Editorial

From the desk of the editor

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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Pharmacy Needs a Peak Body

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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.

Once upon a time pharmacy was a small, typically one-person show that focussed on patients (as distinct from customers).
It was considered very bad form if a patient presented with a problem and ;
(i) they were not immediately attended to by a qualified pharmacist and;
(ii) they left the pharmacy holding a product in their hands that had not been personally compounded by the pharmacist.
Most patients asked for “their pharmacist” by name and entered into an obvious and valued pharmacist/patient relationship. The care was obvious and not substituted with branded medicines or had the patient interviews delegated to pharmacy assistants or technicians.
In other words the human relationships were respectful and this respect extended between pharmacists as a collegiate relationship.

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At that time, all pharmacists, whether pharmacy owners or not, belonged to the Pharmaceutical Society – each state having its own version.
As business complexity grew, it was found necessary to split off a second organisation to attend to those complexities of running a business and so the Pharmacy Guild was born, leaving the Pharmaceutical Society to attend to the remaining professional needs of pharmacists, such as education and professional direction.
Both organisations grew and developed, and eventually became national in scope of operations.

A third-party intervened in this pharmacy mix circa 1952 in the form of a federal government who wanted to introduce a universal health care system. Since then, government has been a dominant influence because they have become the major funder of pharmaceuticals and health services.
To deal with this dominance, pharmacy has had to become more political to deal with politicians of all persuasion, and an ever expanding government bureaucracy that has little experience and understanding of business management and the personal outreach required to deal with patients.
Often pharmacy has been wedged between a “rock and a hard place” at considerable cost.
Most pharmacists feel they are just an extension of a government department due to the punishing and ever-increasing paperwork and regimentation, leaving little time or incentive to get on with the real job i.e. personal patient care.

Over time more pharmacy organisations emerged to cope with the needs of niche pharmacist problems or activities.
We have seen a separate group emerge for hospital pharmacists, a trade union of employed pharmacists, groups established around education and specialties e.g. consultant pharmacists – and the list continues to grow.

The balance of power was inexorably altered when government, wishing to streamline its dealings with pharmacy, appointed the Pharmacy Guild of Australia (PGA) as the sole negotiating body for PBS dispensing and as well, the manager for all grant monies to be applied to pharmacy research activities.

These decisions forced all pharmacy activities to be funnelled down a single tube.
The decisions were not democratic (they were developed secretly) and they have allowed a singular view of the pharmacy world to grow in a monopolistic and uncreative manner.

Those decisions forever split the cohesiveness and collegiality between pharmacists because they have taken the profession down a pathway that has not been agreed to or even democratically voted on by all pharmacists.
This problem has been festering for some years and recently the PGA has come under heavy criticism by the profession and industry for its policies, and deals that were not considered “kosher”.
To such an extent that Stephen Greenwood, a former Executive Director of The Pharmacy Guild of Australia (1992 – 2006), who presided over most of the PGA policy development and direction over those years, has suddenly become very busy cleaning up the PGA image in various pharmacy media through “insider” type articles extolling the virtues of the 5CPA and other PGA activities.

Prior to working for the PGA he worked in the Australian Public Service in Canberra as a senior adviser in the Department of the Prime Minister and Cabinet and in the Department of Health for a total of 18 years. He currently runs his own consultancy business, Greenwood Government Relations Pty Ltd, focussing on Government Relations and Political Strategy particularly in the pharmacy sector.

The fact that the PGA needs this type of consultancy is a measure as to how much it has slipped in the credibility stakes, particularly since its dealings with the student group NAPSA were recently exposed.

But the focus needs to come back to the fact that pharmacy requires a peak body with a democratically elected executive that can lead pharmacy into the next stage of its development.
Clearly, the PGA no longer has any moral authority to claim that privilege (not that it had ever acquired it through open agreement with all pharmacists).

Unless pharmacists (whether pharmacy owners or not) can get in line and support a single peak body, the profession is doomed to go into disarray for at least a decade, before it reforms itself.
The attitude for the PGA to resolve is how it will maintain its relevance and position within a new peak body.
The previous national president of the PGA, John Bronger, foreshadowed a peak body potential by publicly stating that he could see an argument for the “PGA and the PSA amalgamating as a single group to provide a peak body initiative”.
Time has moved on since that particular idea was mooted with the formation of new pharmacy groupings that would not necessarily work under that combined banner.

The Pharmacist Coalition for Health Reform is a new group that would carry the moral authority for a peak body, because it is focussing on health reform on a “whole-of-profession” basis and embraces existing, as well as future groups, that may emerge.
The fact that it is an inclusive grouping without requiring existing organisations to disband or amalgamate, would gain approval from a majority of pharmacists.
If the PCHR was to evolve to not only have organisational membership but include individual membership as well, it would become even more attractive.
The argument for the PGA then would be simply how many votes it could control within its PCHR membership.
Stephen Greenwood states in his most recent writing “Pharmacists should get down on their hands and knees and thank the Guild for delivering the Fifth Agreement because that seems to be one of the few certainties that Pharmacy can rely on in the year ahead.”
Most of us can see the agreement – that is certain- but we also see the major dollars stripped out through mandatory price reductions on April 1 2012, the inevitability of bankruptcies/receiverships continuing (possibly up to 110 over 2012), plus a lack of properly designed professional services and the physical infrastructure to promote them.
Most of all, we see a PGA not capable of carrying a consensus for the majority of pharmacists.

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