Andy Gray
One stirring phrase resonated through the recent Combined Pharmaceutical conference in Sun City – "face to face". Each time I heard this clarion call, I was reminded of Hemingway’s glamourisation of the mano a mano between the matadors Antonio Ord\ Z ez and Luis Miguel DominguR n in the summer of 1959. Now it does not take an aficionado to spot the estoque behind this particular scarlet muleta. No matter how many passes the matador makes, the sword is pointed at one target – distance dispensers. So what does this have to do with SAAHIP? Is the supposed nobility of the bullfight to see its pharmaceutical equivalent in the call to regulate for a standard of "opportunity for face-to-face contact between pharmacist and patient/caregiver"? Those who promote this idea ride into the ring on the back of Pharmaceutical Care, brandishing banderilla ready to poke any who would dare to challenge the applicability of this "universal norm". But I am afraid that what might work in Minnesota will certainly be a pipe-dream in Matatiele. What might be attainable (and desirable) in a well-resourced private sector setting, catering for a privileged minority, will not be attainable (however desirable) in the public health system. That much was made clear in the final day workshop hosted by the Academy and SAAHIP. When drafting Regulations, the Pharmacy Council and Department of Health will need to bear in mind the import of the new section 52A: "This Act is binding on the State". And they will need to be careful not to entrench the inequities of the past by applying to different categories of pharmacy practice standards so disparate as to make a mockery of section 52A. This is not a call to abandon Pharmaceutical Care, rather a reminder of the unfinished business of putting flesh on the bare bones of a population approach to the philosophy, taking into account such concepts as periodic supervision of auxiliary staff, essential drugs lists and standard treatment guidelines. And my prognosis for our brave matador – I can’t see him walking away with both ears and the tail this time. To quote another famous aficionado – a luta continua!
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