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European Community 2007
European legislators have placed professionals’ rights to work in any European country above patients’ rights to be properly protected from deficient practice
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Pharmacists registered in other European countries will soon be able
to register with the Royal Pharmaceutical Society and work in Great Britain
as temporary or occasional visitors without being subject to the checks
on competence and good conduct that apply to domestic pharmacists.
The Society fears that this will put patients at risk (PJ, 16 June, p715).
European Union Directive EC2005/36/EC, which has to be implemented by
20 October, says that pharmacists registered anywhere in the European
Economic Area (EEA) can take temporary
and occasional work in any other member state without having to register
with that country’s professional regulator. Alternatively, national
legislation can require temporary registration, but it has to be granted
automatically and free of charge. This is the approach that the UK Government
has chosen to take.
The UK Government has also decided that UK requirements for pharmacists
to undertake continuing professional development should not apply to
foreign pharmacists taking advantage of the new system even though that
is not precluded by the EU directive if it can be objectively justified.
In fact, the Directive notes the importance of lifelong learning to professional
practice and says that it is for member states to adopt “detailed
arrangements under which, through suitable ongoing training, professionals
will keep abreast of technical and scientific progress”.
Despite this, the UK Government’s view is that any CPD requirements
would be an “unjustifiable restriction” on European freedom
to provide services.
Some checks will be required, but these are limited to matters relating
to professional conduct and specifically exclude non-profession-related
criminal convictions and disciplinary sanctions and any health-related
matters, such as drug addiction, alcoholism or mental
illness, that can impinge on professional practice.
Also, it will not be possible to replicate in the UK any practice restrictions
imposed on foreign pharmacists in their countries of origin because UK
law only allows practice restrictions to be imposed after fitness to
practise proceedings. But the Government has said that it might give
regulators discretion to consider breach of such conditions as grounds
for UK disciplinary action.
All these weakenings of public protection are exacerbated by the fact
that the directive provides no indication of what timescales are envisaged
by the words “temporary” and “occasional”. It
says that this should be assessed on a case by case basis in relation
to duration, frequency, regularity and continuity.
There are also concerns that the new rules continue the current prohibition
on regulators requiring EEA pharmacists to take a language test to prove
that they can communicate sufficiently well to practise safely. This
is despite the new EU Directive saying that anyone benefiting from recognition
of professional qualifications “shall have a knowledge of languages
necessary for practising the profession in the host Member State”.
The new rules are to be implemented in the UK by amending the Pharmacists
and Pharmacy Technicians Order 2007. Consultation on
the proposed amendments is under way and closes on 17 August 2007.
The proposed amendments would add a third section to the Society’s
Register of Pharmacists to list visiting pharmacists from relevant European
states. The same would happen to the Register of Pharmacy Technicians.
Registration would be valid for 12 months from the date of application
and would be renewable annually. It would automatically cease if the
visiting pharmacist or pharmacy technician ceases to be registered in
his or her home country or is prohibited from practising there.
Martin Astbury, the Society’s Vice-President, said that free movement
of health professionals was good for health services in Europe. But he
warned that the proposals for visiting EEA practitioners pose a real
risk to patient safety and could severely damage public confidence in
the profession.
Mr Astbury said: “In draft transposing legislation it appears that
this category of practitioner is to be exempt from the Society’s
CPD requirements. The Society would expect all practising pharmacists
to adhere to the same ethical (and soon to be statutory) requirements
regarding CPD and be subject to the same fitness to practise procedures
as UK registered pharmacists. Ensuring this is adhered to would be difficult
to manage if the legislation were to be passed.”
The Society’s concern that patient safety will be jeopardised is
shared by the Patients’ Association.
Vanessa Bourne, head of special projects, said: “Patients have
to assume that the person in a white coat has the right qualifications,
including a language qualification so they can have a safe consultation.”
She added: “Patient safety may well be compromised in the cause
of European union.”
Commenting on the proposed exemption of visiting professionals from CPD
requirements, Ms Bourne said: “That’s extraordinary. It’s
bonkers. That’s another example of the Alice in Wonderland approach
to patient safety in the NHS.”
Richard Marchant, head of regulation development at the General Medical
Council, said that another area of concern surrounded the inability of
regulators to ask for information about what work a practitioner intended
to do, where and for how long before granting automatic registration.
“The stance is that you can ask for it after registration,” he said. “But
if you’re not able to ask for it up front someone could be practising
for a long period under what is supposed to be a temporary provision.
If they’re working for a long time, you would want to apply revalidation
and CPD. Clearly, that doesn’t matter if they’re here for
a few days or weeks, but if they’re here for years that’s
quite important.”
Mr Marchant added that automatic registration could be refused if a practitioner
was prohibited from working in his home country, but if his work was
subject to restrictions, similar restrictions could not be replicated
here.
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The
Pharmaceutical Journal