Terry Maguire reflects on an inquiry that he never thought would happen
Being investigated
I never thought it would happen — but it did. After 40 years on the register of the Pharmaceutical Society of Northern Ireland (PSNI), I became the subject of a fitness-to-practice (FtP) investigation initiated by the Registrar on 19 February, 2025. I am delighted to say that the complaint raised was closed on 15 March, 2025, without further action.
That’s all good and fine, but it is difficult to properly convey the emotions that such a situation creates. There is, of course, the worry that the accusation might be considered correct by a panel of my peers. There is a sense of shame that, when coming to the end of my professional career,
I was potentially facing the ultimate sanction of being removed from the register for wrongdoing. It was, to say the least, a difficult four weeks.
Kneecap controversy
Only a pharmacist can appreciate this, I thought, but then the controversy over the West Belfast rap band Kneecap exploded and I realised that we are all open to attack over our views — and it is just the constant waxing and waning over what constitutes freedom of expression or freedom of speech.
I’m not sure many readers will be Kneecap fans. I’m certainly not. In my part of West Belfast where, at one time, plastic kneecaps were more common than false eyelashes, I think the name ‘Kneecap’ is in particularly bad taste, as is driving around in a 1980s RUC Land Rover. But, hey, that’s rock and roll, and as Voltaire reportedly said: “I disapprove of what you say, but I will defend to the death your right to say it.” So long as it’s lawful, I should add.
PSNI chaos comment
The complaint against me was based on an article I published in the UK pharmacy magazine Independent Community Pharmacist on 9 December, 2024 and titled ‘A Regulator in Crisis’.
OK, it was a bit tongue-in-cheek, it was a bit cheeky. I said I felt sorry for our poor old regulator PSNI, which celebrates its 100th birthday next year. Perhaps I went too far when I suggested that it was showing its age. But pharmacists do get a sense of utter chaos within.
I suggested that a newly-appointed CEO, who walked out after only 18 months, got a bad rap from the start. She had to deal with a sharply negative report from the Professional Standards Authority (PSA). The PSA, the regulators’ regulator, said that the PSNI had failed on three standards out of 18. For me, this was quite damning, as this is the regulator who regulates me and the day-to-day work I do. I suggest this really is a matter of public interest.
Standard 4 was not met because of the PSNI’s inability to provide timely and accurate information. The PSA felt that this raised serious questions about the confidence it had in the PSNI and its ability to address concerns. Standard 10 was not met because there were a number of registration errors on the PSNI’s register. It seems there were no robust processes and controls in place to ensure the accuracy of the register and, worse still, the PSNI had not taken action to reduce the risk of similar errors occurring in the future.
Standard 15 was not met because the PSNI was taking too long to deal with FtP cases. More worryingly, the PSNI could not provide sufficient explanation for the delays or what it was doing to minimise them.
It does make you wonder what we get for the annual registration fees. What are they doing all day in the office? This is what the PSA more or less said while also pointing out that given the PSNI’s small caseload, it should be able to manage delays more effectively.
In the article went on to say that I believed the core of the current chaos was cultural and that a legacy from a previous senior management team was proving difficult to eradicate. Staff disempowerment and central control is embedded in the organisation, as is its disdain and contempt for pharmacists. These are things that must change if the PSNI is to survive, I suggested.
There are major ongoing problems. The PSNI was struggling to appoint sufficient managerial staff and, until very recently, there were four vacant places on the Council.
But I was consolatory. I stated that the PSNI must continue to protect the public, but that does not mean it needs to shun the needs, views, and aspirations of those whom it regulates and who pay its wages. The current culture must change, I proposed, and, if it did, I would be happy to celebrate the PSNI’s centenary with a refrain of “many happy returns”.
The complaint
The complaint to the Registrar stated: “The factual inaccuracies in the article have the potential to damage the reputation of the profession through
the breaches in the Code cited… The absence of evidence, and where evidence is provided it’s [sic] inaccuracy, is inconsistent with the diligence required of a healthcare professional…”
My response to the Registrar gave careful regard to the Society’s threshold criteria for investigation. The article was written to address an issue of public concern in relation to the discharge by the Society of its regulatory function.
I made a case that my authorship of the article did not undermine the public’s trust and confidence in the pharmacy profession. Someone holding a contrary view to one expressed honestly by me
in an opinion article is certainly the wrong measure as to whether or not the public’s trust and confidence has been undermined in the pharmacy profession. This person is hardly the first to be enraged by my comments — hopefully they won’t be the last.
We need to have a right to honestly say what we feel. I consider that the article, which related to a matter of public concern, was an exercise of my basic right to freedom of expression. This, of course, is assured by Article 10(1) of the European Convention on Human Rights. Regulatory action taken against me in respect of my article, I felt, would be disproportionate.
The person bringing the complaint failed to identify how, and in what way, any alleged inaccuracies could amount to a concern about my diligence in the discharge of my professional responsibilities as a Registered Pharmacist. I believe strongly that it is outside the powers of the Society to investigate such a complaint and I am now looking to challenge that power for all who might find themselves in a similar position. It’s much too easy for the bullies to suppress healthy public debate and honest discussion.
What can the Registrar investigate?
In spite of my concerns about the right of the Society to investigate, I agreed to participate in the FtP process and to allow completion of the investigation stage, as I fully respect this process and its role in assuring patient and public safety. Had it gone beyond the investigation stage, I would have been forced to seek a Judicial Review, with all that would have entailed both for me and for the PSNI.
This person is hardly the first to be enraged by my comments
— hopefully they won’t be the last
In the threshold criteria issued in June 2020 and in the PSNI leaflet Rising Concerns; Patient and Public Guidance, the PSNI states that there are a number of areas that the Registrar cannot investigate. The latter document states: “It is not possible to provide an exhaustive list of all matters which fall outside the jurisdiction of PSNI.”
The areas explicitly excluded are: Customer complaints, contractual disputes, and employment issues. It seems obvious, to me at least, that expressing an opinion in a magazine honestly and in the public interest should be one of these excluded areas. The right to Freedom of Speech is such an important principle that it must be protected. If an article is truly dishonest, defamatory, or a cause of harm, this should be addressed in a different place, at least in the first instance. And whatever happened to a good old-fashioned Letter to the Editor? This investigation should not
have been initiated. By initiating an investigation, and giving it an FtP number, I was involved in an FtP process and this is the core of my objection. Instead, the complaint should have been dismissed. I am also unclear how the PSNI could fairly prosecute an FtP case in which there is a clear and unambiguous conflict. The article was critical of the PSNI.
Protecting freedom of speech
I wrote to the President requesting that the right to freedom of speech be explicitly stated in both the threshold criteria and the Raising Concerns leaflet. It seemed a simple request but the newly appoint CEO replied denying my request and saying that he had undertaken a review of my case and considered it had been dealt with appropriately.
In writing to the President, I was not seeking a review of my case. What I was seeking, and I will continue to seek, while being fully aware that there are well-established limits — Kneecap, you cannot incite people to kill other people — is to ensure that all pharmacists have a right to freedom of speech without fear of professional censure.
It is, perhaps, somewhat ironic that at this time, when professional leadership has become a key concern for our four UK Chief Pharmaceutical Officers, that ordinary pharmacists may be afraid to engage in robust and honest public discourse about professional matters in case they are sanctioned by their Regulator.
Terry Maguire owns two pharmacies in Belfast. He is an honorary senior lecturer at the School of Pharmacy, Queen’s University Belfast. His research interests include the contribution of community pharmacy to improving public health.
