regulatory agenda. In our view,
we must reflect the wishes of the members. To that end, if Andrew Foster’s
review insists that there should be an unelected majority on the Society’s
governing body, professional or lay, then the 18 pharmacists on the Council
must think long and hard as to their next move. To maintain control over
their own Society, the members must be able to elect the majority of
the governing Council, whatever the form that Council might take. Any
scenario that cannot guarantee that happening makes the Society a dead
duck as a professional body. We believe that the Council should float
off the regulatory functions of the Society to a newly formed “General
Pharmaceutical Council” allowing the Society to revert to what
Jacob Bell intended — a professional body that promotes pharmacy
and pharmacists’ professional interests whenever and wherever it
can.
This renewed Society would be freed from the dead hand of Government
regulation and would be able to set its own agenda. It would seek to
retain control over pharmacy education, setting standards for students,
preregistration trainees, pharmacists, continuing professional development
and, eventually, revalidation. It would set high professional standards
to be enforced by the separate regulator (our proposed GPC). It would
have a smaller council (30 is too many) but could still retain some lay
members.
At the most recent Council election, neither of us stood on a “Split
the Society” ticket. Both of us were convinced at the time of the
synergy of an integrated role. But, post-Shipman, times have changed
and the simple truth is that it is not working. Pharmacists are in danger
of being regulated to a standstill and we are woefully under-represented.
This benefits neither the profession nor the public. The Council should
not prevaricate over taking this decision. With the chief pharmacists
in England and Scotland and the minister in Whitehall not opposed to
a split, the window of opportunity to design such a separation may well
be short, and the favourable opportunities that exist at the moment may
well not be there forever.
It is not the principles of the elected pharmacists that have changed
but, to deliver for the profession, we will have to change the vehicle
for the delivery of those principles. It is time for all of those on
the Council to stand up and state their position. We can return to our
roots and focus on pharmacy and pharmacists or contrive a Faustian deal
to retain an illusion of a “dual role” with no influence
on the regulatory agenda save for a commitment to foot the bill.
In the near future, the Council will have to determine its position on
this issue or risk the Government doing it for us. It is a difficult
decision to take, but it may well become easier as the post-Foster scenario
becomes clearer. The retention of a regulatory role will almost undoubtedly
mean an unelected, lay majority on the Council. The Council will have
to make a recommendation, then consult with the members. Splitting the
Society would be a fundamental change. No Council has the right to take
the final decision: that is for the members alone. |
The
Pharmaceutical Journal