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Welcome to the May 2012 homepage edition of i2P-Information to Pharmacists. Rollo Manning has been having some time out having staples removed from the site of his open heart surgery.He is now at home recuperating in Darwin, having arrived home last Friday, beating a cold and hasty retreat from Canberra.We all wish him a speedy recovery and hopefully, he will be fit enough to contribute by next month.
This month, Pharmedia discusses the toll that is taken when someone complains about you to an authority without good cause. Well, the good news is that you can now take action to protect yourself if such a complaint is made, and that may even include action for defamation. Read about a recent case involving two doctors, with Mark Coleman drawing on personal experience to illustrate.

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Does the PGA Really Represent its Members

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Neil Johnston articles by this author...

Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000.

This month we have selected a media story that appeared in Pharmacy News on the 3 November 2011, and it is story of the continuing saga of direct distribution by Pfizer.
The bigger story underneath is - what is the Pharmacy Guild of Australia doing to represent its members in this ongoing dispute?
i2P has covered the direct distribution saga since its inception here in Australia.
The problem seems to be worsening rather than improving, so we have asked Mark Coleman to comment.
His comments appear below the media item that follows.

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Guild members dissatisfied with Pfizer Direct

3 November, 2011

Dissatisfaction with Pfizer’s Direct distribution deal remains significant, a major online survey of Pharmacy Guild members has revealed.
The Guild surveyed 911 community pharmacies during October, in response to reports of a range of problems, including medicine delays, after the program was introduced in February this year.

The surveyed pharmacists reported a total of 8194 patients had been ‘adversely impacted’ - defined as inferior access to Pfizer medicines compared to previous distribution by wholesalers - by the Pfizer model in the past month.
This represented an average of nine patients per pharmacy, with one reporting 79 patients had been affected.
On Pfizer’s performance since March, 21 per cent of respondents said it had improved, 59 per cent said it had stayed the same, and 18 per cent believed it had worsened.

The majority of the respondents said the Pfizer Direct model had also increased patient waiting times.
On DHL’s performance since March, 15 per cent said it improved, 66 per cent said it stayed about the same, and 17 per cent  said it was worse.

The most popular recommendation to improve the Pfizer arrangements, (74 per cent), was Government action requiring manufacturers to supply all PBS medicines to full-line wholesalers, while allowing the manufacturer to also supply directly if they choose.
The removal of delivery charges was the second most popular recommendation according to 60 per cent of members.
 A third of respondents recommended all manufacturers supply all branded PBS medicines to all full-line wholesalers, while allowing manufacturers to also supply direct.
 The introduction of Saturday deliveries and extended cut off times for ordering also garnered support.  
A Pfizer spokesperson said they would discuss the survey results with the Guild as a “matter of priority” and were committed to improve pharmacy services and making Pfizer Direct work. 

“Our commitment is to deliver our medicines on the next business day. We have delivered 366,000 orders since February, including more than 8,000 urgent orders delivered free of charge,” the spokesperson said. 

Mark Coleman

The PGA executive enjoys quite a few little luxuries, courtesy of the Australian taxpayer (management commissions), and substantial payments from drug manufacturers (subsidising various activities).

This has had the effect of converting the PGA into a big and wealthy business.
What is really happening underneath both the above types of payments is that the payers are buying influence often to member detriment.

As for all things in life, if there is balance in the peddling of influence and the dollar values received are distributed for the benefit of all members, then the PGA is seen to be doing its job properly.

That does not appear to be the case because pharmacy costs are increasing because changes in the supply chain, principally because of Pfizer, are beginning to make pharmacy uncompetitive through higher costs.
Changes in PBS payments and loss of gross profit through arbitrary price reductions means that pharmacies face a "double whammy" after April 1 2012.

So the PGA is caught in the middle with both sets of "payers" demanding their "pound of flesh" to ensure they can demonstrate to their shareholders (taxpayers in respect of the PBS) they are getting value for money.
The PGA is very quiet on the PBS front knowing that their political masters have a different agenda to that of community pharmacists, Their priority lies in getting the budget deficit off their back and getting re-elected in a climate where Tony Abbott's virulent criticism is blunted.

The PGA is also relatively low key about Pfizer complaints, paying lip service to the problems by simply recording pharmacy complaints on their website.

But hold on - isn't the PGA a trade union with the ability to flex industrial muscle where necessary, in support of its members?
But that would mean losing lucrative dollar streams and having to tighten up on executive perks.
Confrontation is the last thing they would want.

Ask the average PGA member and you would find that confrontation is exactly what they want. So the PGA executive is not carrying out the wishes of its members and will confront and isolate any member who dares to step out of line.

It's a dangerous game in an unstable financial climate.
The gamble (by the PGA executive) is to try and ride events through to a manageable end without being challenged from within.

The only thing that makes community pharmacists combine for a common good is a diminishing bottom line. With the bankruptcy rate well up and expected to continue to rise and the competitive pressures that continue to occur through disruptive retail models (such as Pharmacy Warehouse), low bottom lines will be more apparent over 2012.
As events unfold later this year and the turmoil rises, we may yet see a new breed of PGA member ready to make their executive accountable to members and refresh it with new talent.
At that time it may be possible to rectify some of the items ignored some 12 years ago in the Wilkinson Report and create a new and dynamic pharmacy environment.

Items to consider will be:

1. Allowing pharmacy companies to have unregistered content.

2. Ensuring that pharmacy boards are allowed to recruit non-pharmacist directors with special expertise.

3. Ensuring that there is balance between the supply side of pharmacy and the professional services side of pharmacy. This might mean that chain groups of pharmacies must have a certain level of contracting pharmacists in each premise, or that individual pharmacies over a certain turnover have a similar provision.

4, That location rules should be abandoned in favour of allowing a highly competitive market place to encourage innovation. The current regulated market place is stifling initiative and keeping new pharmacists out of employment.

5. That the PBS be competed against with a private version that uses professional services as the defining difference.

The above variations will be more stimulating than what is currently on offer.

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