The pharmacist at the service of society

It is very clear that there are many confusing thoughts and issues in the mind of some of our dear colleagues (Pharmacists, March 30). This may possibly be a result of misinformation by third parties, who may have a hidden agenda in their unethical methods to attempt to undermine the Malta Chamber of Pharmacists, its role, achievements and objectives for pharmacy, pharmacists and, not least, patients. This may instill apprehension in pharmacists.

At the onset, let it be stated categorically and unequivocally, that the chamber has and continues to express full support of pharmacists in primary health care, individually and collectively, whether in government or in private practice. The chamber is not critical of pharmacists' practice in government primary health care services but of the present system, which does not have the necessary scope for the pharmacists to realise their full potential.

The integration of pharmacy in the health system and, in particular, in primary health care must be viewed holistically in the changing scenario of health care and, especially, its sustainability.

On an explanatory note, the chamber did not "form an alliance with the GRTU on February 15 (2007)". The chamber has been making joint representations with the GRTU pharmacy section, on matters concerning community pharmacy, by a mandate obtained at the chamber's extraordinary general meeting in 1996. This strategy has been confirmed in all subsequent general meetings of the chamber (the last having been held in November 2006).

This is the reality because our legislation stipulates that pharmacies may be owned by non-pharmacists and the latter, together with pharmacist proprietors, are supporting the developments of community pharmacy services that the chamber has been campaigning for (... for decades now!). So, basically, this is the way which has been found to be necessary and effective to attain our objectives for community pharmacy.

The introduction of the pharmacy/pharmacist of the patients' choice (POYC) project, that is, the decentralisation of the distribution of free medicines to the community pharmacy of the patients' choice, is long overdue by about 20 years; that is how long this has been debated by the chamber and its social partners with subsequent administrations (although all parties are in agreement in principle). By European standards, it is possibly overdue by about 40 years!

The chamber is the national pharmaceutical association. It is a professional association having trade union rights and obligations. It has certainly lived up to the latter, having negotiated and signed (1993) the first ever agreement on the reform of the government pharmaceutical services. Previously, there was no such structure and pharmacists in government services were not even recognised as professionals, their remuneration level having been far below that of other professionals in the service. The reform negotiated by the chamber has given the opportunity to our colleague and many other generations of pharmacists many opportunities to practise in several departments or sections in the government pharmaceutical services with further opportunities for career progression up to director level, professional development and the introduction of new practices.

Moreover, the chamber has campaigned for the development and integration of private community pharmaceutical services at primary health care level as an integral part of the health system. This is not stating in any way that the pharmacists in government primary health care are not doing there job well... far from it! They are practising in a system, however, which is not conducive to allowing them to use their full potential, while patients or their carers, besides queuing for far too long for their medicines, cannot have the full benefits of a one-to-one relationship with their pharmacist.

The way forward in the chamber's opinion is to decentralise the present system. The solution in our opinion is not that of temporary, piecemeal solutions... The chamber is proposing that, in parallel with decentralisation, the pharmacists practising in primary health care are redeployed to practise at clinical pharmacy stations on each ward specialty at the new Mater Dei Hospital. Indeed, there should be the necessary vision for the development and implementation to full capacity of clinical pharmacy services at our new state-of-the-art hospital.

The chamber's goal is that of achieving seamless care at the interface between public and private pharmaceutical care services. The elimination of queues at health centre pharmacies, though necessary in this day and age, is a limited view. It is expected to be however the first impact of decentralisation. The chamber would like to see, for example, the implementation of full computerisation in private community pharmacies - perhaps, linked to the newly-developed ICT system in health to facilitate the introduction and the maintenance of patient medication profiles by community pharmacists - which should impact on better medicines usage by patients. Elsewhere, this is not a myth but day-to-day practice. It is also recognised that economic viability is critical for the sustainability of community pharmacy.

This is a glimpse at the chamber's vision for pharmacy in Malta. Let us all pull the same rope for better patient care, more professional satisfaction and... professional esprit de corps.

The chamber and its council, not least the undersigned, are by our raison d'etre open to objective criticism. All pharmacists are invited to participate proactively with us in the moulding of the present and future of the pharmacy profession in the service of society.

Ms Sant Fournier is president of the Malta Chamber of Pharmacists.

spizjar@waldonet.net.mt