Andy Gray
Of the many phrases which have come to represent our times, perhaps none has quite the resonance of Harold Macmillan’s famous "The wind of change is blowing through this continent", delivered on 3 February 1960 to a joint sitting of both Houses of Parliament in Cape Town.
Perhaps less well-known is the final sentiment of that great speech: "Let us resolve to build, not to destroy, and let us remember always that weakness comes from division, strength from unity".
We are engaged in this country in building a brave new version of a national heath system, one based on geographical districts rather than isolated health facilities. The promise is to provide an accessible primary health care system, of good quality. More importantly, the promise is to ensure equity, so that similar services can be delivered irrespective of location.
The obstacles to such a promise are myriad, but perhaps the most intractable is that of providing sufficient staff of the appropriate calibre at the points of greatest need. In that respect, Pharmacy is no different to Education. We also face the prospect of redeployment of personnel. We also bemoan the inability of government to provide incentives that will attract and keep staff in rural and under-served areas. We also seek to build the new without so weakening the old that the entire edifice collapses. To forcibly relocate staff from tertiary institutions to remote district hospitals would most probably increase the flow to foreign climes which is already a factor.
Thus, while we welcome the announcement that Pharmacy is to be included in the second wave of professions called upon to complete Community Service, most probably in 2001, we must continue to advocate structural changes which will build permanent rather than transitory capacity in district-based pharmaceutical services.
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