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Split and merge: a way forward for the Royal Pharmaceutical Society

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The Pharmaceutical Journal Vol 265 No 7110p263
August 19, 2000 Broad Spectrum

Split and merge: a way forward for the Royal Pharmaceutical Society

By Anthony Cox and Howard Fox

The publication of the NHS national plan for England is now a reality, and serious consideration is being given to the future of the regulatory functions of the Royal Pharmaceutical Society of Great Britain. We believe its days as a combined regulatory and representative body are clearly numbered, and the profession should have the self-confidence to separate these functions.
Professional self-regulation is under the microscope at the moment, following several high-profile failures by regulatory bodies to spot poor practice and to deal effectively with individuals. At the Guild of Healthcare Pharmacists weekend school - "Practising to perfection" - in April, Baroness Audrey Emerton expressed the view that health care professionals were "not good" generally at external scrutiny. She also warned about the discussion in government about the wisdom of continuing self-regulation. On July 17, the Independent newspaper forewarned that the national plan for the NHS would include a proposal to create an NHS disciplinary body which would cover all professions.
In the wake of the NHS plan it has now been announced that the Society is to be part of the new UK Council of Health Regulators, which is to be formed to fulfil the need for formal co-ordination between the health regulatory bodies. This new body will also include the General Medical Council, the successor bodies to the UK Central Council for Nursing, Midwifery and Health Visiting, and the Council for Professions Supplementary to Medicine, as well as the General Dental Council, the General Optical Council, the General Chiropractic Council and the General Osteopaths Council.

The end of self-regulation?

One particular note within the NHS plan could spell the end of professional self-regulation: "Were concerns to remain about the individual self-regulatory bodies, its [UK Council of Health Regulators] role could evolve." Perhaps pharmacy is in a good position, as throughout the years the Society's inspectorate and the Statutory Committee have shown an exemplary dedication to duty. Indeed, had the GMC adopted the Statutory Committee model, it is likely that self-regulation would not have become the issue that it is today.
Following the Independent's report, the Society's Secretary and Registrar stated: "One of the great strengths of the Society's arrangements is our inspectorate. This allows us to handle complaints personally and to resolve many informally, to the satisfaction of complainants." Also the Secretary expressed the view: "Our proposals for reform of our legislation, prepared in 1998, provide for greater lay representation, wider powers and more flexible sanctions. We believe that they would meet the justifiable demands of the public." The announcement of the national plan has been welcomed by the Society and it looks forward to working with the new UK Council of Health Regulators.

Persuasive argument

However, to many lay people the argument to remove self-regulatory powers from health professionals is persuasive, especially in the current climate. A desire by a profession to maintain self-regulation can be seen as self-interest to an outsider, especially when that regulatory function is maintained by a body, such as the Royal Pharmaceutical Society of Great Britain, which also serves a representative function.
The Society was founded in 1841 in order to protect the interest of the profession, and the supplemental charter of 1953 sets out its functions clearly. There are four main objects, which are, in brief, to:

  • Advance chemistry and pharmacy
  • Promote pharmaceutical education
  • Maintain the honour and safeguard and promote the interests of the members in the exercise of the profession of pharmacy
  • Provide relief for distressed persons who are members, who are related to members or who are students

Although these do protect patients in an indirect way by promoting best practice and education, they are all concerned with the representation of pharmacy and pharmacists, not regulation.
Since the Society was given its statutory function by the Pharmacy Act 1954, it has become increasingly confused about its role and has been unable to separate its regulatory function from its representative role. Can the Society even consider itself a representative body if it, for example, increases lay membership on its Council or has a Government-employed chief pharmacist on its Council as of right?
Having wider powers, increased lay membership and more flexible sanctions would finally demolish the fa?ade of its representative function: it will cease to be a representative body and become a regulatory body. Many members do not see the Society as a representative body, and the ongoing corporate governance battle could be attributed to this tension within the organisation.
If the Society and the profession wish to take forward professional self-regulation, and have a continuing desire to go on representing pharmacists, there should be serious consideration of the option of splitting the Society into a regulatory body and a representative body. This would help to clarify the distinction between the two roles.
We propose the Society should continue with plans to reform the inspectorate and the Statutory Committee but at the same time prepare to create the following bodies:

  • The Royal Pharmaceutical Society of Great Britain - to represent pharmacists, and to promote and advance all branches of the profession
  • The Regulatory Committee for Pharmacy - to provide a statutory function to protect the public (it should be formed from the Statutory Committee and the inspectorate and have greater lay representation, wider powers and more flexible sanctions)

Today, pharmacists are represented by a number of disparate bodies and our failure to promote the profession nationally is a result of this fractured lobby. Some in the Pharmaceutical Services Negotiating Committee and the National Pharmaceutical Association have recognised this and the two bodies recently attempted a merger. Although the attempt failed, a merger is still seen by some as the only viable way forward for pharmacy. Considering the small number of pharmacists in Britain, we are over-represented. Rationalisation would go some way towards improving the standard of representation that pharmacy and pharmacists obtain. Once the Society sheds its regulatory role it too will be in a position to merge, becoming the single parent body for all pharmacy organisations.

Missed the point

Some may feel threatened by our proposal to split the Society, but by planning to reform the inspectorate and the Statutory Committee without considering the problems associated with having both regulatory and representative functions combined, the Society has completely missed the point. This will be seen as a last-ditch effort to maintain the status quo by attempting to hold on to self-regulation come what may. The Society has missed the mood of the Government and the national plan. It should cease trying to maintain its present structure, grit its teeth and radically reform for the benefit of both patients and the profession.

Anthony Cox and Howard Fox are pharmacists from Sutton Coldfield, West Midlands, and Dorchester, Dorset, respectively

Citation: The Pharmaceutical Journal URI: 20002559

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