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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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Pharma-Goss - With Rollo Manning - August2009

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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.

For August i2P

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A SINGLE ISSUE COULD CHANGE THE WORLD

Single issue parties rarely succeed in a political race but one Sydney pharmacist believes the “location rules”, if abandoned, could change the pharmacy landscape for the better through the 5th Community Pharmacy Agreement (5CPA). The rules governing the distance between Approved Pharmacies for PBS dispensing are up for review during the course of the 4th CPA and will be “on the table” for negotiation if there is to be a fifth agreement between the pharmacies of Australia, represented by the Pharmacy Guild and the Commonwealth Government.

Tim Flaherty, who has owned some 20 pharmacies in his 20 years as a pharmacist told Pharma-Goss that the profession would always remain stalled on professional development activities while competition between Approved Pharmacies was so limited.

“The only way to improve things is by competition that would put everyone in a situation where they had to perform or go broke”, Mr. Flaherty said.

As a contribution to the 5th CPA the attached one page explanation (click here) of a world without location rules is offered by Tim Flaherty. He is urging all pharmacists to forward this to their local member of Federal Parliament so representations can be made to the Minister for Health, Hon Nicola Roxon.

“There is no reason to restrict the opportunity for young pharmacists to open a business wherever they like and compete with the ‘big boys’ for dispensing PBS scripts and add value with knowledge in the form of information to patients”, according to Tim Flaherty. “We have to get away from this idea that the system dictates the process and start focusing on the patient. While the Pharmacy Guild comes up with all the reasons why something should NOT be done the patient is the one that is missing out in the name of protecting the business interests of a pharmacist.” he added.

MISTAKES WE’VE HAD A FEW

Another report this month (July) pointing to the number of mistakes in the taking of medicines by Australians that has lead to hospital admissions. The headline in The Australian (8th July) said “Medicine harming patients” at the same time as pharmacy leaders were shouting to the rooftops the wonderful contribution “community” pharmacy could make in helping the Government implement its National health policy. Let’s be honest about this – pharmacists are still seen as the ones who supply medicines – put the labels on the boxes and hand them out – with little patient intervention and invariably with the pharmacist making no contact with the patient.

It is one thing to state that this can be done – but another to demonstrate through research what is happening now. Everyone associated with retail pharmacy knows that there are hundreds of pharmacy businesses that simply supply - so let’s get real and put the house in order before claiming to be able to do more that what is humanly possible.

A position exists around the country where pharmacists are being required to work a 12 hour day dispensing 400 plus scripts a day and thus without the time to have a lunch break. When is the time going to be available to enhance the preventive health measures of the government?

Structural reform is needed to make way for high volume dispensing outlets with the critical mass to employ enough pharmacists to use their knowledge in helping patients to understand the elementary elements of primary health care and the social determinants of ill health. Until this happens through a major restructuring of how the PBS is supplied to the Australian public pharmacists will be bound to the dispensing bench trying desperately to convert investment capital into useful dividends. This is not the climate for a successful primary health care approach to pharmacy practice.

In the ten years from 1998 to 2008 the number of adverse effects from medication rose by 20% and this at a time when pharmacists are claiming to be the most accessible and informed health professional at the coal face with the community. If it is that good these reports would not exist. Get on with doing what you are supposed to be doing well before branching out into something else and that includes the ability to prescribe. Nurses are fast becoming the number two behind doctors in prescribing stakes and pharmacists should be supporting them as much as possible with drug knowledge rather than trying to compete in the proscribing role.

SCLAVOS AT NATIONAL PRESS CLUB

It is the opinion of this columnist that if something is said passionately and often enough the audience might start to believe it is true. However to stretch the truth and use words that imply something is better than it really is leaves the speaker open to harsh criticism when the truth is found out.

Mr. Kos Sclavos, National President of the Pharmacy Guild of Australia, the peak National body for the owners of pharmacies in Australia, indulged in this poetic license when addressing the National Press Club in Canberra on Wednesday 29th July 2009.

In fact the billing alone is enough to turn off the honest listener. The Guild is a peak body for the owners of pharmacies and not health in Australia.

For some examples the following is from the address given by the Guild President:

(Reviews of the health system) no systemic issue was identified as being problematic with community pharmacy or the PBS.

Reviews are about identifying opportunities for improvement and it could be equally honest to say that no opportunities were identified for future involvement of pharmacists.

200 million prescriptions or 80% of PBS medicines dispensed each year to price is the same…$5.30 everywhere…

This is using a very bureaucratic definition of “PBS medicines”. At $5.30 the Pensioner/HCC price is the same by definition. However to make out this is a lot at 80% by excluding the huge volume of non subsidised PBS listed medicines is deceiving.

(The Guild) is the peak health organisation to help shape the PBS…

The Guild is the only organisation to represent the owners of pharmacy businesses – no more – no less. To say it is a peak health organization is extending the scope to a level that is not acceptable. The Guild is the ONLY organisation listed in the National Health Act with respect to the PBS so the PBS is in its charter.

…we invest our own funds in many projects.

With extreme help from the taxpayers of Australia through the $500 million plus for research and development through the 4th CPA. This is not “own funds”.

Community pharmacy is a $12 billion a year health industry

It is a $12 billion retailing business that has the license to distribute the PBS to the public.

70 per cent of that $12 billion comes from directly dispensing prescription medicines – about 250 million scripts a year.

Oh yes! So there are 200 million Pensioner/HCC scripts – so is this saying there are ONLY 50 million scripts for general patients? Surely the under co-payment dispensing is in itself a large number but one which the Guild is reluctant to state in case someone works out how much money is being made from that sector of the script market. Let’s have the facts on the total dispensing business and not try and make out that PBS subsidised is the only sector.

(Increased wages) will cost jobs…because every other sector can just put up prices but for community pharmacy the prices are fixed.

Garbage- the only fixed charges are the $5.30 and $32.90 patient contribution – and even these can be discounted. Surely this unbelievable statement would have made the listener wonder how Chemist Warehouse and Discount Pharmacies can get away with the lies they advertise. The Government cannot fix the prices – it would be in breach of its own Trade Practices Act.

Their (the 3200 line items on the PBS) average price is around $43

Wrong. This is the average of the items where the PBS pays part of the price and does not include the large sector of dispensing where the patient pays the full cost as there is no Government subsidy.

…the Australian public pay either (the $32.90 or $5.30 patient co-payment) wherever they are on this great continent – that’s a triumph for equity and access.

What!! Either $5.30 or $32.90? What about all the values in between that can vary depending on location (remote or urban), mode of shopping (Internet or mail order), and government policy – Queensland where PBS on hospital discharge is a flat fee. That is no triumph in equity but a competitive market place treating medicines as items of commerce.

While there is much media speculation about generic medicine prices there is no other area of the Australian economy that has that level of transparency.

And what about the discounts, bonuses and incentives that are loaded on pharmacies just to stock a range of generic brands. The Guild President knows as well as anyone how cheap these can get the buy in price down to – let’s see the consumer benefit from low prices. Where is the transparency?

Over to you Mr. Sclavos – care to respond to these comments?

 Send your subject suggestions to Pharma-Goss for comment by using the panel below.

Edited by Rollo Manning at rollom@iinet.net.au

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