Editorial

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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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The Face of Pharmacy's Moral and Financial Bankruptcy

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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.

The face of pharmacy has evolved to be that of the Pharmacy Guild of Australia (PGA).
Whether all pharmacists are accepting of this role is problematical as evidence of shabby commercial deals and political suppression of a pharmacist majority is seen to be a blatant reality.
Most pharmacists (including some members of the PGA) are trying to distance themselves from this bad behaviour, but find themselves inextricably bound up in these events with the 5CPA becoming the "glue".
Recently there has been a call from the Pharmacy Coalition for Health Reform to renegotiate the 5CPA, and a call by Greens Senator Richard Di Natale for an inquiry into the Government’s dealings with the PGA.
Pharmacy is beginning to be seen by the public at large as fast becoming morally and financially bankrupt.
I personally don't wish to be part of this image-do you?

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The complacency exhibited by most members of the Pharmacy Guild of Australia (PGA) is astounding.
They have simply accepted what their executive has cobbled together over the past decade without asking any hard questions, to the extent that no research seems to have been undertaken to determine what is the best business and professional model for a community pharmacy to present to an Australian health consumer.
What are their needs and how are those needs best met through a variety of supported pharmacy models?
Now we have an alarming number of bankruptcies that have erupted over 2011, set to continue into 2012.
This is a product of poor leadership direction, resultant consumer drift and poor individual pharmacist owner management skills.

It is certain that the marketplace will quickly determine who stays and who leaves from this point on, but unless the average PGA member is willing to change and adapt to the required conditions for servicing Australian Health Consumers, they will quickly join the ranks of the “leavers”.

Given the money that the Australian Government passes over to the PGA for purposes of research (and pays the PGA a 10% commission for “management”), it is appalling that the most visible model of a community pharmacy is now the warehouse version. These versions provide minimal to nil professional input with a significant number selling discredited products and appliances.
Because they encompass a large market share, they bring criticism down on all pharmacists.

Kos Sclavos, when addressing the recent PGA annual dinner said:

“The Guild will always be working to ensure the best outcome for pharmacy, as well as for the Government and consumers,” he said.

“I acknowledge that we sometimes make mistakes, the key is how you respond to those mistakes. You can be certain the Guild will always be playing a role, not criticising from the sidelines.”

When he talks about the “best outcome for pharmacy” this has come to mean the best outcome for the PGA executive with even PGA members being left out in the cold.
The best outcome for government is always assured because of their control over the privileged PGA position of being a single negotiator for all of pharmacy.
This has meant that suitable seed funding to develop new innovative pharmacy practice models has been unavailable through the allocation of government grants, and that other substantial groupings of pharmacists have been isolated from the decision-making process.
It has also meant bending to the government will, otherwise privileges involving grant management and deal-making decisions would be lost.

The best outcomes for consumers are also being ignored when innovative pharmacists are suppressed in their desire to serve the community with the skills that they have been trained in. This is a circular problem resulting from the lack of PGA leadership in developing a community pharmacy model that encourages, develops and nurtures pharmacists to provide professional services.
I do not know of any community pharmacy that has a position with the job description of “practice pharmacist”- and that just about sums up the problem (which is a PGA creation).
When Kos Sclavos says the “Guild will always be playing a role, not criticising from the sidelines” you would have to comment:
(i) Where is the professional model of pharmacy identified by the PGA as far back as 1978?
(ii) Where is the value in the range of PGA-promoted professional services that are mostly imported from the US and are “top down” versions that do not create a suitable professional channel for Australian pharmacist development?
(iii) “Critics from the sidelines” have now coalesced into the Pharmacy Coalition for Health Reform that involves representation of pharmacist numbers far in excess of PGA members.
While i2P has no formal membership of this group it endorses its objectives without reservation.
As an organisation they are threatening to leave the 5CPA Reference Group because they are being ignored, and their ability to influence new professional programs is virtually nil.
What a way for the PGA to demonstrate leadership!
Government does not want to lose its influence and control over pharmacy through the PGA and the PGA does not want to lose its privileges and lucrative and exclusive funding source through grant management.
This borders on being corrupt and it is time for both Nicola Roxon and the PGA executive to take heed, because enforcing the existing system will lead to a pyrrhic victory at best, and a collapse of the entire fabric of pharmacy at worst.

It is well known that health consumers want to access a pharmacy information system of primary health care to enable users to self-manage or take responsibility for their conditions.
A study into GP Practice called Bettering the Evaluation of Care of Health (BEACH Study) found that over a ten-year period, GP’s had written 5.5 prescriptions per 100 patients fewer, than when compared to 10 years ago.
Overall, prescriptions increased because of increased patient visits which increased 26 percent over the same time.
It has been pointed out previously that a number of these visits could have been managed more efficiently and cheaper by pharmacists, even in their currently deficient environments.
There is a demand out there for primary care services that will continue to rise.
GP’s are not handling the demand adequately (have you tried making an appointment lately? In my area the wait is now six weeks!)

So what has the PGA done in practical terms to assist in servicing this demand?

Effectively nothing – and it is preventing pharmacists who can deliver substance from being involved, by starving them of grants and seed funding.
Kos Sclavos now has on his patch the largest number of bankruptcies in a single year-more than for the combined annual total for the past decade.
Should that not be a signal for a change in both PGA leadership and the way we do things in the whole of pharmacy?
In the past the PGA earned its leadership position.
It no longer has that moral authority.

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