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Letters to the Editor
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The Society
Lose the arrogance
From Mr B. D. Nathwani
I was appalled to read the answer given by the Royal Pharmaceutical
Society to the Disciplinary Committee when asked what two silent partners
common were alleged to have done wrong when the third partner had made
endorsement errors (PJ, 1 March, p235).
The reply was “that the Society did not have to answer” and
the Society referred the Disciplinary Committee to the Code of Ethics
for Pharmacists and Pharmacy Technicians.
This highlights the reason why so many have lost confidence in the ability
of the Society (both as a regulatory body and a professional body) to
engage meaningfully in simple, commonsense dialogue with any entity (individual
or statutory).
The code of ethics (item 6.8) to which the Society referred the Disciplinary
Committee also states that pharmacists should “respond honestly,
openly and courteously to complaints and criticism”. Would the
reply given by the Society to the Disciplinary Committee fall within
this ethos?
An aggravating feature of this case is that the members will have to
foot the bill for the Society?s incompetence. Can we be assured that
the individuals responsible for taking this case forward will face some
disciplinary action for failing to do their jobs properly?
It is of note that in its 2004–05 performance report the Council
for Healthcare Regulatory Excellence hinted that the Society may want
to “commission an external audit of decision-making at the Infringements
Committee stage for quality assurance”. It is even more galling
that the Society in June 2007 had the audacity to advise the General
Medical Council: “The Society considers that there should be an
independent audit, and report published on the use of undertakings as
a method of disposal.” Given that the Society understands and knows
the value of an independent external audit (for other regulators) as
best practice we can legitimately ask why has the Society failed to apply
this best practice of an independent external annual audit for its own
fitness to practise processes and cases.
Incidentally, Item 6.1 of the code of ethics also states that pharmacists
should comply with legal requirements, mandatory professional standards
and accepted best practice guidance.
Presumably this best practice, like many others, does not apply to the
Society or its staff.
Bharat Nathwani
Pinner, Middlesex
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JEREMY HOLMES, Chief Executive and Registrar, Royal Pharmaceutical
Society, replies: The Society does not normally comment on individual
cases, but
has decided to make an exception given the criticisms made by Mr Nathwani
in relation to one of the Society’s recent disciplinary cases.
This letter refers to a case involving “small pack endorsing” which
was heard by the Disciplinary Committee (sitting as the Statutory Committee)
on 7 to 11 January 2008. The case was brought against three partners who jointly
owned a pharmacy business. One partner was alleged to have endorsed NHS prescriptions
for Gaviscon liquid to indicate that small pack sizes had been dispensed, when,
in fact, large pack sizes had been dispensed. The Disciplinary Committee found
this partner guilty of misconduct and issued a reprimand. The case against the
other two partners was that they all had a responsibility under Part 2 of the
code of ethics, at paragraph A2 (a), to ensure the observance of all legal and
professional requirements in relation to the business, and therefore a responsibility
to ensure that the claims made to the Prescription Pricing Authority were accurate.
The information on which this case was based was received from the NHS Counter
Fraud and Security Management Service. The Society had a statutory duty to investigate
the allegations. These were properly considered by the Infringements Committee
and the Committee referred all three partners to the Statutory Committee. Given
the personal professional responsibilities imposed on all pharmacy owners by
the Code of Ethics, the Society considers that it was entirely proper for the
case to proceed against all three partners.
It is not correct that the Society “said that it did not have to answer” when
asked what the two partners were alleged to have done wrong. This issue was considered
at a case management meeting in August 2007 where the legal representatives had
the opportunity to raise any concerns. At that meeting, the Society clarified
the legal basis for the charges against the second and third partners. The case
then proceeded to a hearing before the Disciplinary Committee on that basis.
On the particular facts of this case, the Disciplinary Committee decided to halt
the proceedings against the second and third partners in the pharmacy.
The letter refers to the need for independent external audit of the Society’s
Fitness to Practise processes and cases. Since 2007 the Infringements Committee
has been replaced by the independently appointed Investigating Committee, members
of which have received extensive training. All disciplinary cases are subject
to the external independent scrutiny of the Council for Healthcare Regulatory
Excellence (CHRE). The Society is also subject to an annual performance review
by CHRE. The Society has been working for some time with CHRE and the other healthcare
regulators to devise an appropriate audit scheme. This work is now being taken
forward by CHRE and guidance, which will apply to all healthcare regulators,
is expected shortly.
The Society is committed to discharging its regulatory role in the public interest,
in compliance with all proper legal requirements and in accordance with best
practice, which is stipulated and monitored by CHRE.
The determinations in this case are available on the Society’s website.
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The
Pharmaceutical Journal