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PJ Online homeThe Salvadore
Vol 274 No 7355 p789
25 June 2005

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· Reciprocity (2)
· Prescribing
· New Pharmacy contract
· Birdsgrove House
· The Society

Letters to the Editor


Disappointed (Mr J. Edmunds)

Mutual ignorance (Dr M. King)


From Mr J. Edmunds, MRPharmS

I have been waiting for reactions from “practising” members regarding the end of reciprocal registration between Britain and South Africa, Australia and New Zealand (PJ, 23 April, p495). As few have been forthcoming, I have decided to raise my head above the parapet.

As a pharmacist who qualified in South Africa in 1962, and who has now been registered in the UK for almost 20 years, I am most disappointed that this has come to pass. Especially when one reads of the shortage of pharmacists and our need to employ pharmacists from the EU.

Many hard-working well-trained pharmacists from the countries mentioned above have performed a valuable service to the profession, particularly by filling vacancies that would otherwise be left open, or by providing much needed locum services. To remove the possibility of recent graduates from these countries continuing this tradition, with the stroke of a pen, seems unreasonable. I cannot understand why this reciprocity cannot be perpetuated, when it is continued with other health care related professional bodies.

I do believe that the Society is pushing itself into a corner. It is already depriving the profession of experienced pharmacists, via the recent fee changes which have forced pharmacists to choose between being practising or non-practising. It is now exacerbating the situation by denying itself access to an alternative reserve of competent practitioners.

I shall not sympathise with future reports complaining that there is a shortage of pharmacists, but merely draw the attention of the leaders of the profession to their follies. I was of the impression that we were intent on “saving our Society” not the opposite.

John Edmunds
Tring, Hertfordshire

Mutual ignorance

From Dr M. King, MRPharmS

Lois Quam and Richard Smith, former editor of the BMJ, published an article in March this year asking what the US and UK health systems could learn from each other.1 They cite mutual ignorance as a barrier to the exchange of ideas and note that few people have a deep understanding of more than one system.

The loss of reciprocity will further the cause of mutual ignorance, as pharmacists with a good knowledge of the British and Australasian systems will slowly die out. Academic exchange will be restricted, as many academic appointments require registration. European pharmacists may fill places, but the health systems in many European countries are quite different to those in Britain, making the transfer of many ideas impractical. Britain and Australia are similar in this respect and many ideas have moved between countries. There is no point highlighting how Australia has benefited from this exchange, but I am able to highlight some benefits for Britain.

The Scottish Medicines Consortium has been able to draw from the experiences of Australia’s Pharmaceutical Benefits Advisory Committee. The long established nature of the Australian pharmaceutical benefits scheme (over 50 years) and its methods of offering patient choice, while controlling expenditure, reducing the use of inappropriate drugs, preventing the inappropriate use of expensive drugs, supporting original pack dispensing and managing prescription repeats, means that Britain has a wealth of experience from which to learn.

Recent research in Australia involving the “Quality care pharmacy program” (a system of standards and accreditation for community pharmacy), medication review, and dose administration (compliance) aids, is relevant to Britain. But the door is about to be closed on the free flow of information and ideas. These exchanges will eventually be lost, or worse, be between those operating in mutual ignorance.

At the very least, those eligible under the reciprocal agreement on the date it ceases should be able to register under those terms if they come to Britain in the future, as surely their training does not become inadequate overnight. The adjudication process of a year of university, a year of preregistration and the registration examination should be re-examined. Britain can learn from pharmacists in many countries, but these requirements are demeaning and offensive to those it can learn the most from. Please reconsider.

Michelle King


1. Quam L, Smith R. What can the UK and US health systems learn from each other? BMJ 2005;330:530-3.

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