Having been involved in trade unions at national level since the mid-90s, Paul Day is well versed on the challenges facing the Pharmacists’ Defence Association. Its director talks to Neil Trainis…
It is a good time to be connected to the Pharmacists’ Defence Association (PDA) but Paul Day gives the sense that its recent triumph over Boots should extend way beyond Warholism.
Where once few had heard of the PDA outside of the realm of pharmacy, a famous success which saw the Pharmacists Defence Association Union (PDAU) win two ballots to secure independent trade union representation of pharmacists at the health and beauty giant has cast the PDA into the spotlight. And for a great deal longer than 15 minutes.
“Our members are in community pharmacy, hospitals, GP practices, primary care, CCGs, health boards, military bases, prisons, anywhere there’s medicines, there’s a pharmacist,” the PDA director says at a table at the back of a busy coffee house just off Regent Street.
“Wherever they are, we’d expect to, over the coming years, forge relationships with those employers. Even if an organisation that’s got a recognition with another union, an organisation where we don’t get to the point in the short period of getting recognition with them, you’d expect that if they’re doing something around pharmacy, something major, that they would talk to us because we’re the largest pharmacy organisation.
“People have said we’ve had involvement in a Guardian article, a BBC documentary, etc. Other mainstream journalists, if they say ‘I’m doing a story about pharmacy, who do I come to?’ they come to us.”
After eight years of, at times, bitter wrangling over who should negotiate pay, hours, holiday and general working conditions of pharmacists at Boots, the PDA’s stock is on the up.
After all, they inspired those pharmacists, as they put it, to become “the first group of employees in UK history to vote to remove a sweetheart union arrangement,” in this case with the Boots Pharmacists’ Association. It begs the question; where next? Paul suggests LloydsPharmacy “is a big one.”
“Firstly, we’ve got to look after 7,000 pharmacists who work at Boots who have had eight years of wanting us in there but not having us negotiate their pay,” he says.
“So there are steps to take to make that pay system more transparent, more understandable and to improve it. But Lloyds, anywhere our members work, we want to help maximise their pay, maximise the way they’re treated at work, allow them to be more able to look after patient safety.
“Everywhere is on the radar. We deliberately started with Boots because they’re the biggest. If we started with Boots, we would hope people like Lloyds would not put themselves through the public embarrassment Boots put themselves through in being so obviously out of touch with their own staff. That ballot ended 92% in favour.
“As good as we might be at the PDAU, you don’t get a 92% result because you’re good, you get that because there was an absolute strength of feeling among the workforce.
“Lloyds, we would hope, will talk to us. Of course, we’ve got the lines of communication there. Lot’s of the other supermarkets have already got recognition for USDAW in place or ASDA has got recognition for GMB in place. So there’s already trade union representation for all those people. We’re friends with all the other trade unions. We couldn’t go in.
“Where Boots had no independent trade union, we could go in. But, everywhere our members work, we want to go and help people. Part of the reason we started at Boots is if we start to improve the conditions, the transparency, the focus on professional autonomy at Boots, it is bound to filter through. That’s why we started with the biggest.
“Boots is about a sixth of the sector. Because they’re listening to us and working with us, then other will start to. If Boots can’t stop us, nobody can stop us.”
"We can go to anyone"
Paul suggests the PDAU could go for union representation at any chain - “if there’s no trade union in place, we can go to anyone,” is his dogmatic take – and he is asked what evidence he has that pharmacists are being compelled to work in poor conditions.
“Every day we’re helping pharmacists who come to us. Wherever you work, if you’re a journalist, a doctor, if you’re sweeping the streets, you can have instances where your boss, either your manager or the employer itself, is treating you not right because of your sexual orientation, age or colour, gender, just because the managers aren’t properly trained or they’re over-focused on targets, it happens everywhere.
“I wouldn’t say one place is particularly worse than the others. It’s broadly proportionate. Boots and Lloyds between them employ around a fifth of all community pharmacists. So you’d expect one in five of our caseworks from community pharmacy to be from Lloyds or Boots.
“If you’re talking about a small regional multiple, with seven or 12 stores, we’re not going to get an issue from there every day or every week are we. With Lloyds and Boots, we’re constantly advising pharmacists.”
A change in legislation would make it easier for the PDAU to establish independent trade union representation of pharmacists at other chains that have sweetheart arrangements, although Paul concedes that is unlikely to occur any time soon.
“The current government is not known for improving trade union law. You’d need a change in government to a more union-friendly government but we’re the only people who have ever tried to get rid of a sweetheart union as they call them and the only one to have succeeded.”
Having been involved in trade unions at national level since the mid-1990s - he has worked for the Association of Teachers and Lecturers, Abbey National Group Union and Business Disability Forum - Paul is well versed on the challenges facing the PDA and PDAU.
A second proposal for a pharmacy apprenticeship was recently put forward but Skills for Health, acting on behalf of Health Education England, refused to reveal the identity of the employers deciding whether or not to pursue the plans.
The situation was opaque enough to prick the curiosity of the PDA who naturally wondered why there was secrecy, just as the first proposal, which stalled, lacked detail.
“Some people like Lloyds are very much transparent in that they are members of the employer group as they called it. The contact for the first proposal was a Boots person, so it was clearly Boots involved.
“The first thing that strikes you is the secrecy. This isn’t down to the employer group, this is down to the Institute for Apprenticeships and Technical Education and if you Google some of the stories around them regarding other sectors, there’s lots of criticism (that) they’re a government body, they’re really secretive, they’re not at all transparent and they’re focusing too heavily on expensive apprenticeships rather than lower cost apprenticeships.
“In some ways, the pharmacy employers are victims of the fact the Institute are so secretive. But given 6,000 members of the public, most of whom we can safely say are pharmacists, have complained, we’ve called on them, and I’ve got an email exchange with the Institute, to make sure (they) have passed on our message ‘reveal yourself, let us know who you are.’
“They could help themselves by publically coming out and saying ‘we’re the group of 10 employers, this is the deal.’ The (first) proposal that was rejected said pharmacists aren’t involved in diagnosis and care. We’re not sure who wrote that by clearly that doesn’t make (sense).
“Apprenticeships are supposed to be filling a known skills gap fully representative of the whole sector. A pharmacist coming out of an apprenticeship should be able to walk into a hospital and be a pharmacist or walk into primary care.
“The concern was the first apprenticeship that said you’re not involved in diagnosis and care would bring out low-level pharmacists suitable perhaps for only one employer or part of the sector. We’d like to get past the secrecy and them have the conversation about ‘what is this skills gap you’re filling?’”
Skills for Health indicated that the employers’ identity would be revealed after a stakeholder meeting which the PDA was due to attend on July 18 but that promise has not assuaged concerns.
Low hourly rates, poor levels of staffing in the pharmacy team, too much focus on income generation rather than patient care and treatment by local management have been communicated to the PDA as reasons apprenticeships will not be accepted.
“We haven’t properly heard what the proposal is but if it’s not good for patients and pharmacists, we would be opposed to it. But we haven’t got to that because of this issue over secrecy and transparency,” Paul says.
Other issues, he insists, are unfolding within primary care such as pharmacists working in GP practices being asked to work outside of their competency.
“We’re clear that pharmacists should not ever act outside their competency. That’s not safe practice.
“There’s an issue that perhaps a partnership of doctors running a private business, albeit it’s got NHS branding all over it, will say ‘it’ll cost us X to get a locum doctor in, why don’t we get a locum pharmacist on the team instead?’
“That’s ok as long as you are only asking them to be a pharmacist but we’re finding new risks where pharmacists are being presented with ‘you can do all these things’ and the pharmacists are not necessarily competent to do all those things. You’re there to be a pharmacist, you’re not there to be a GP or junior doctor.
“There’s questions over running clinics and if you’re there, unsupported by a GP and you’re running a clinic, if it’s a specific clinic and it’s in the realms of your independent prescribing qualification, that may ok, but you need to be clear on diagnosis process and that you’re only dealing with the stuff you’re competent to deal with.
“People come to a general practitioner with a general illness. These sorts of things are unfolding as the increase in GP practice pharmacists goes up.
“(These are) all newly qualified pharmacists who are now into primary care, GP practices, and for us there is a new area of casework coming up for us where pharmacists are saying ‘actually, I’ve been asked to do this by the doctor but is that my job, should I say yes, how do I manage that? And it’s a different world.’”
Asked how many of these types of cases the PDA has received, he says: “Enough. I don’t have numbers but enough. In shorthand we’ve sometimes said they are not there to be mini-doctors. I’m aware of a case where a pharmacist said ‘a doctor said to me ‘here’s a pile of repeat prescriptions, just sign them through.’ But I’m a pharmacist, I’m going to check every one properly. That’s not how we do it.’”
Paul is asked if pharmacists approach the PDA about issues that could be handled by the Royal Pharmaceutical Society, who have been criticised for a lack of leadership.
“We sometimes get approached by people saying we should take on some of the stuff that the RPS do but we are very clear, we are very happy being an excellent defence association and trade union and for us, the whole world of pharmacy is an eco system and it’s important that there’s an effective professional body, that there are effective employer organisations, because for the success of the whole sector, everybody needs to be fairly represented.
“We all know the RPS used to be the regulator for Britain and therefore, not too long ago, there was a time when everybody had to be a member of the RPS because to practice you had to be registered.
“It’s no wonder, after that change of structure, the RPS needs to reassert itself as the professional body and make clear to pharmacists it’s there.
“But we’re supportive of the RPS in that we encourage people to vote in its elections, we reimburse our pharmacist employees for their membership of the RPS and its incredibly important there’s an effective professional body just as there is a professional trade union in place. Everything needs to be functioning in an eco system like pharmacy.”