INTERVIEW
tension between being a clinician and being a politician would be too great. But, whatever discomfort it causes me, I also feel the understanding I have of the issues and whatever insight I have from working as a clinician in the Highlands and Islands, will be to the advantage of the committee. I am not claiming I can solve all of the difficulties we will address, and I am not sure how I will solve all the things I am asked to fix, but I spent 20 years advocating for people and trying to find a way through challenging clinical situations and I am pretty sure that those skills will be useful.’
Maree Todd got a taste for pharmacy as a schoolgirl working in her local chemist’s shop in Ullapool run, she says, by an inspirational woman pharmacist who was very much part of the local healthcare system. She studied pharmacy at Robert Gordon University, doing her pre-reg training in community pharmacy in Troon.
‘From a very early age I knew I was interested in science and also was a people person, so being a healthcare professional was an obvious way to make a difference. But why I chose pharmacy in particular, I am not sure. I think it was more ‘sciencey’ than other options.
‘Working in community pharmacy came as a bit of shock as all through university I had been very clinically orientated and I found working in the community wasn’t quite what I was expecting. I went back to it after qualifying but it was not what I was hoping. I thought I was going to be very much part of a healthcare team, integrated into the local healthcare environment with many opportunities for clinical activity, but in those days it turned out such opportunities were pretty limited.’
The move into acute psychiatry just months after qualifying was, Maree admits, a bit of a shot in the dark, but the alternative might have been to leave the profession. With no hospital experience, she applied to cover a maternity leave in Inverness.
‘I thought that’s an opportunity to try something very different and from the minute I started I loved it. Working within mental health, you get a real sense of satisfaction because the consequences of having a mental illness can be so devastating on every aspect of a person’s life, impacting
their physical health, their overall wellbeing and their place in their communities. I found there was a real opportunity to make a difference.
‘Also the drugs are quite toxic, quite tricky to use and people don’t want to take them. There is a job of work to be done to explain to people why these horrible drugs with horrible side effects can be a good thing in their lives. I found it fascinating. I have spoken to doctors who decided they weren’t going into psychiatry because they wouldn’t get that heroic feeling of having cured someone or having saved someone. For me that was part of the attraction because you often develop a long term relationship with people.’
In their manifesto, the SNP promised a new ten-year plan to transform mental health and to invest an additional £150 million to improve mental health services. There is now a Minister for Mental Health for the first time.
Maree says the extra funding will be welcome and is delighted that steps are being taken to start to close the huge health equality, and life expectancy, gap between those with chronic and enduring mental illnesses and those without. She does, however, have a real concern about the apparent low priority given to mental illness compared to other life-limiting conditions.
‘In the 20 years that I spent working in psychiatry, there wasn’t a huge number of new drugs or amazing developments. We did learn how to use what we had in a more refined way, doing less harm and being more likely to achieve a benefit. However, if you compare that with the progress that has been made in cancer in the last twenty years: cancer is almost like a different diagnosis now from then.
‘I keep asking myself what is it that drives pharmaceutical companies, for instance, to develop new medicines, and it is about having a market for them. There is a huge market in mental illness but the new drugs are not there.’
The SNP committed itself during the election to the development of community healthcare hubs, bringing together a range of professionals in GP surgeries, including practice nurses, district nurses, mental health professionals, pharmacists and
allied health professionals. All GP practices will, the government has promised, have access to so-called ‘enhanced pharmacists’, allowing GPs to focus more on the patients who require their assessment.
Maree Todd hails the move towards all clinical pharmacists being prescribers, but says that the democrat in her makes her wary of talking about a vision of pharmacy in the community and primary care for fear of being seen to be trying to impose something. And she knows from experience that what works in a hospital may not work outside it. She and her colleagues had wanted to connect better with the majority of their patients, who were living in the community not in hospital, by managing their medication through work with community mental health colleagues. However, they found that, with community teams covering several GP practices, each patient’s prescription had to go through their own practice and it was not going to be possible to simply extend the hospital pharmacy footprint into the community.
‘I sometimes feel that community pharmacists are working with both hands tied behind their backs. I can’t speak for people in other places, but working in the hospital where I did, I loved being an integrated member of the team, having someone to turn to when I needed. You can contribute a lot more if you contribute early rather than, as community colleagues have to do, trying to challenge a decision after it has been made.
‘I felt isolated as a community pharmacist. You don’t have access to the medical records in the way that a hospital pharmacist does. I recognise that there is far more opportunity to use all your training and be a more integrated part of your local healthcare now than there was, but I feel there still a way to go.’
At the start of the first meeting of the new Heath and Sport Committee, the convener went around the table asking members to declare their interests. Maree Todd declared just one: that she is a pharmacist registered with the General Pharmaceutical Council. She says she is keen to maintain her registration if she can.
‘I think that will be a challenge SCOTTISH PHARMACIST - 13
“IN THE TWENTY YEARS THAT I
SPENT WORKING IN PSYCHIATRY, THERE WASN’T A HUGE NUMBER OF NEW DRUGS OR AMAZING DEVELOPMENTS. WE DID LEARN HOW TO USE WHAT WE HAD IN A MORE REFINED WAY, DOING LESS HARM AND BEING MORE LIKELY TO ACHIEVE A BENEFIT.”
because I realise already, having done one month in the job, that it’s quite hard even to see my friends and family. I absolutely imagined that I would be back at the hospital on a regular basis saying hello to my old colleagues but time is a real challenge. One advantage that I will have, at least for the first few years, is knowing people to speak to and having access to people who will have ideas on how services can be taken forward, just because they have been colleagues.
‘To be able to maintain my registration is going to mean practising somewhere, somehow – I haven’t quite worked out that detail – so that should hopefully keep me connected to the coalface of the profession.’
Maree Todd MSP may not have to try very hard to keep abreast of the issues affecting pharmacy. It is a novelty to have a pharmacist as an MSP, and it’s a fair guess that the pharmacy profession will come calling on her at Holyrood.
John Macgill is Director of Ettrickburn, a communications and government relations consultancy specialising in Scottish healthcare and lifesciences.
www.ettrickburn.com •
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