Friday, September 21, 2007

NEWS

More registered pharmacists needed: Khaw

SINGAPORE: While the move to set up a separate register of specialised pharmacists is aimed at boosting the level of clinical care, it would be counter-productive if patients do not know whom to turn to for help.

Unlike doctors with areas of specialisation — such as oncology or gynaecology — who "can be easily identified by the public", it is "a lot more difficult" for patients to do the same for pharmacists with different areas of specialisation, according to Jurong GRC MP Halimah Yacob.

Which is why Mdm Halimah, the Government Parliamentary Committee (Health) chairman, urged the Health Ministry to make accessible to the public a list of specialist pharmacists, so that the register can be of "greater use to the public".

MP for Ang Mo Kio GRC Lam Pin Min suggested the formation of groups to look into the needs of the rapidly ageing population and increased prevalence of certain chronic illnesses in Singapore.

Also, these Specialist Training Committees can help provide the specialist manpower required by the bio-medical and medical communities, he said.

These ideas — which Health Minister Khaw Boon Wan said would be taken up — were among others thrown up by the four MPs who spoke in Parliament on Thursday about the Pharmacists Registration Bill.

This is the first time in over two decades that amendments are being made to the Pharmacists Registration Act.

These include compulsory continuing professional education for all pharmacists, just like doctors and dentists; converting the current Singapore Pharmacy Board into a new statutory body — the Singapore Pharmacy Council — and permitting the conditional and temporary registration of foreign-trained pharmacists.

There are about 1,500 registered pharmacists in Singapore. This figure needs to be ramped up, due to the growth in the healthcare and biomedical sciences sectors, Mr Khaw pointed out.

The Minister noted that pharmacists are no longer just "custodians of drugs" for patient care.

"They will play an increasingly important role as domain experts in drug evaluation, drug use and surveillance." Given their growing role, there is a need for a "more robust disciplinary and health inquiry framework" for pharmacists, which is modelled after the medical and dentist professions.

One suggested change is the ability to suspend or restrict the practice of a registered pharmacist involved in ongoing disciplinary proceedings against him.

Currently, a pharmacist under investigation can still practise — a situation that could undermine the interests of the public or the pharmacist, Mr Khaw said.

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Docs dispensing drugs: System not without its benefits, says Khaw

HEALTH Minister Khaw Boon Wan is in favour of keeping the current system where doctors are also allowed to dispense medicines.
But he told MPs yesterday that he would work to enhance the system.

'The key is to give our patients the choice to fill the prescriptions wherever they wish, be it at the doctor's clinic, in a private pharmacy, or even across the Causeway,' he said during yesterday's debate on the Pharmacists Registration Bill.

Madam Halimah Yacob (Jurong GRC), who heads the Government Parliamentary Committee for Health, raised the idea of separating prescribing and dispensing of medicines - as is done in some countries.

She said such a system would have pharmacists acting as a check on doctors' prescriptions, which would improve patient safety.

And patient safety, she argued, was a 'greater overriding consideration' than the convenience of being able to consult a doctor and fill a prescription at one place.

Doctors in private practice here prescribe and dispense medication; in public hospitals and polyclinics, doctors usually prescribe the drugs, while pharmacists in the same institution dispense it.

But Mr Khaw was not in favour of leaving all dispensing of medicines only to pharmacists.

Saying that the current system was 'not without its benefits', he pointed to convenience and cost savings for patients who pick up their medicine at the same place they see the doctor.

However, he suggested that, as a start, doctors in private practice should follow the lead of public-sector clinics and hospitals and provide all patients with a clearly written or printed prescription as a matter of course. They should then leave it to the patient to pick up the medicine anywhere he wants to.

If they choose to do so at the doctor's clinic, the cost of the medication should be itemised on the bill, separate from the consultation fee.

With the passing of the Pharmacists Registration Bill yesterday, higher standards will now be demanded of the 1,468 pharmacists here.

Like doctors, they will have to clock 50 hours of continuing professional education to renew their practising certificates every two years.

And with a register to be set up to list pharmacists with training in areas such as cancer, more will be spurred to pursue further training.

Another change with the passing of the Bill: The Singapore Pharmacy Board, a department within the Health Ministry, will become a new statutory board.

The new Singapore Pharmacy Council will have more power to discipline errant pharmacists. It can, for example, suspend such pharmacists from practice even before investigations are completed.

Two new categories of registration - temporary and conditional - will enable more foreign pharmacists to work here.

Mr Khaw noted that despite the National University of Singapore tripling its intake of pharmacy students from 41 to 115 over the last 10 years, Singapore needs still more such professionals - 200 more a year for the next decade.

Madam Halimah, Dr Lam Pin Min (Ang Mo Kio GRC), Dr Fatimah Lateef (Marine Parade GRC) and Mr Seah Kian Peng (Marine Parade GRC) spoke in support of the changes yesterday, saying that they would improve the standards of what Madam Halimah called 'a neglected lot'.

But Dr Lam cautioned against taking in foreign pharmacists who were not up to par just to ease the shortage, while Mr Seah hoped that foreign pharmacists would be allowed to work in private retail pharmacies.

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Why pharmacists resign?

Better work conditions, pay may help stem high turnover rate of these professionals

I refer to the report, "MOH to recruit more pharmacists from overseas" (Sept 17). It was reported that of the 1,482 pharmacists on the register here, less than half are involved in direct patient care, such as practising in hospitals, polyclinics and retail pharmacies.

This is a worrying figure. While I applaud the ministry's efforts to recruit more pharmacists from overseas, it should also delve further into why pharmacists are not practising and find ways to stem the drain.

I know a pharmacist who has worked in a retail pharmacy and in one of the restructured hospitals. During her stint with the retail pharmacy, she worked from 10am to 10pm, with only half an hour's break for lunch and dinner. This included Saturdays and Sundays, when business is most brisk. Most times, she was the only pharmacist during that 12-hour stretch.

When she was working at a hospital, it was common to see her and her colleagues having lunch at 3pm, after they attended to the last patient from the morning crowd.

At times, she was called back to the hospital even though she was on leave. She worked till 3pm on Saturdays, even though the official knock-off time was 12.30pm. Sundays could become working days when duty called — working one Sunday per month is common.

Such is the life of a pharmacist, be it in hospitals, retail pharmacies or polyclinics.

Increasing demands on pharmacists without adequate compensation leads to many leaving the profession.

Perhaps it is time to review pharmacists' salaries. They are, after all, highly-trained medical professionals who run specialised clinics and make rounds with the doctors to ensure patients fully benefit from treatment.

Until we address the concerns of pharmacists and plug the outflow, increasing the number of pharmacists will not ease the crunch. Sourcing from foreign supply is but a short-term solution to a long-term problem.

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Letter from Darren Chong

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Curing the ills of fewer pharmacists

Letter from Heng Cho Choon

The report "MOH to recruit more pharmacists from overseas" (Sept 17) clearly shows that the Department of Pharmacy at the National University of Singapore (NUS) will not be producing enough pharmacists for local needs over the next five years.

So, where lies the ailment of this issue of supply and demand?

Last month, a parent wrote to the press to complain that her daughter with four distinctions in her A-level examination could not gain admission to the NUS to study pharmacy.

Perhaps it is time to upgrade our oldest polytechnic, Singapore Poly, to a full-fledged university with courses for our students who aspire to become pharmacists.

This converted university could also run courses for external degrees like those awarded by the University of London. It could cater to the needs of full-time, part-time and mature students.

I also welcome the news that the current Singapore Pharmacy Board (SPB) will be converted into a new statutory body known as the Singapore Pharmacy Council (SPC).

The SPB was established under the Pharmacists Registration Act 1979 as the registration and disciplinary body for pharmacists in Singapore.

Foreign-trained pharmacists who want to register with the SPB need to undergo a period of training of three months in an approved training centre and also sit for a compulsory examination relating to Pharmacy Laws in Singapore.

There is no provision for a course in pharmaceutical ethics for pharmacists vis-a-vis doctors and other drug and health personnel.

Perhaps the SPC, when it is established, could look into this problem that has been plaguing the pharmaceutical industry and the Singapore Association of Pharmaceutical Industries in the last decade.

In the United States, it is an open secret that drug companies usually target the "detailing sessions" that the firms use to inform doctors about new drugs to also ply them with special benefits, ranging from free air tickets to expensive gifts like cars and computers.

Consumer health advocates are worried that this may encourage doctors to unnecessarily recommend more expensive drugs for their patients.

The SPC should also look into ways to resolve the problem of the pharmaceutical industry, which will time and again try all sorts of ingenious ways to grease the palms of its honourable members.

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So many news suddenly haha. Medical hub siazzz


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