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The Pharmaceutical Journal
Vol 269 No 7213 p278-281
31 August 2002

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Letters to the Editor

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Modernisation

Stifling of initiative and suffocation of innovation

From Mr R. Blyth, FRPharmS

The views of an eminent medical historian who died recently may be relevant to the present crisis facing the Royal Pharmaceutical Society. According to an obituary in The Times on 7 August, the burden of the work of Oswei Temkin, who died at the age of 99 years, was to emphasise the importance of ideas and that advances in medicine had been made by thinking doctors (as indeed, one could add, advances in pharmacy have been made by thinking pharmacists [aided, let us acknowledge, by thinking doctors on occasion] and advances in science by thinking scientists).

One of Temkin's heroes was Galen who claimed that the best doctor was a philosopher. As The Times said: "Owsei Temkin pursued and put into practice the implications of that claim."

It may be noted that Galen has been described as the last of the great classical physicians and as one who raised the art of healing from a rather discredited calling to the dignity of an honoured profession. In his works he codified the medical knowledge of the classical age and handed it on to future generations.1

I would contend that Temkin's conclusions are relevant to the present debate in pharmacy concerning the future regulation of the profession. Why do I take that view? Because I believe that advances are made in every profession by members of the profession, and not by lay people. Pharmacy is no exception. Developments in the profession, from Jacob Bell's time onwards, have been promoted by thinking pharmacists (aided from time to time by thinking doctors) — individual pharmacists within and outside the Council, on the staff of the Society and in the branches, and in practice.

The present enthusiasm on the part of the Modernisation Steering Group to embrace the dilution of the Council with lay people, as part of the new regulatory system, may stem from the Council's 1997 Banks report with its radical proposal, now embodied in the Byelaws, whereby the secretary and registrar need not be a pharmacist. That change seems to have undermined Council members' belief in the value of pharmacists as exemplified repeatedly since 1997.

I would also argue that a profession will not achieve development through excessive regulation. As a business commentator said in The Times recently, over-regulation and high corporate taxation have become a millstone for companies [in Germany] such as BMW.2

For politicians and their civil servants, regulations may be a large part of their raison d'?tre, but for the common man they are a necessary evil to be promulgated advisedly. If politicians and the implementers of their policies were seen to be competent one might have greater faith in the outcome of their interventions. But, as the Sunday Times said recently, referring to Government computer program failures, no one allowed for the dead hand of Whitehall".3 As The Journal seemed wisely to be suggesting last week, the Department of Health needs to tread warily with electronic transfer of prescriptions (PJ, 24 August, p236).

The present regulatory mania springs from the behaviour of certain individuals. But will regulations remove all incompetent practitioners or the mentally deranged whose unaccountable actions startle the nation from time to time? It seems unlikely. However, such hysterical reactions to events are no doubt examples of the well recognised political knee-jerk phenomenon. And the other political trap is the law of unintended consequences. The consequence of the present rush to regulate will be a stifling of initiative and suffocation of innovation.

References

1. Grier, J. A history of pharmacy. London: The Pharmaceutical Press; 1937.

2. Harrow, M. A grubby Wall Street affair. The Times, 17 August 2002.

3. Leading Article. The Sunday Times, 25 August 2002.

Robert Blyth
Milton Keynes, Buckinghamshire

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