As a potential main player in the primary health care sector and the impending National Health Insurance (NHI), community pharmacists could make a significant contribution to easing the health care burden in South Africa. Recent legislative and organizational changes related to the corporatization of pharmacy in South Africa have impacted significantly on the profession and stand to weaken the already ‘tenuous’ professional identity of pharmacists in the country. Since community pharmacists are viewed as potential main players in the primary health care sector, the influence of corporatization on pharmacists’ identities and their concomitant ability to contribute to easing the health care burden in South Africa need to be considered. In this regard, this study examined the influence that corporatization has had on the professional identity of community pharmacists practicing in the Nelson Mandela Bay area of South Africa. That is, in an effort to understand the influence that corporatization has had on changing professional identities and practices the attitudes, beliefs, and behaviours of community pharmacists regarding the philosophy and practice of pharmacy were explored. This included ascertaining community pharmacists’ self-perception of their professional identity and the perception of users of these community pharmacies. The study was conducted from an interpretative epistemological paradigm, based on a philosophy of pragmatism. Data collection was conducted in two phases and a qualitative approach, which included in-depth and semi-structured interviews, was adopted as a design. Phase one investigated the self-perceptions of sixteen community pharmacists, equally distributed between independent and corporate pharmacies in the Nelson Mandela Bay (NMB). Phase two examined the perceptions of thirty-two end-users of the pharmacies included in the study. Data from both phases were then analysed and interpreted. Following the identification of seven core professional identities, namely pharmacists as custodian or keeper of medicines; primary health care givers; confidante and carer; jaded; astute and credible; corporate; and independent, it was determined that corporatization has, to various degrees, had an effect on the undermining of Nelson Mandela Bay community pharmacists’ view of themselves as skilled professionals in the health care sector. In short, it was found that corporatization is believed to have blurred the boundaries related to what it means to be a pharmacist and what role pharmacists should play in the provision of public health care. Corporatization does not appear to have influenced the patients’ or pharmacy end-users’ perceptions of the pharmacist, and furthermore does not play a major role in their choice of pharmacy. It is the perception of pharmacists in this study that with the introduction of legislative changes, more so corporatization, they experienced an undermining of their professional skill and disregard for costs involved in becoming a pharmacist. The perceived undermining of the professional skill of pharmacists threatens the valuable contribution that community pharmacists can make to balancing the country’s socio-economic status by appropriately and efficiently assisting in preventing, managing and/or reducing the disease burden in South Africa. Corporatization of the community pharmacy sector seems to have realized the government’s intention of making medication affordable to its citizens, however, the certainty of whether corporatization benefits patients that are in need of access remains to be seen. Community pharmacists could in fact, capitalize on the identification and enactment of their clinical skill (pharmaceutical and social caregiving) as this skill appears to be a tool that will allow pharmacists meaningful transition to being real contributors of primary health care in the imminent introduction of the NHI. At the same time, recognition of the role a pharmacist plays in primary health care will be supporting the government in its endeavours to making medicine accessible and affordable to all South African citizens without compromising their health needs. Ultimately, pharmacists can assist in the balancing and/or improvement of the socio-economic status of our society and the country.

The thesis explores the various instances in which pharmacists may incur delictual liability for harm suffered by their patients or third parties. As such, it is primarily concerned with the field of professional negligence. The work focuses specifically on the wrongfulness, fault and causation enquiries in pharmacy malpractice cases. The discussion is set against the backdrop of the pharmacy profession's shift towards patient-orientated service in recent years and explores whether this change in the profession's social role has had any effect on the legal duties and standard of care to which pharmacists are currently bound. It is argued that, in light of the dangers posed by modern medicines and the extent to which pharmacists are professionally expected to involve themselves in patient care, pharmacists can no longer escape liability simply by accurately dispensing pharmaceutical products. Rather, they are expected to participate actively in avoiding drug-related injury by, for example, providing patient counselling, detecting invalid or erroneous prescriptions and monitoring prescription refills. Although the thesis places particular emphasis on the role of pharmacists in achieving risk management, it also argues that pharmacists are, in very limited circumstances, required to participate in the risk assessment process traditionally thought to fall exclusively into the realm of physicians. It is furthermore demonstrated that pharmacists can incur liability regardless of whether a patient's harm can also be partially attributed to the blameworthy conduct of another healthcare professional. Although the thesis concludes that pharmacists are currently exposed to greater risks of liability than they were in the past, it also shows that plaintiffs who seek damages from pharmacists will usually experience a number of difficulties in establishing liability. In particular, problems are likely to be encountered in satisfying a court as to the presence of factual causation, which is notoriously difficult to establish in drug-related cases.