Comments for this topic have been frozenFrom Mr G. S. Phillips, MRPharmS
We should be grateful to Nigel Clarke and his team for an excellent
report against a difficult background
and in a short timescale. It provides a helpful platform for debate as
the Royal Pharmaceutical Society
moves towards demerger.
However, Clarke inevitably failed to achieve “the Heineken effect” (reaching
out to the width and depth of our profession). I understand that fewer than
150 pharmacists in total attended his road shows. So he heard from the great
and the good (and the vested interests) but not the silent majority.
This will not deliver a professional body that enough grassroots pharmacists
will feel inspired to join, and pay for, voluntarily. A high (>70%) membership
by pharmacists is crucial. If that is not achieved how will the professional
body be financially viable or remotely credible as the voice of pharmacy.
The Society’s Council has no plans to simply go ahead and implement Clarke’s
60-plus recommendations. This is clearly recognised in the five-minute guide, “Plans
for new professional body pick up pace” (PDF 260K), sent out with
last week’s
PJ. So the next step is to inform and then listen to the members.
Pharmacists need to debate, to argue, to discuss, to conclude and, ultimately,
to vote on what Clarke recommends and the process has already begun. The Society
has all the tools for the job: branches, regions, special interest and sector
groups and, carefully enshrined within the 2004 Charter, the democratic process
that must be followed for changes on the scale proposed.
The use of technology,
such as the Society’s website, and pharmacist discussion groups, such
as Private-Rx, mean that not one of the Society’s 48,000 members should
be excluded from playing a part in the debate or, finally, from voting on the
proposals.
As I noted in the Council
discussion, (PJ, 3 May 2008, p543) one
of the notable absences in Clarke’s report is any consideration of alternative
options to a chartered body. This, too, must be discussed and agreed with the
members.
But time is short: the creation of two shadow bodies (a regulator and a professional
body) must be achieved by the end of 2009 if we are to meet the planned timetable
of formal demerger of the Society in January 2010. So we must move forward
with the process of transition, in parallel with consultation.
This is a professional matter and is, therefore, for pharmacists alone and,
logically, must be led by the democratically elected pharmacist members of
Council, working with other stakeholder bodies from within the profession.
It will be crucial, while simultaneously consulting the broad membership,
to include bodies like the UK Clinical Pharmacy Association, the College
of Pharmacy
Practice and the Institute of Pharmacy Management International, which have
committed themselves to merge with the new professional body. Council must
also ensure the Society’s national boards play their key role here.
To give the process credibility and to ensure transparency it will be crucial
to appoint a neutral chair. Nigel Clarke, and no criticism is intended here,
cannot perform this role since, otherwise, the transition process will be
seen simply to rubber stamp the
Clarke report.
There is an interesting parallel here with the Carter report. Lord Carter’s
helpful recommendations have been the basis for further debate within and
without the profession.
But it is Ken Jarrold, not Lord Carter, whom the Government
chose to chair the current Pharmacy Regulation and Leadership Oversight
Group, which is overseeing the establishment of the new regulator for
pharmacy,
the
General Pharmaceutical Council.
The Society is working hard to get closer to its members. This is a golden
opportunity to help achieve this crucial objective.
Graham Phillips
Member of Council and Chairman, Public Affairs Planning Group
Royal Pharmaceutical Society
From Professor H. McNulty
The Institute of Pharmacy Management (IPM) has some suggestions to help the transitional committee take the Clarke report recommendations forward. The following need to be considered by or under the jurisdiction of the transitional committee in addition to the development of a prospectus:
IPM believes that given the above, the time lines proposed for establishing the new body pose significant risk to members, to the regulator, to the professional body and to the public. It can take many months to recruit to senior positions and the plans, structure, governance, titles, duties and function of the posts have to be developed and agreed.
IPM Council is very pleased to see that the Clarke report believes “that the case that management advice is a legitimate area for consideration by the professional body is a compelling one”. IPM suggested a broader role than the management advice.
IPM Council proposes a modification of recommendation 26 for consideration by the transitional committee: “The professional body should work closely with IPM (which might become an integral part of the organisation) to ensure that its members have better access to management qualifications, appropriate standards, education, training, CPD support and advice.”
IPM Council recognises there are organisations interested in or providing management support and would be pleased to hear from groups that share a similar vision. IPM looks forward to working with the transitional committee, The Royal Pharmaceutical Society and other organisations to help meet the challenges and demanding targets for both business planning and the management proposal.
Howard McNulty
General Secretary
Institute of Pharmacy Management InternationalFrom Mr D. A. Morgan, FRPharmS
We are disappointed, therefore, with the tone and content of the subsequent letter from Council member Douglas Simpson (ibid p688) querying the motivation of the college and the Waterloo Group organisations, which are committed to the same aims. We would like to assure Mr Simpson that he has no reason to feel threatened by the involvement of the college in developing the new professional body or by the college being one of the partners in the Waterloo Group. Our position, and that of the Waterloo Group, is accurately described in the letter from Mr Holmes. We totally refute Mr Simpson’s spurious suggestion that either the College or the Waterloo Group has plans to sequester the Society’s assets; indeed this has never been discussed.
The college was established by the Society in order to promote a high standard of pharmacy practice and it has never made a secret of its long-standing aspiration for a royal college for the profession. We have been open and transparent about our views towards establishing a new professional body. We have participated in the normal democratic processes both individually and in participation with the Waterloo Group. The public statements following the two meetings of the Waterloo Group were both supportive of the Society and the second one supported the recommendations in the Clarke Report. The college has declared from day one that it wishes to be incorporated within the new body and will continue to support the Society to achieve this.
Having seen the Society’s response to the Clarke Report, we recognise that there are a few matters which will require further debate, and we look forward to a constructive dialogue on these points. The college will continue strongly to support the Clarke Report’s recommendation, which promotes a broadly defined membership for the new body. In doing so, we recognise that it is of the utmost importance to make the new body relevant to generalist members as well as specialist members.
Finally, we fully support the Society’s view that there is a continuing need for dialogue and partnership working with other pharmacy groups and organisations and we should all seek to co-operate together to implement the new professional body. A win-win partnership is required and we would urge Mr Simpson to embrace this concept and join constructively in the deliberations of the Transitional Committee.
David Morgan
Chairman, College of Pharmacy Practice
From Mr G. Hall, MRPharmS, and others
There was no involvement of the Department of Health in convening the Waterloo Group. Following informal discussions at the United Kingdom Clinical Pharmacy Association 25th Anniversary Conference in the autumn of 2006, it was agreed that representatives of UKCPA, the Guild of Healthcare Pharmacists and the College of Pharmacy Practice should meet with a view to working more closely together. This was given added impetus by the publication of the White Paper “Trust Assurance and Safety” in February 2007, and it was agreed that there would be merit in involving other organisations in the meeting.
The deciding factor was the announcement that the Royal Pharmaceutical Society was to hold a meeting to discuss the White Paper, but that attendance was to be limited to its own regional and branch representatives. The Society subsequently reversed that decision and invited representatives of other organisations, but by that time arrangements for our meeting were at an advanced stage.
The meeting was held on 15 March 2007 at a neutral venue at Waterloo, London, hence the name of the agreement and the group. The Society was not invited, but the President, Vice-President and Secretary and Registrar were told that it was happening.
At the meeting, there was a remarkable degree of unanimity, and we were excited and energised by this. We wanted to publicise our agreement and, as a few of us had been invited to the King’s Fund seminar on 20 March, it was agreed that the college’s chief executive should seek an opportunity to make an announcement at that event. The Department of Health was contacted on Friday 16 March as a result of which the college chief executive received an invitation on Monday 19 March to make a short presentation at the seminar the following day.
The Waterloo Agreement, which was published by the King’s Fund in its report of the seminar, was supportive of the Society’s role as the basis for a new professional body, but with the involvement of other bodies as well, and that is still our position today. At our second meeting in March 2008, the Society’s Chief Executive was invited to speak, along with Nigel Clarke and Peter Noyce on behalf of the Pharmacy Regulation and Leadership Oversight Group. A report of the meeting was forwarded to the Society as soon as it was ready, it was publicised in the PJ and on the websites of the College and other organisations.
There is no question, therefore, of the Waterloo Group being secretive or subversive; in fact we have communicated openly with the Society, Department of Health and others about the meetings we hold, and our aspirations to engage positively with the development of a professional body which will support all of our profession wherever it may be practised.
There certainly is no suggestion that it should sequester the Society’s assets. In the absence of any evidence it is, therefore, at best mischievous that such a suggestion has been made.
Graeme Hall
Professional Secretary United Kingdom Clinical Pharmacy Association
Richard Cattell
President
Guild of Healthcare Pharmacists
Ian Simpson
Chief Executive
College of Pharmacy Practice
On behalf of the Waterloo Group
From Mr R. Dickinson, FRPharmS
It would be reasonable to distil from them a scenario that has considerable merit, ie, a pharmacist-only professional body, operating without a charter and providing services of real value to community pharmacists as well as to those practising elsewhere.
The views at the branch representatives meeting are a significant indication of how the majority of active members probably feel about whether pharmacists should have their own professional body. The arguments for inclusion of other professionals have been well rehearsed. I believe that the least convincing reason for such a decision would be that they would help to make the new body financially viable. Be that as it may, surely the next step is to find out whether or not the majority of individual pharmacists agree with the BRM resolution.
As to the maintenance of a link with the Privy Council through a charter, this was of first importance when the Royal Pharmaceutical Society was acting on behalf of the government in the regulation of the profession. These duties have been forcibly removed from the Society, a decision I deplored. Those pharmacists who welcomed this change emphasised the Society would now be free from any restraints when representing the best interests of pharmacists and that it could now be completely independent.
I know from experience that on matters to do with pharmacy the Privy Council works closely with the Department of Health. We have seen how the DoH has tried to influence the development of the new professional body. If it so wishes, the profession now has the opportunity to remove the influence of government from the internal workings of our professional body by severing the link with the Privy Council.
I am not surprised that the minority interest groups within pharmacy have expressed their views through the Waterloo group but the driving force behind the creation of the new body must be the membership of the Society as a whole. It is certainly not time for the Society to take a back seat.
A voluntary membership professional body for pharmacists will only succeed if its planned activities and services support the aspirations of the majority of pharmacists. As in the past, minority groups of pharmacists would decide whether they could function best within such a body or independently. I would hope that the new body would make every effort to create an environment conducive to the work of such minorities.
Raymond Dickinson
Former Deputy Secretary, Royal Pharmaceutical Society
Farnham, Surrey
From Mr G. S. Phillips, MRPharmS
I am grateful to Michael Schofield (PJ, 14 June 2008, p714) for putting forward the other side of the argument around chartered status and the role of lay members in pharmacists’ new professional body. This is the right time to be having this debate and creating such a debate was my prime objective in writing my article the week before (PJ, 7 June 2008, p687).
Professor Schofield’s arguments in favour of lay input and chartered status are founded upon three assertions:
1. That this will confer greater influence upon the professional body
2. That governance and public confidence will benefit
3. That lay members bring additional skills
I use the word “assertion” purposefully since Professor Schofield, despite the age of evidence in which we live, cites no facts to support his case.
Greater influence In my article I listed a series of examples of the Privy Council’s unwarranted interference in matters unrelated to regulation. This interference occurred despite the presence of 10 lay members on the current Royal Pharmaceutical Society’s Council. This is hardly compelling evidence of their great influence.
But the nail in the coffin for Professor Schofield’s first assertion is the fact that the Government rejected the arguments in favour of an integrated body and consequently decided to remove the regulatory role from the Society. This was despite considerable and very public opposition from a number of lay Council members. If this is evidence of the greater influence that lay members confer then I suggest we would be doing just fine without it.
Governance Professor Schofield provides more assertions but still gives no facts. He quotes the Nolan principles as if they and, by implication, proper governance are the sole preserve of the lay members. I reject these unjustified assertions and resent the implications, which I regard as a slur upon the professionalism of pharmacists.
In fact, my experience on the Council was quite the reverse of the picture Professor Schofield paints. Some lay members laid claim to “openness” and “transparency” but some behaviour I witnessed at close quarters appeared far from open, transparent or patient-centred. Professor Schofield himself admits that governance has been difficult at Lambeth despite the lay members’ presence.
More generally, I have had the opportunity to be involved in considerable work seeking the views of patients and the public, not only through the Society but also via local primary care organisations and my own pharmacies. Not once has anyone shown a shred of interest or even mentioned governance at Lambeth or the need for lay members.
What does interest the public (as the Government’s own research as background to the recent White Paper on pharmacy reinforces) is obtaining much more from pharmacists in the crucial areas of public health and medicines management. I want to see our new body deliver on the vision of pharmacists as patient-centred, medicines-focused clinicians.
We will need to count on strong patients’ voices, a small and dedicated expert staff and a small, visionary and dedicated Council of pharmacists to deliver this. What we do not need is a continuance of Lambeth’s lay-led regulatory obsession (let the new regulator deal with that) to hamper our progress.
Skills There can be no suggestion that all the necessary skills reside with pharmacists. Pharmacists’ new professional body must work in close collaboration with “internal” stakeholders (non-pharmacist pharmacy academics, pharmaceutical scientists and, of course, technicians) as well as “external” stakeholders (patients and the public, with all that entails) to have a chance of delivering on the vision.
The networks to which Professor Schofield alludes would undoubtedly be strengthened by effective public and patient participation. The skills to which he refers (marketing, financial management etc) will be provided by appointing the right expert staff. Thereafter any additional skills required could be provided by co-option or external consultancy.
The profession will decide. On this, if nothing else, Professor Schofield and I are in complete agreement. Hence I am seeking an immediate and public commitment from the Society to consult its members on this issue. The Society has been guilty of paternalism in the past, which has only served to distance it from the members. Now is the chance to promote a vision for our future and thereby to re-engage members’ hearts and minds. Time is short. I hope the Council will seize the opportunity.
Graham Phillips
St Albans, Hertfordshire
From Mr D. Solomon, MRPharmS
What has decided me against becoming a member of a chartered professional body is the doctrinaire way, without regard to evidence base or established best practice, that the Privy Council has interfered in the administration of our honourable profession. I am grateful to Graham Phillips (PJ, 21 June 2008, p747), among others, in helping me reach this conclusion.
I do not believe that it would be either in pharmacists’ or indeed patients’ best interests for us to pledge our allegiance to a body that would subject itself to such interference.
The argument about lay members is separate: those who have written in this journal would get my vote; some others would not. It seems to me that they, too, would have more freedom without a charter, and those with genuine interest in our profession might still be persuaded to serve.
David Solomon
Manchester
From Mr M. Williams, MRPharmS
Whatever their own personal views on the inclusion of lay members on the governing council of pharmacists’ professional body, both correspondents refer to the need for the profession to decide whether or not to pursue charter status and, as such, contribute to the start of an ongoing debate. However I am most concerned about Professor Schofield’s unsubstantiated assertion that “chartered status is valuable”.
Although one can accept the need for chartered status with lay Privy Council appointees in a regulatory body, Professor Schofield fails to persuade adequately the need for a charter for a professional body. It was the bitter arguments over the charter that led to actions in the High Court, before the Government eventually agreed a new charter with the profession in 2004. This was agreed on the basis of the Royal Pharmaceutical Society continuing as an integrated body combining professional and regulatory functions.
Less than two years later, with the wax on the Royal Seal barely set, the Government reneged on its agreement, effectively ending the Society as we know it, destabilising the organisation and the profession itself. One must ask what value Professor Schofield sees in creating an organisation that could allow a similar situation to occur in future.
One thing is for sure, and is alluded to by both correspondents: it is for the members (note, not registrants, affiliates or others) to decide which direction the profession takes. Under the current charter, pharmacists have the right to vote to accept changes to the organisation which could see its assets redistributed and its composition altered. If there is one value in having chartered status, it must surely be that.
Mike Williams
Solihull, West Midland
From Professor H. McNulty, FRPharmS
Mr Phillips suggests members need to consider all other options for a non-chartered body — but the nature of this body, its aims, objectives, powers are vague. It will take many months to establish and agree to these starting from a blank sheet of paper; time is not on our side.
Why members should take any more notice of another consultation is unclear, with the risk that at the end, we could have a few hundred responses. We could then be in a situation where the General Pharmaceutical Council is about to be established and there is no body for it to work with, Royal Pharmaceutical Society expertise, networks and services could be lost and any alternative body could take years to become established in a vacuum.
A crucial factor to consider is that for any such new body to receive RPS resources, the current Council must be convinced of the merits of and member support for the new body. Another factor is the credibility of the body with the new regulator. How will this be achieved by dropping the charter? Losing a royal society title that is worth millions in marketing terms and one that many other professions would die for, is a high risk strategy.
Lay membership and technician involvement were covered by the Clarke inquiry, which has already made recommendations based on the responses received. It is unclear why the responding members’ views on these subjects are now unacceptable. The Council was elected by only 16 per cent of members, but that doesn’t mean the results are not valid or another election is needed. The arguments made against lay membership on the Council are based on personal experience of a mainly regulatory role for it, with 10 newly appointed lay members.
The Privy Council has much less interest and involvement in non-regulatory professional bodies. As examples, the royal medical colleges and the Royal Society of Chemistry have charters and no lay membership. However, as the public view can often help focus the profession’s perspective and aid the public interest, perhaps we could pioneer. There were few concerns with a much smaller lay input (three members) in the past.
The technician debate is confused by the unqualified use of the word “membership”. It is entirely possible to allow them and other non-pharmacists a different level of membership or affiliation, with lower fees and restricted voting rights and Council input, but with access to membership benefits and networks. It is against pharmacists’ interests to propose that technicians, who will also be regulated by the General Pharmaceutical Council, should establish their own body and work separately with the regulator. If there is to be clear leadership of the profession and practice of pharmacy we need to work together.
An example of how to do this is the Institute of Physics, which has six membership categories of which honorary fellows, fellows and members are known as corporate members while the associate members, students and affiliates are non-corporate members. Its council has up to 25 members of whom 16 (64 per cent) are elected by corporate members. Six are elected from branches, divisions and groups, and its council has the power to co-opt up to three further members. Thus, physicists are always in the majority and there is also no defined lay specification.
We must proceed at full speed to consider the results of the Clarke consultation and get the new professional body under way to have any chance of success. Members will get their chance to vote and comment. Based on past experience of voting and earlier consultations, actually getting them to do this will be a major challenge.
Howard McNulty
Glasgow
From Mr M. A. Walker, MRPharmS
Is this what most pharmacists want? Do pharmacists agree to the assets being diverted for these uses? What happened to the professional representation of pharmacists, as the raison d’être of our new professional body? Let us not forget that it is this need that most grassroots pharmacists see as the over-riding function of the new professional body. It is sadly missing from the current Society. Mr Clarke, Lambeth staff, the Waterloo Group, the good and the great, etc, appear to be unaware that a two-thirds majority of members is required for any major change to the Society. Why will they not listen to the grass roots of the Society, concerning the formation of the new body?
I trust that members realise that Council controls the Society’s considerable assets and, if not, here is a warning. I do not expect that the current membership will hand over tens of millions of pounds of assets to a rebranded Society led by the Waterloo Group. If pharmacists allow that group to determine our professional future then the Society’s assets will be lost to the vast majority of pharmacists forever. Most pharmacists will be left without a representative body, a disastrous result.
What will happen when the vast majority of members realise that the assets are threatened? History shows us the fate of the Hawksworth Council, supported by Michael Schofield, when they did not include the phrase “promote the interests of pharmacists in their exercise of the profession of pharmacy” in a draft Charter. I hope we avoid a similar debacle.
I fully appreciate why members have ignored the recent Council election — only 16 per cent voted. Why bother to vote? Does anyone in Lambeth really expect that many members will renew a voluntary membership if that body does not have the professional representation of pharmacists as the main function? When working as a change consultant, I knew that the person paying the bill was the customer, also that time is required for successful change. The voluntary membership fees of pharmacists and revenue from the assets will be the main income of the new body, so members are the ultimate customers. I trust that the President is aware of who his real customers are and will not be deafened by Lambeth voices.
Pharmacists must be given sufficient time to turn the Society into a representative body with the assets fully intact, and I hope our President will be able convince the Government appointed members of the Council to “butt out” of the Transitional Committee. Speed or rushing to form a new body could lose members and put our considerable assets at risk. Please note that transforming the Society to coincide with the creation of the General Pharmaceutical Council is not critical. However, creating a professional body, which pharmacists choose to join, is the absolute key to success.
Mark Walker
Oxford
From Mr S. J. L. Churton, MRPharmS, and Mr J. Holmes
The current Council of the Royal Pharmaceutical Society takes collective responsibility for its decisions and the input of the lay members to those decisions is highly valued. The form of incorporation of the new professional body and the composition of its governing body are not yet decided, but are part of the remit of the Transitional Committee. That committee, under the independent chairmanship of Nigel Clarke, has been set up to advise the Society’s Council and other bodies committed to the process on the membership, business plan and governance of the new professional body.
The Society itself will shortly be running a survey via The Pharmaceutical Journal on key issues relating to membership of the new professional body. The prospectus, which results from the advice of the Transitional Committee towards the end of this year, will then be given the widest possible circulation. The associated consultation will aim to ensure that the final design of the professional body has comprehensive support.
Steve Churton
President
Jeremy Holmes
Chief Executive & Registrar
Royal Pharmaceutical Society