To my mind, it would be, perhaps, understandable if the incumbent national pharmacy boards and Assembly of the Royal Pharmaceutical Society were keen to steer a course comparatively different in direction from the inertial legacy bequeathed by the antecedent ruling, corporate-led Council. However, in looking to our future (PJ, 2 october 2010, p368), we must not neglect our roots.
Charter
Crucial to the Society’s existence is the obligation under what is now object 1 of its Royal Charter: “To safeguard, maintain the honour, and promote the interests of pharmacists in their exercise of the profession of pharmacy.” The roots of how the present wording of this object came about can be traced through the origins of the Supplemental Charter of 1953, whereby (inter alia) the Charter was revised circumspectly in light of the Jenkin judgment of 19201 to reflect the reality of an increasing proportion of employees within the pharmacist membership.
Sydney Holloway (PJ, 8 June 2002, p809, and 13 December 2003, p810) and Jonathan Buisson (PJ, 19 April 2003, p554) have explained in detail how this was influenced by the wording of the British medical Association’s memorandum of association such that the Society could act thenceforward within the scope of its Charter to represent all of its pharmacist members, including employees, without fear of reprisal. it seems to me under today’s wording that, rather than restrict its representations to members, the Society must represent the pharmacist profession as a whole — including members and non-members — but must not act to represent non-pharmacists, even if they become members under any category, lest this should be open to question as being outwith the scope of its Charter.
This Charter object was central again when, in finding against the Society in the Dickson judgment of 1968,2 the Law Lords nonetheless made clear that the Society could act to restrict or impose conditions on commercial practices so long as this could be justifiable as, in the words of Lord Hodson, “reasonable in relation to the objects of the Society” and as, in the words of Lord Morris, “either necessary or desirable for the purpose of maintaining the honour of members or for the purpose of promoting the interests of members when in serving the public they are carrying on the profession of pharmacy”.
The potential importance of this object in representation may be inferred from the extraordinary peregrinations by the Society Council. Apparently in thrall to the regulatory whim of the New Labour government, the Council attempted — in reaction to the Bristol Royal Infirmary Inquiry of 2001 — first to relegate the object to the status of an optional power and later to rewrite it to remove reference to members or to pharmacists except, eventually, “to support [their] professional interests” (PJ, 18 October 2003, p561, 13 December 2003, p826, and 20/27 December 2003, p839, etc). These moves were within a suite of Charter changes that were to be imposed in the face of opposition from some pharmacist members. The proposed changes were averted at the considerable expense of a concerted political and legal campaign to “Save our Society” (PJ, 24 May 2003, p729), culminating in the agreement of the Supplemental Charter of 2004 (PJ, 17 July 2004, p95). Compromises reached on much increased “lay” representation within an expanded Council to retain governance over both regulation and professional representation — and ensuing conflicts as forewarned by the young Pharmacists’ Group (PJ, 29 June 2002, p906) and by 11 Society past-presidents (PJ, 6 July 2002, p15) — paved the way for the perhaps inevitable separation of 2010.
I consider it worth remembering at this time that, had those Charter drafts from 2003 reached fruition, then proposals for new membership categories, such as for pharmaceutical scientists, could have been submitted for Privy Council approval in the same way as was the December 2003 draft Charter, without the need for the consent of the membership.
The new Society
I welcome the encouraging news of a substantial majority of pharmacists renewing their memberships of the Royal Pharmaceutical Society (PJ, 2 April 2011, p393) and would urge those who have not already done so to join their colleagues. The present administration, comprising the national boards and Assembly, has performed commendably in the few short months thus far, in my view, to steer a new course for the Society at long last to represent its pharmacist members, for whom it exists. However, if one were to compare this process with the reversal of a runaway train that had been heading off the rails then it would be clear that much more time and hard work is needed.
While seeking to give due weight to the interests and concerns of pharmacists working across all sectors of the profession, the Society must do as it did during the time between the Jenkin judgment and the 1953 Charter in recognising the changing demographics of its target membership. Most pharmacists who face patients on an everyday basis in their work today are far more likely to be engaged as employees or as self-employed locums.
Issues to address
The most formidable professional issue impacting on those from this majority who work in the community sector, in my experience, has to be the workplace conditions that are far too commonly endured. The commercial imperative is to provide ever more “services”, many of which seem of little relevance to pharmacy, on top of ever greater floods of prescriptions, and with scant opportunity for statutory rest breaks free from responsibility.
Also, pharmacists have to make do with the help of support staff who, in my experience, have more often than not been employed in fewer numbers and are all too often unqualified or “in training” due largely to a combination of staff turnover and regulatory reluctance to get involved in this area.
The continued delivery of pharmaceutical services, as workload and conditions have become strained ever nearer to breaking point, can only attest to the professionalism and assiduousness of patient-facing pharmacists.
These conditions may seem more akin to third world sweatshops than to a suitable infrastructure for the delivery of professional healthcare services. Yet surmising from what we have heard so far from the General Pharmaceutical Council, I am far from encouraged that it has the will to take on the non-pharmacist owners, shareholders and management who now control the bulk of premises.
Many disaffected pharmacist members may allow the Society only a year or two before expecting tangible returns for their hardearned money. In this present situation, the unedifying spectacle of a faction of members trying to oust an elected representative (PJ, 22 January 2011, p58 and p65, and 12 February 2011, p166), and the precipitate balloting on proposals to invite “pharmaceutical scientists” to join their own membership category of the Society despite the support of only 39 per cent of pharmacists responding to the consultation (PJ, 13 September 2008, p295), for me cannot be construed as prioritising the collective interests of pharmacists, both members and potential members.
No one to my knowledge expects the Society to act as a trade union, but it must act where potentially it could make a real difference, with the support of the unions, by leading on professional standards. It may have failed in its duties here when it had regulatory authority, but the GPhC’s reluctance to take over now may present a window of opportunity to open some degree of separation of the powers to write the rules for regulation from those to enforce them. In my opinion, the Society must play its trump card, following the guidance of the Dickson judgment, in producing professional standards to address these issues and in lobbying vociferously and tirelessly for their sanctioning by the GPhC in the interests of pharmacists and the public.
The modern Society must remember its roots and stand up and be counted if it is to attract and hold on to comparable numbers of pharmacist members to confer a representative mandate for years to come.
Mr Tyas is a committee member of the Locum Group, PDA Union. The views expressed here are his own and do not necessarily reflect those of the locum group or the union.
References
- [1921] 1 Ch 392. October 1920. Available at: oxcheps.new.ox.ac.uk (accessed 16 June 2011).
- [1970] AC 403. May 1968. Available at: oxcheps.new.ox.ac.uk (accessed 16 June 2011).
