Posted by: Anas Hassan18 SEP 2013
A year today, Scotland will be voting in a historic referendum on independence. The decision next year could fundamentally change the make up of these islands for ever if Scotland votes to end the union with the rest of the United Kingdom. And the pharmacy profession is not immune to what might happen in twelve months time.
I might be wrong in saying this, but I believe I am the first pharmacist across the UK and from Scotland to very openly explore the subject of Scottish independence with relation to the pharmacy profession north of the border. And I refuse to apologise for doing so. There needs to be a debate now about the issue because pharmacy will have to adapt to any potential changes that may take place.
Although current polls show that a majority of people north of the border are against the break up of the United Kingdom in Scotland, a turnaround is possible. The Scottish National Party, who currently govern Scotland, were well on the way to a humiliating defeat in the 2011 Scottish Parliamentary elections until they pulled off one of the most stunning comebacks in British political history. It was so good that they even won an overall majority of the seats available in the Scottish Parliament at Holyrood, in an electoral system where it is almost impossible for a single party government to be formed. And, ironically, Alex Salmond MSP, the current First Minister of Scotland, was declared as "Briton of the Year" by The Times newspaper.
But what will Scottish independence mean for pharmacy? Well one can forecast that not much will change. And the reason for this is because health policy is already devolved to Edinburgh.
Prescriptions are free of charge for people who live in Scotland, although the same can be said for people who live in Wales and Northern Ireland. In England, unless you are exempt, you have to pay for your medicine. But would such a policy be sustainable under independence? The cost of medicine could rise under independence due to the newly established economic environment of an independent Scotland. Factors such as the economic policy of an independent Scottish Government, interest rates and currency will make a significant contribution to the economic direction of the nation, especially the last one. Scotland, like Australia and the Republic of Ireland in past times, may well continue on with the Pound Sterling - yet that is uncertain. Scotland may have a currency of it's own or even join the eurozone.
And could patients even have to pay a fee to see their GP for an appointment? This is certainly not unheard of across the Irish Sea. It will depend on what priorities an indepdenent Scottish Government set for health north of the border. Personally, I don't forecast much change as health policy has always been set independently in Scotland for nearly fifteen years now although affordability and the health budget will count for a lot under what is likely to become a changed economic environment that an independent Scotland may have to face.
But what about the pharmacy profession itself in an independent Scotland? Well there's no doubt that Scottish pharmacy is wealthy with talent and prestige. So prestigious in fact that the achievements of pharmacy are recognised all over the UK and internationally. Devolution has brought out the best in Scottish healthcare, particularly pharmacy.
Our community pharmacy contract is celebrated, recognised and envied all over the UK and internationally. The fact that Scotland has innovated and sustained a unique contract for community pharmacy could never have happened without the return of the Scottish Parliament.
We also have two of the finest schools of pharmacy across these islands at Robert Gordon University in Aberdeen and Strathclyde University in Glasgow, producing pharmacy gradutes of an exceptionally high quality. Hospital pharmacists play a major part as part of a multidisciplinary approach within the NHS in Scotland and are widely respected for their expertise and clinical skills. They also benefit, alongside their colleagues in other areas of pharmacy, through access to continued professional development and education programmes from organisations such as NHS Education for Scotland.
And Scotland's pharmaceutical industry, particularly the area of research and development, is one of major strength with a competitive edge, putting them on par with the rest of the world. It can be argued that Scotland, as part of the United Kingdom, is benefiting economically and that the strength of the union enables economic stablity in order for the pharmaceutical industry to flourish.
But what if corporation tax was dramatically cut under independence? There is no doubt that business would find this incredibly attractive and a low rate of tax could allow industries such as the pharmaceutical sector to flourish. This could see additional investment and a growth in jobs. Pharmacy contractors could also benefit through paying a competitive rate of tax and being able to hire more people. A more competitive business environment could even have the answer in solving the emerging crisis a lack of jobs for pharmacists.
And would the General Pharmaceutical Council continue to be the main regulator for pharmacy under an independent Scotland? Well this is technically possible and the GPhC could well operate as the regulator across the border. But there is no ruling out the possibility that a new regulator may have to be established in an independent Scotland. It'll be interesting to see if an independent Scottish pharmacy regulator would have different priorites in comparison to the rest of Britain.
And what about the Royal Pharmaceutical Society? Will it have to be dissolved in Scotland if the United Kingdom comes to an end? There's no doubt that an equivalent Scottish organisation may well emerge in it's place. But it's also not wrong to imagine the possibility of the continued presence of RPS in an independent Scotland, especially if the Queen remains the head of state.
To sum it up, the next twelve months are uncertain. Nobody, not even supporters of Scottish independence, know for sure how things will turn out if the union comes to an end. If Scotland votes for independence then many matters will have to be negotiated between London and Edinburgh. Scotland should be independent by 2016 if approval is secured and negotiations end successfully.
But whatever the outcome, now is the time for us all in pharmacy to start discussing what the whole constitutional debate means for the future of the profession and healthcare provision.