Spare the special pleading

November 1, 2012

It is perhaps unsurprising that Vikesh Kakad, president of the British Pharmaceutical Students' Association, and John Smart, chairman of the Pharmacy Schools Council, fear the spectre of an increase in the number of students studying pharmacy in the UK ("Pharmacy recruitment may be unhealthy in high doses", News, 25 October). For many years, the restriction on places has limited the supply of trained pharmacists, leading to a situation in which the profession has been able to ensure that its members command high salaries. In turn, this has driven demand for places among school-leavers, and the limited number of slots has substantially inflated the A-level qualifications required for entry. This situation has been to the great advantage of those fortunate enough to enter the profession, but to the detriment of almost everyone else.

Smart notes approvingly that the profession wishes to instigate a statutory body that would control entry to undergraduate pharmacy courses. But such a body would be inimical to widening-access ideals and would maintain a situation in which the long-standing practice of restricting student numbers imposes needless costs on the healthcare system. In parallel, the profession is also seeking to persuade Hefce and the Department of Health to standardise UK pharmacy degrees as five-year courses. This would bolster its reputation but cost students and the public purse.

It is far from clear that the profession needs the AAB students Smart refers to, and it is unconvincing to claim that pharmacy training must be long-winded and expensive. The role that many pharmacists perform today is relatively straightforward, both on the high street and in hospitals: entailing the provision of medicines that have already been packaged, measured and tested.

The truth is that it would be more rational to open up courses while spending less on them, including shortening their duration. Then, unless the profession's trade bodies manage (as they will surely try) to fix salaries artificially, the economics of supply and demand would gradually drive down the remuneration of pharmacists to a more reasonable and socially beneficial level.

Kakad worries that it would be "unethical" to recruit students if they are not assured graduate careers in pharmacy, but this applies only if they are recruited under false pretences. This concern could thus be removed by the simple expedient of redrafting course prospectuses to make it clear to applicants that there is no guarantee of a job.

Most other professionals, including biomedical researchers and academics, do not have their positions artificially bolstered by restrictions on undergraduate numbers. Advocates such as Kakad and Smart who seek to maintain this privileged position for pharmacists need to form persuasive arguments to justify what otherwise may be viewed by those outside the profession as special pleading.

Kevin Smith, University of Abertay Dundee

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