The chemist and druggist, 18/25. December 2010 (issue 6778)
17/36

What do you think? A pharmacist's Christmas Carol "AND SO, GENTLE READER, WE HAVE ALL SEEN THE FUTURE AND WE TOO MUST ACT-OTHERWISE, AS TINY TIM OBSERVED: GOD HELP US, EVERY ONE!" It's Christmas next week, there's snow on the ground, so sit by the roaring fire with the C+D and let me tell you a story. Twas the night before Christmas, and Scrooge Chemists was still open. "Can I go Mr Scrooge?" asked dispenser Bob Cratchit. "There may yet be another prescription," said Scrooge, "and we can't miss it!" But when Scrooge finally locked up, at the door was his old partner Jacob Marley who had died and become an agency locum. "Scrooge!" he said, "don't continue like this. I couldn't cope with all these new services and look at me now!" "The PCTs are being abolished," replied Scrooge, "so these stressful services will be gone and it's back to proper dispensing." But that night Scrooge was visited by three ghosts. First was the ghost of pharmacy past. "Look Scrooge - before new services, with all your training, in the 1980s you were a glorified shop keeper. But you were young and enthusiastic and you believed the profession could grow and develop." "Yes," said Scrooge, "that's why I became a pharmacist - the contribution our access and availability meant to public health. I believed we could make a difference!" Soon after, the ghost of pharmacy present appeared. He showed Scrooge the tills ringing in supermarkets and drugstores selling traditional chemist goods, the directors of oxygen and ostomy supply companies growing fat on the profits of services, and private providers working with CP commissioning groups. "Everyone is having a good time apart from us," said Scrooge. "What are the pharmacists doing?" "You're squabbling over the last few scripts on the high street," the ghost said. Finally came the ghost of pharmacy future. "No, Spirit," said Scrooge, "I fear what you will show me." The ghost said nothing, but showed Scrooge Chemists closed and abandoned on an empty street, while patients struggled to large private health centres for a host of services from Dr Healthcare Ltd. "Are there no pharmacists left, Spirit7" Scrooge closed his eyes and wondered how he could have let this happen... When he opened his eyes it was still the present day. He looked out the window and saw it was a white paper Christmas. "I must change," said Scrooge, "I must fight for my profession, my job, my future!" So he rushed out to lobby the LPC, and PSNC He ran to his former competitors shouting: "We must work together! We must see our CPs and get involved with commissioning!" And he trained Bob Cratchit to be an ACT and stop smoking adviser. And so, gentle reader, we have all seen the future and we too must act - otherwise, as Tiny Tim observed: Cod help us, every one! What actions should warrant a conviction? There have been countless consultations affecting pharmacy this year, but one issue stood out from the crowd. Elizabeth Lee's conviction and sentence for a non-fatal dispensing error dominated the pharmacy world in 2010. In late November, the Law Commission, which has a proven track record of having its proposals translated into law, finished a consultation on proposals on the subject: Criminal liability in regulatory contexts. The Commission specifically looked at pharmacy, including dispensing and the safe custody of controlled drugs and related record keeping. The Commission proposed limiting criminalisation - for example, to cases where the harm done or risks should be regarded as serious enough to warrant it. The Commission's proposals extended not only to individuals, but also to cases where a company or company director could be prosecuted. Just as the Law Commission's consultation period ended, the MHRA, which has responsibility for reforming the Medicines Act, published an 'informal consultation' on whether the Medicines Act should be amended so that, where the defendant is a regulated healthcare professional, an offence is only committed if they are found to have acted with intent or negligence. I am not sure the MHRA has grasped the problem. Obviously, intentionally incorrect supplies should be criminal. But I do not understand the reference to "negligence". Almost every incorrect supply of a medicine is unintentional and any unintentionally mistaken supply would be categorised by the courts as "negligence". The MHRA should recommend scrapping the existing laws and reversing the recent High Court ruling that a dispenser who selected and handed a patient incorrect medication was a criminal. You can email your comments to judith.m.thompson(5>mhra. gsi.gov.uk by December 22, 2010. There will be a formal consultation for 12 weeks from spring 2011, but why not try to mould the MHRA's ideas now? In 2011, watch out also for the Department's consultation on the way new control of entry regulations will operate and whether there will be a right of appeal against PCT decisions. These are your opportunities to have a say in the laws that govern your professional lives and livelihoods. David Reissner is a specialist in pharmacy law and head of healthcare at Charles Russell LLP (www.charlesrussell.co.uk). Contact him on 0207 203 5065 or email david.reissner@ charlesrussell.co.uk "THE MHRA HASN'T GRASPED THE ISSUE. YES, INTENTIONALLY INCORRECT SUPPLIES ARE CRIMINAL, BUT I DON'T GET THE REFERENCE TO 'NEGLIGENCE'"