Editorial

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Welcome to the first homepage edition of i2P for 2012.
In many ways it has been a slow start to the New Year because of having to deal with the “leftovers” from 2011.
One of those items for i2P was that a third-party provider to the site did not advise of a code change to the security section in our subscribe panel, creating a range of frustrated subscribers not able to get on board.
We apologise to all those potential subscribers who were unable to register with us in the second half of 2011, but if you try once more you should have no problem.

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Volume 2012 Number 1

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ABORIGINAL HEALTH

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Rollo Manning articles by this author...

Rollo Manning has experienced pharmacy practice from all sectors of the industry – retail, administrative, policy and remote Aboriginal practice. He spent 10 years with Glaxo Australia and was the first Director of Public Relations at the Pharmacy Guild National Secretariat in Canberra. He has also held the position of Pharmacy Policy Officer for Territory Health Services in Darwin. Rollo is currently a Consultant working in his own practice with remote Aboriginal communities, in Northern Australia.

“Medicines are just a packet of chemicals which without information will not work” – Anon E-Drug.

The quest to “Close the Gap” between Aboriginal Australians life expectancy and the mainstream population will be made all the more possible when some attention is given to taking medicines seriously.

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In mainstream the PBS costs the Government $325 a person for PBS medicines consumed in a year. This figure is the Government contribution to PBS payments and does not include the below co-payment spend that is incurred by all non concessional persons buying their own PBS medicines at full cost. The amount is nearer to $500 per head if this is included. The dollar value expended by the same agency (Medicare Australia) for Aborigines living in remote places in the Northern Territory is $340 per person. This despite a much lower life expectancy, median age at death and general morbidity. Recent publications have remphasised the dire state of Aboriginal health in the NT and the impact it has on the hospitalisation rate due to chronic diseases.

Effective drug therapy is one criterion given to describe chronic diseases yet there is very little spent on the “quality” way that medicines are viewed in the overall health system. The programs tackling this burden of disease do not give the emphasis that is needed to bring the availability of advice forward to the remote Aboriginal population.

Even with the recent (Federal Budget May 2009) increase in “handling fee” for retail pharmacies supplying remote health clinics PBS medicines it is still $3.30 short of what is being paid to mainstream Australia.

A fee of $2.69 is paid for the supply only function (s100) compared with $5.99 through the PBS Section 85 arrangements for the rest of Australia. This means that when anyone in Australia gets a prescription filled they have the opportunity to have the advice of a pharmacist on the drug, its actions, interactions and anything else needed to be known to make the drug effective.

For the Aboriginal person in remote Australia none of this is available.

If the Government is serious about closing the gap it should make available an amount of money equivalent to the mainstream PBS amount to allow pharmacists to be employed by Aboriginal health services. At least then a start could be made on the education process needed to help people understand what medicines are for and where they slot in to the chronic disease management process.

In the NT in the 2007-08 year there were 692,824 prescription items on the PBS supplied to the 53,000 remote living Aboriginal people. Given the $3.30 per item this would provide $2.28 million to employ a number of pharmacists working at the regional level.

The NT is also working towards an Area Health Service structure and every area should have on its agenda a pharmacy business that would go a long way towards achieving better quality use of medicine by employing pharmacists with the money made from PBS supply.

After all – it is the PBS that pays the cost of employing a pharmacist at every community pharmacy in Australia so why not do it for the communities where remote Aboriginals live?

The employed pharmacists could be attached initially to the Aboriginal Medical Services Alliance of the NT at be part of the planning process towards the new Area Health Services.

Once this happens the Nation will be taking medicines seriously.

Comments to Rollo Manning at rollom@iinet.net.au

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