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Baroness Jay of Paddington: I am very grateful indeed to the noble Baroness for her replies. I am sorry that both she and I seem to need the attentions of a pharmacist--I shall try not to cough during my brief remarks. I am grateful that she seems to be very encouraging to the professional concerns of some of the pharmacy people with whom we have been talking about these two specific areas. I understand her difficulties about GP prescribing. Perhaps I may take away her replies and consult on them with the profession. But, for the moment, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 44 not moved.]

Clause 24 agreed to.

Clause 25 [Authorised provision of pharmaceutical services by medical practitioners]:

[Amendments Nos. 45 and 46 not moved.]

Clause 25 agreed to.

7.30 p.m.

Baroness Flather moved Amendment No. 47:


After Clause 25, insert the following new clause--
(".--(1) The Pharmacy Act 1954 is amended as follows.
(2) In section 10(1), after "eight" insert "or 11(4)".
(3) In section 11--
(a) at the beginning of subsection (1) insert "Subject to subsection (4) below,"; and
(b) after subsection (3) insert--
"(4) Where the Committee makes a direction under section 8(1)(ii) in respect of a registered pharmaceutical chemist providing pharmaceutical services or additional pharmaceutical services under or pursuant to--
(a) section 41 or 41A of the National Health Service Act 1977; or
(b) section 27 or 27A of the National Health Service (Scotland) Act 1978,
and the Committee is satisfied that it is necessary for the protection of members of the public or that it would be in the best interests of that registered pharmaceutical chemist, it may order that his registration in the register shall be suspended forthwith.".").

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The noble Baroness said: I shall speak to both amendments standing in my name as they are closely connected. Amendment No. 47 will bring the powers of the professional misconduct committee of the Royal Pharmaceutical Society in line with the other professional misconduct committees of doctors and dentists.

It may surprise the Committee to know that at present an erring pharmacist cannot immediately be stopped from dispensing. At the very least, he can continue working normally for three months, in which time he may lodge an appeal. It is also possible that an appeal may be lodged to give him still more time to continue practising.

I wish to declare an interest. My husband has been chairman of the statutory committee--the professional misconduct committee of the Royal Pharmaceutical Society--for seven years, during which time, on a regular basis, there have been cases where he and others felt strongly that this power should be available to that committee in line with other professional bodies. There was a call for the society to seek the power of suspension from the register by the branches, as set out in the pharmaceutical journal, which stated:


    "A Motion urging the Royal Pharmaceutical Society to seek power to suspend convicted pharmacists from the Register of Pharmaceutical Chemists was among nine 'non-controversial' motions referred to the Council from the branch representatives' meeting without debate, on the assumption that they would have been carried. The motion had been put forward by the Society's Bristol branch, which wanted the power of suspension to be used for pharmacists convicted of offences involving drug misuse and/or theft from an employer. The branch was concerned at the length of time that could elapse before such a pharmacist could be struck off under the current Statutory Committee procedure. The branch believed that the Society should emulate the dental and medical professions, which had mechanisms for temporary suspension, pending a full hearing".

There have been many cases of pharmacists stealing cocaine from their employer; of dispensing drugs to addicts without prescription; and of stealing cocaine to feed the habit of a partner--those are examples of actual cases--yet all the pharmacists involved can continue dispensing in the normal way for a minimum of three months, and longer if they lodge an appeal, however spurious that may be. We have been talking of level playing fields. Surely, with a profession that will become more important under present legislation, it is necessary that it be regulated in the same way as the other professions.

I should mention to the Committee that a Private Member's Bill recently had its First Reading in the Commons. It proposes to establish a health committee for pharmacists who have been found to be suffering from alcoholism or other kinds of mental illness. But it is not clear at the present time, because the Bill has not yet been published, whether that committee will have the power of immediate suspension. Even if it has such powers, and that Bill is passed, cases will still arise which are not due to illness but to sheer wickedness on the part of the pharmacist.

The amendment seeks to fill a gap in the armoury of the statutory committee to protect the public from the worst people in the profession; it is only the worst

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people who will need to be suspended forthwith and not those who commit minor infringements which can be dealt with by fines or by other means. I hope that the Committee will consider it seriously and that my noble friend the Minister will see its virtue. Pharmacists are still covered by an Act of 1954, which the provision seeks to amend. Also, it is some time since 1954 and no doubt the Pharmacy Act itself is due for revision. Until then, steps should be taken to protect the public as and when the opportunity arises. I beg to move.

Baroness Miller of Hendon: While I understand the concerns of my noble friend and I welcome the spirit of public protection in which she tabled these amendments, there are reasons of equity why the Government cannot accept them.

It seems unfair to us that some pharmacists working in what is generally known as community pharmacy should be subject to the immediate suspension of their registration by their professional regulatory body, while their colleagues working in hospitals or the private sector face no such sanction. For that reason alone I must invite the Committee to resist these amendments.

However, I hope my noble friend will be encouraged by the provisions we introduced early this year to give the NHS tribunal power of interim and immediate suspension from a pharmaceutical list. Matters of misconduct likely to prejudice the efficiency of the service can be brought before the tribunal which, if it considers it necessary, may effectively prevent the person on the list from providing any NHS pharmaceutical service.

Lord Winston: Before the Minister sits down, as a matter of clarification can she explain in the case of an NHS pharmacy whether it is right that a health trust cannot immediately suspend a pharmacist if serious misconduct occurs.

Baroness Miller of Hendon: My understanding is that if the committee finds that the pharmacist is unfit to practice, the name can be removed from the register but the pharmacist has three months in which to lodge an appeal.

Baroness Gardner of Parkes: My view is that a trust directly employing a pharmacist would have employment rights by which it could immediately suspend its employee. However, that could not be done if the pharmacist was a direct contractor in his own pharmacy. Only the registering body could do that and apparently it does not have the power.

Baroness Flather: I was interested to hear the Minister's comments. The distinction is quite spurious. The amendment increasing the powers of the statutory committee will apply to all practising pharmacists. It may not apply to people in employment because there will be other means by which they can be suspended. To prevent a pharmacist found guilty by the statutory committee of serious misconduct from dealing with the public for three months does not make the pharmacist less equal. It brings him in line with the other medical

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professions of doctors and dentists. Pharmacists can cause just as much damage to members of the public with whom they are in direct contact.

I shall not press the amendment today but will take the opportunity of discussing the matter further with my noble friend the Minister. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 48 not moved.]

Clause 26 [Provision of certain services under NHS contracts]:

[Amendments Nos. 49 and 50 not moved.]

Clause 26 agreed to.

Clause 27 [Medical lists and vacancies: England and Wales]:

[Amendments Nos. 51 to 54 not moved.]

Clause 27 agreed to.

Clauses 28 and 29 agreed to.

Baroness Hayman moved Amendment No. 55:


Before Clause 30, insert the following new clause--

Position of Health Authorities

(". Nothing in this Act shall prevent the direct employment by a Health Authority of a medical practitioner who provides personal medical services.").

The noble Baroness said: The purpose of this amendment is to introduce an extra degree of flexibility into the pilot schemes that may come into force under the Bill. As the Bill now stands, a wide variety of people may put forward pilot schemes. They may be medical practitioners, they may be dental practitioners, they may be NHS trusts and they may--we probed this point earlier today--be commercial organisations. The one group that seemingly cannot put forward pilot schemes is health authorities.

I understand, and the Committee will be aware from earlier discussions, that difficult issues are involved here. If a health authority were directly to employ medical practitioners to provide personal medical services it would be blurring the line between being a provider and a commissioner of services. However, as we discussed earlier, general practitioners are already in that position. There is also the issue of the scrutiny of proposals, but I think that is covered by the fact that the Secretary of State has to scrutinise and approve proposals.

We on this side of the Committee are keen that health authorities should be able directly to employ medical practitioners because we are concerned that in some areas there may be needs which are clear to the health authority but for which there is no taker for a pilot scheme from among local general practitioners or local trusts. I think particularly of areas of great deprivation: the provision of primary health care and personal medical services for homeless people, for a drug addict population and--this is an area to which we shall have to give greater attention in the future--for residents of long-term residential homes and nursing homes. That area needs to be addressed.

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The purpose of the amendment is simply to introduce a greater degree of flexibility and to allow that in those circumstances where the health authority, with its epidemiological and overview of the health needs of the population, has identified a need that has not been met by someone coming forward with a pilot scheme, it would be able directly to employ a medical practitioner. I beg to move.


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