Regulation of the pharmacy profession throughout Australia

Background: Pharmacy state and territory legislation provides for the regulation of the profession throughout Australia by the pharmacy registering authorities. The Council of Pharmacy Registering Authorities (COPRA) was formed to harmonise these regulatory requirements and facilitate communication among pharmacy registering authorities. COPRA was recently renamed the Australian Pharmacy Council. The Council of Australian Governments (COAG) has made recommendations that will impact on the regulation of all health professionals in Australia. Aim: To compare the regulatory requirements and identify regulatory consistencies and differences between jurisdictions. Method: A qualitative approach encompassing a survey and interview was used. All 8 pharmacy registering authorities were approached to participate via an invitation through the Australian Pharmacy Council in September 2006. Results: Pharmacy registering authorities operate under diverse legislative frameworks and requirements. There are different definitions for disciplinary processes and the extent to which the registering authorities are able to sanction practitioners. The jurisdictions have different requirements for pharmacy premises registration, the inspection of premises and the required equipment and resources to practise. Differences in pre-registration programs, the assessment of pre-registration pharmacists and initial and ongoing registration specifications were also identified. Conclusion: The Australian Pharmacy Council and the pharmacy registering authorities have made significant progress towards the harmonisation of pharmacy regulation. However, the regulation of the profession throughout Australia remains varied. COAG needs to focus on early reforms such as a national pharmacy register before addressing the complex issues of consistency in disciplinary outcomes, pre-registration programs and annual pharmacist registration requirements. J Pharm Pract Res 2007; 37: 174-7. INTRODUCTION The regulation of the pharmacy profession is the principle means of ensuring public trust in the services provided by pharmacists. The regulation of Australian pharmacy dates back to the 19th century with the establishment of colonially-organised pharmaceutical societies.1 These societies became powerful moulders of Australian pharmacy practice as they produced the first documents detailing organised standards in education, qualifications and ethics. They also influenced the development of pharmacy legislation in each colony or state.1 Australia has recently started a process of review of the regulatory framework for all health professions. This has been done under the auspice of the Council of Australian Governments (COAG) that, in July 2006, agreed to establish by July 2008 a single national registration scheme for all health professionals. The purpose of the single scheme would be to facilitate workforce mobility, improve safety and quality, and reduce bureaucracy.2 These recommendations have high level support from the Prime Minister and state and territory leaders. The COAG recommendations have the potential to cause major reforms in the regulation of all health professionals in Australia. History of Pharmacy Regulation In the 1870s, Victoria and New South Wales (NSW) were the first jurisdictions to introduce pharmacy boards as entities separate from the society councils.1,3 The creation of the pharmacy boards, as independent bodies separate from the professional organisations, established the principle that the boards existed for the protection of the public and acted in the interest of consumers whereas the societies acted on behalf of their members. This approach was followed by all the other jurisdictions, except Western Australia (WA). The process of separating roles in WA has also commenced through the drafting of the Pharmacists Bill 2006. The separation of roles in Australia was a departure from the English precedent. However, the UK structure has often been criticised and following an extensive review the regulatory role of the Royal Pharmaceutical Society of Great Britain will be taken over by a General Pharmaceutical Council in the near future.4-8 In New Zealand the regulatory and professional representative roles were separated in 2004.9,10 Role of the Pharmacy Registering Authorities State and territory legislation provides for the regulation of the profession throughout Australia by pharmacy registering authorities. The authorities have responsibility for the registration and discipline of registered pharmacists. In contrast, the professional pharmacy organisations represent their members. What is in the interest of the public is often also in the interest of the profession and the roles of the registering authorities and the professional organisations thereby overlap to some extent. There is a degree of co-regulation between the authorities and the professional organisations. This overlap in functions is evident in practice standards; the professional organisations determine the standard of practice through the development of practice standards, and the standards are then used by the authorities as a frame of reference when conducting professional hearings.11 Pharmacy registering authorities maintain a register of pharmacists, approve pharmacy premises, oversight the training of pre-registration pharmacists, and ensure that professional standards are maintained with pharmacists failing to meet the standards being disciplined. The administrative costs of the authorities are financed through registration fees. Although there are some similarities between the legislative provisions and the powers and the structures of the individual authorities, there are various inconsistencies. In an attempt to inter alia harmonise procedures and facilitate communications between pharmacy registering authorities, the Association of Pharmacy Registering Authorities was formed in the early 1990s and was succeeded by the Council of Pharmacy Registering Authorities (COPRA) in 2002, which was renamed the Australian Pharmacy Council (APC) in July 2007.12 The APC, through the New Zealand and Australian Pharmacy Schools Accreditation Committee, also accredits pharmacy schools to ensure national consistency of university pharmacy courses.12 Although the APC and the pharmacy registering authorities have made some progress towards harmonisation, many of the