The Pharmaceutical Journal
Vol 280 No 7498 p484-485
19 April 2008

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Clarke Inquiry

Scotland gathers to discuss Clarke

Pharmacy’s future professional body has to be seen as a new body and it has to be focused on members, according to Nigel Clarke, chairman of the Clarke Inquiry.

“The starting point is that it must generate its core income from membership fees and, if it has that in mind, then its focus will be on membership services from the word go,” he said.

“It must have a package of membership services that are attractive to members. It has to be valuable: don’t think in terms of cost but in terms of value,” he explained.

Furthermore, services will have to be delivered at an appropriate level within the new organisation: in other words, taking notice of devolution. “It will need to respect that fact of devolution. To present Scottish pharmacists with things that are appropriate for English pharmacists is pointless,” he said.

This means ensuring that issues are dealt with at a devolved level and only pushed back to the centre when necessary. “I make the point loud and clear here [in Scotland] that policy development is a national exercise. Policy development happens at different places in the UK these days and the professional body must be able to respond to that,” said Mr Clarke.

He suggested that more should be done through the national boards and that the boards need greater autonomy than they currently have. “The national board level is the level at which liaison with governments needs to take place,” he said. “There may be some GB-wide council papers but, on a day-to-day basis for NHS policy, it is logical for boards to perform this function.”

However, Mr Clarke cautioned: “I should stress that the real challenge for devolution is not Scotland and Wales: the real challenge is England. It is so much more difficult in England to work out what to provide in different regions, how to do that and how to do that in a way that is cost-effective.”

On membership numbers, Mr Clarke said that the new body should be aiming for a figure of 70 per cent, something he said is achievable since other professions have professional bodies with memberships of 85 per cent, even when membership was not mandatory. He suggested that if membership of the new professional body were low, it might not to be able to provide the services that a professional body would need to offer.

Asked about the assets of the Society, Mr Clarke said that it is important to remember that the Society still exists and, if nothing happens, will still exist after 2010 when the General Pharmaceutical Council takes over regulatory functions. He noted that the Society’s Charter is permissive; it does not require the Society to carry out regulatory functions.

Inquiry’s findings reflect views of pharmacists

“People want to see the Society split. People want to see a professional body unfettered by regulation. They want this to happen,” said Rose Marie Parr, chairman of the Scottish Pharmacy Board.

Dr Parr said that the Scottish Pharmacy Board broadly welcomed the Clarke Inquiry’s report, noting that it clearly reflected the views of the profession. She added that the board was pleased that the inquiry recognised that devolved government must be reflected in the new professional body’s functions and structures.

“The new body has to reflect devolution. Devolution is about different health policies between the different countries. We have different policies and different ways of working,” she said. “Not to have devolution within the new body is not affordable because people won’t join.”

Explaining why the Scottish Pharmacy Board had organised the meeting, Dr Parr said: “The professional body is about development and leadership. And that’s why today is about leadership.”

However, the challenge now is how to engage the rest of the profession. “How do we engage those pharmacists who are not involved in the debate? We need them to join us. This is a long journey and we are just at the start of it,” she said. Part of the Scottish Pharmacy Board’s plan to engage pharmacists is a series of road shows planned for May and June 2008 (see News, p458).

Dr Parr emphasised the importance of involving pharmacists: “The transitional process is about getting grass-roots pharmacists to join the new professional body because the body delivers what they need and what they want. If there is apathy, then the process has failed,” she said.

Dr Parr went on to highlight issues within the Clarke report that required more thought in order to stimulate debate during the meeting’s workshop sessions (Key points made during workshops are discussed in the Panel on p485.) The issues were:

• Membership categories

• The proposed forum of prescribers

• Local support networks (Dr Parr added that this did not mean branches since the branch network is not currently working in Scotland)

• Education and training

• Structures (eg, the national boards)

• Autonomy for national boards

• Creation of a federal model

In conclusion, Dr Parr said there is potential to create a new professional body to bring coherence and strength to the whole profession.

“For me, the big question is can we create a professional body that is about a clinical profession? If we can, then we have achieved a good outcome,” she said.

Chief executive says the Society needs to change

“It is very clear to me that the Society has to change,” said Jeremy Holmes, Chief Executive and Registrar of the Royal Pharmaceutical Society. Mr Holmes explained that there are three main ways in which he believes the Society has to change. “The first way is that we have to be more collaborative,” he said.

“It is a telling piece of history that a number of the smaller organisations in pharmacy spun out from the Society when their members thought that the Society was not delivering their needs. We need those organisations to coalesce now to form the new professional body.”

The second change is to develop a sharper member focus, Mr Holmes explained. He said that this had been difficult when the Society has both regulatory and supportive functions.

“We are just embarking on a fundamental reorganisation within the Society so that we can clearly separate regulatory activity from professional leadership activity. This will start in May,” he said.

The third change is to deliver something valuable to members. “I was impressed by the manifesto for pharmacy developed in Scotland for MSPs [members of the Scottish Parliament]. This is a text book case of creating something tangible and we need to do more of that,” he said.

The next step in the process of forming pharmacy’s new professional body is the establishment of a transitional committee to oversee the process. “The General Pharmaceutical Council will be in operation by 2010 and I agree that this should be the target date for the new professional body. So we need to get going on this,”

Mr Holmes said. He explained that although the Society will convene the transitional committee, it will have an independent chair. “I am absolutely clear about this. And it needs to be a committee that the whole profession has ownership of and commitment to,” he commented.

The proposed transitional committee will have a core membership of pharmacy bodies that want to become part of the new professional body and a reference group of other stakeholders that have an interest in the new body. A key task of the transitional committee will be to produce a prospectus so pharmacists can see what the new professional body is about, he explained.

In the meantime, the Society’s Council will meet on 23 and 24 April to formulate its full response to the Clarke Inquiry. Mr Holmes said this will be published before the Society’s annual general meeting on 21 May 2008.

On finance, he noted that the costs of the new structure will not be cheap and will have to be balanced against what people are prepared to pay. But he suggested that if a valuable product and suite of services that are useful for the profession is produced, then people will pay to be members of the new body.

Federal structure has different meanings

Hemant Patel, President of the Royal Pharmaceutical Society asked the audience to think about was the concept of a federal structure.

“The Scottish Pharmacy Board has talked about a federal structure. But this means different things to different people,” he said. Mr Patel asked the audience to consider what a federal structure meant, what it would look like, how it could be financed and how it would fit with the branch structure.

Future professional body must be strong enough to speak up

Closing the meeting, Frank Owens, vice-chairman of the Scottish Pharmacy Board, concluded: “We want a strong professional body for the future. One which can speak with authority, one which has the support of its members, one which, importantly, is independent of Government, which will seek to work collaboratively with Government where possible but is also strong enough to speak up and disagree with Government and/or other professional groups when we believe decisions are not in the best interests of patients or the health service.”