Clinical Pharmacologists

Baroness Gardner of Parkes Excerpts

Monday 12th September 2016 Lords Chamber

[Baroness Gardner of Parkes (Con)]

My Lords, almost all my working life, I was involved in the National Health Service and in general dental practice for over 35 years; also, I had the privilege of serving as a member of various health boards. It is because the NHS means so much to me that I put my name down to speak in this debate.

Noting that the subject was “clinical pharmacologists”, I realised that I did not know precisely what they were and what they did. Although I asked the party Whips’ offices of Government and Opposition to provide me with their definition, neither did so, so I had to have a good look at Wikipedia, which was a great source of information. I know that this debate happened at very short notice, so I am not blaming anyone that only the weekend intervened between the time that we heard about it and now.

Wikipedia makes it clear that clinical pharmacology,

“is the science of drugs and their clinical use. It is underpinned by the basic science of pharmacology, with added focus on the application of pharmacological principles and quantitative methods in the real world. It has a broad scope, from the discovery of new target molecules, to the effects of drug usage in whole populations. Clinical pharmacology connects the gap between medical practice and laboratory science. The main objective is to promote the safety of prescription, maximise the drug effects and minimise the side effects. It is important that there be association with pharmacists skilled in areas of drug information, medication safety and other aspects of pharmacy practice related to clinical pharmacology. In fact”,

in some countries people,

“train to become clinical pharmacologists. Therefore, clinical pharmacology is not specific to medicine”.

Another point I must mention is how valuable the service is to general practitioners. They rely on the advice that comes through clinical pharmacologists to tell them which drugs are safe to put together and which drugs counteract or damage one another or create dangerous situations.

Another important factor is the role that they play in the national poisons centre. GPs have told me that when a patient presents and they have taken some sort of poison—or they believe that it is poison—they get on immediately to the national poisons centre, which assesses whether there is something available that could counter the poison that has been given or whether the person needs to be rushed immediately somewhere to be put on to a different type of treatment. The role that they play in the field of toxicology is extremely important.

Wikipedia lists the branches, which I shall mention by name. They include pharmacodynamics and pharmacokinetics, as well as dealing with rational prescribing, toxicology, drug interactions and drug development. So it is pretty wide-ranging—and it has been very informative. I have learned a great deal from speaking to people in the practice, who know what the position is.

However, it seems in many ways to be a very academic position, and education experts will probably know exactly what training is required. Are the facilities for training readily available? Does it require a double degree? Is the drop in numbers due to the difficulty in recruiting people wishing to be trained in this particular discipline?

From the speech of the noble Lord, Lord Hunt, it sounds as if there is a bit of a lack of interest. People may not be aware of how significant the role is and how satisfying it could be to do it well. Even the little I have found on the subject has revealed how important a part clinical pharmacology plays in the National Health Service. After listening to the speech of the noble Lord, Lord Hunt, I was better informed on that than I was just from Wikipedia, because he spoke about the very important roles that clinical pharmacologists play. But they are rather the invisible people; ordinary members of the public probably have no idea what they are—just as even I, who have worked so much in the health service, did not know exactly what it was. So we must be sure that the role is more widely recognised.

The noble Lord expressed the wish that people would be encouraged to go into it and made to feel it is worth while, and there might be more prospect of that when the subject is aired like this—then people have more idea of what they could do and how it could be a very valuable contribution. However, it requires a special temperament, because very demanding and highly skilled science is required. Their role of helping on rulings about rational prescribing—and I understand they have a place in the preparation of any new protocols for medicine—is vitally important work.

We cannot afford to lose too many clinical pharmacologists. The Government must look at ways of ensuring a continuing stream of these essential specialists for the NHS.