Andy Gray
One of the classic defining properties of a profession is that it is self-regulating. However, there has long been a conflict between what can be expected of a voluntary society of professionals on one hand, and a statutory body on the other. It might be worth recalling that the British General Medical Council (a statutory body designed to protect public interest) was created in 1858, largely as result of representations by the British Medical Association (the voluntary body established in 1832). The conundrum has been well stated by the medical sociologist Maykovitch: “the professional’s high degree of learned competence creates special problems of social control in that lay people cannot realistically judge the performance of the professional. As a consequence, bureaucratic supervision and judgement by the customer, which are two of the most common forms of control, are not applicable to the profession. The dilemma is supposedly resolved by a strong emphasis on the professional’s self-control, supplemented by collegial surveillance”. The latest draft of the National Health Bill, which might be introduced in the New Year, provides for a “Certificate of Need” based licensing process for all new or modified health establishments (including pharmacies). However, in the proposed Regulations to the Pharmacy Act, the delegation of certain powers to the Pharmacy Council is expressly mentioned. Thus, while it would be incorrect to give the power of licensing pharmacies entirely to the Pharmaceutical Society, it would be preferable to vest that power in the statutory body (and hence allow the greatest measure of “collegial surveillance”) rather than locate it purely in the Department of Health (the bureaucratic locus of control). In our review of the Regulations we should look for all means to promote maximum self-regulation and minimum bureaucracy, not only in the unfortunately acronymed CON.
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