Greece: The National Chamber of Pharmacists

The current three distinct Greek associations might be coordinated by a single National Chamber of Pharmacists, representing the only reference point for the safeguard and the promotion of the profession, the keeping of registries of pharmacists and acting as the counterpart of institutions in the development of new laws. The examples active in French, Italy and Poland

Giuliana Miglierini

15 May 2019

The profession of pharmacist may be exerted according to several different pathways, each of which with its own peculiarities to be safeguarded by a relevant professional association. In Greece three distinct professional bodies are currently active, representing respectively graduate pharmacists who own and operate their own community pharmacy (the Panhellenic Pharmaceutical Association), all graduate pharmacists who do not own their own pharmaceutical enterprise in general (the Panhellenic Association of Pharmacists) and hospital pharmacists of Greek public hospitals (the Pharmaceutical Association of Hospital Pharmacists).

To overcome this fragmentation, a major goal set forth by the board of Panhellenic Association of Pharmacists is the creation of a National Chamber of Pharmacists, similar to those already present in many European countries. The new Chamber may better provide protection of the integrity and independence of the profession, as it would include all its different declensions.
The maintenance of a register of pharmacists may also be centrally organised, supporting the better monitoring of competencies. The National Chamber may be also involved in giving opinions on draft regulations and laws concerning pharmaceutical affairs, or on pre-and post-graduate education pathways of pharmacists, and it may have disciplinary jurisdiction over the professional liability of pharmacists.
We provide analysis of the French, Italian and Polish models of National Chambers of Pharmacists to help understanding of the potential offered by the creation of such a professional body in Greece too.

The French Ordre des Pharmaciens

The French National Chamber of Pharmacists (Ordre des Pharmaciens) is the central reference body for all pharmacists who are active both in Metropolitan France or in the overseas departments and collectivities. It is structured according to seven different sections, each representing a specific pharmaceutical professional occupation (apart from section E):

Section A – Community pharmacy owners;
Section B – Pharmacists working in the pharma industry;
Section C – Pharmacists working for wholesalers;
Section D – Employed community pharmacists;
Section E – Overseas;
Section G – Clinical laboratories;
Section H – Hospital pharmacists.

The administrative and jurisdictional roles are played by the regional Councils for section A and the Central Councils of the other sections. A central governing board is made by representatives of the different section Councils, and those members are elected for a six years mandate. Up to half of Council’s members can be renewed in half of their mandate, during elections held every three years.
The French Public Health Law (Code de la Santé, art. L.4231-1) establishes that the National Chamber of Pharmacists is responsible for safeguarding the legality and integrity of the profession, in fulfilment of a public service mission. This include the respect of professional duties, the protection of the integrity and independence of the profession, the monitoring of the competency of pharmacists and the promotion of public health and the quality of treatments, with a particular attention to the safety of professional actions. The Chamber organises and keeps updated the Pharmaceutical record (Dossier pharmaceutique), listing all the medicinal products provided to each patient over the last four months (21 years for vaccines, 3 years for biological drugs), prescribed by a doctor or advised by a pharmacist.
The French National Chamber of Pharmacists also represents the sector with the public authorities and assistance bodies and it can initiate civil actions before all jurisdictions to safeguard against direct or indirect prejudice to the collective interests of the pharmaceutical profession.

All pharmacists need to be registered with the Chamber in order to exert their profession in France, with the exception of public health inspection pharmacists, regional agency health inspectors, inspectors of the French Health medicines and Products Safety Agency, pharmacist officials or related roles in the ministry for health and ministry for higher education, not involved in any pharmaceutical activity, and pharmacists involved in active service in the health services of the land sea and air forces.
The registration is a formal act aimed to validate law requirements to exert the profession (qualification, competence, respect of ethical standards, independence, the holding of a dispensary operating licence, etc.), and it is supported by the presentation to the Chamber of the documentation pre-determined by law. Establishments where pharmacists work need also to be authorised. Should the pharmacist exert different types of pharmaceutical activities, he/she would be registered in all the relevant sections of the Chamber. Private practice companies (SEL) have also to register, in addition to single pharmacists operating within them. Upon granting of the registration, a certificate is released to the applicant, or motivation of refusal is provided. A tacit refusal period of three months is set for applications in the area of Metropolitan France. Any decision can be appealed before the National Council of the Chamber.

The Italian Federation of the Chambers of Pharmacists

In Italy the profession of pharmacist can be exerted by law upon registration to the local Chamber of Pharmacists. These are organised at the level of each single Italian county (101 in total), and are centrally represented by the National Federation of the Chambers of Pharmacists (Federazione degli Ordini dei Farmacisti Italiani, FOFI). This last one – created in 1946 – is in-charge of the coordination of the local Chambers and represents at the national level all issues pertaining to the profession. It also organises the central registry of pharmacists. Elections to renew the board members occur every three years.

The institutional role of FOFI is similar to what is seen above for the French Chamber. The association exerts the disciplinary power with respect to the local Chambers and promulgate directives for the resolution of disputes regarding the profession that might occur between pharmacists and citizens or other bodies. The Chamber also supports the cultural growth and the professional development of its associates, and it designates its representatives within national commissions, institutions and other bodies. It collaborates with the government for the development of new laws impacting on the profession.

To be qualified for registration to the Italian Chamber of Pharmacists it is not enough to have completed the five year course of studies in Pharmacy or in Chemical and Pharmaceutical Technologies: a six months period of apprenticeship within a community or hospital pharmacy is also needed, followed by the passing of the National Exam. The Chemical and Pharmaceutical Technologies curriculum is more focused on the technological and industrial aspects of the preparation of medicinal products, dietary supplements and cosmetics, while the Pharmacy curriculum more generally covers all activities typical of the profession of pharmacists, including aspects related to health education and communication towards the public.

The Polish Pharmaceutical Chamber

The Polish Pharmaceutical Chamber (Naczelnej Izbie Aptekarska, NIA) represents all pharmacists working in the country, irrespective of their specific type of activity. It safeguards the autonomy and independence of the profession, working to code and promote ethics and deontology of pharmacists. The Chamber cooperates with the public bodies and other social entities, scientific societies, universities and research centres to solve issues regarding the profession or the public health. It also express the position of pharmacists on the organisation of the healthcare system and the pharmaceutical governance.
The Chamber’s representatives may take part to selective procedures regarding the profession. Its governing board may ask for new legislative initiatives, and expresses its opinion on pre- and post-degrees education pathways for pharmacists.
The Polish Pharmaceutical Chamber is responsible for keeping three different registries, the central register of Polish pharmacists, the one confirming the right for pharmacists from other EU countries to exert the profession in Poland and the disciplinary sanctions registry.
The Chamber is organised in thirteen different commissions, including those specialised on the different sectors of pharmacists activity (public or hospital pharmacies, wholesalers, etc.)