Pharmacist Coalition for Health Reform and the call for a Senate Inquiry

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SHPA believes that consumer interests should be at the centre of health delivery and the health reform agenda.  SHPA members have a strong ethos of working collaboratively within interdisciplinary healthcare teams and across the continuum of care.

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It is imperative that legislation governing the delivery of health services (and the corresponding business rules and pharmacy practices) allow consumers to receive the services they require in the most effective and suitable way for the consumer rather than the convenience of the provider.  Continuity of care is a core need and service arrangements should not be constrained by geography of service delivery.

SHPA is a founding member of the Pharmacist Coalition for Health Reform (PCHR) to enable national pharmacist groups (APESMA, NAPSA, PSA and SHPA) to provide a united voice to decision makers on common issues and to highlight the roles that pharmacists can play in health reform. It is clear that there should be many roles for pharmacists in ‘non-supply’ activities. Flexible and innovative models are needed to ensure that current and future pharmacists may use their skills to improve the health of individuals and the community as a whole.

The Pharmacy Guild of Australia was invited to be a PCHR member and the invitation remains open.

During all PCHR deliberations, all four national pharmacist groups have been included in decision making and activity planning. 

Recent events have provided opportunities for discussions with the Consumers Health Forum and Senator Richard Di Natale about the governance of the current Community Pharmacy Agreement (5CPA) and the role of the Programs Reference Group (PRG).  The intent being to ensure both a consumer focus and inclusiveness and transparency when decisions are made that determine how professional pharmacist services can be provided.  In addition, that service delivery should be flexible so that the ‘patient journey’ can be supported.

Senator Richard Di Natale has called for a Senate inquiry into the effectiveness of Part VII the National Health Act 1953 and proposed 13 terms of reference.  Several of these proposed terms of reference concern the impact on health outcomes, the capacity to build upon other national health initiatives, integration of care across the continuum and facilitating innovation and the use of pharmacists’ skills to improve health outcomes.  One proposed term of reference concerns the appropriateness of the current CPA, including the appropriateness of a single entity (the Pharmacy Guild of Australia) being considered as the legal voice representing all registered pharmacists. 

The call for the Senate inquiry and the proposed terms of reference drafted by Senator Richard Di Natale has the full support of the Consumers Health Forum. 

Some recent decisions made under the 5CPA that have directly impacted on consumers and the services they can access are: 

1. Accredited pharmacists who for a decade have been contracted to provide residential medication management review (RMMR) services in local aged care facilities are now being locked out (through their application to be 5CPA RMMR providers being refused) if they want to retain their substantive employed status with a hospital.
2. More recent changes now exclude pharmacists accessing CPD support if they are based in places such as Darwin.
3. Section 94 private hospital pharmacy service providers are now receiving reduced reimbursements and reduced ability to cross subsidise for clinical pharmacy services that cannot be funded any other way.

Yet consumers and representative organisations like SHPA have no input into these changes to business rules and pharmacy practices.

Furthermore chemotherapy arrangements that are provided by public and private hospitals and the business rules that will apply to post-discharge home medicine reviews have been referred to the 5CPA for deliberation. 

The governance of the 5CPA is a matter for the government and Pharmacy Guild of Australia only.  When input to 5CPA is requested, consumers and stakeholders are disadvantaged in influencing the outcomes.  It has been SHPA’s experience during 4CPA and 5CPA that information about workable, consumer centred arrangements for pharmacists working from a hospital base are not only ignored but that rules are developed that prevent involvement. 

A Senate Inquiry provides opportunity for reflection on CPA governance, CPA focus and inclusiveness.  It could be welcomed as a crucial opportunity to ensure that beyond 5CPA, both pharmacy agreements with government and pharmacist’s roles are enhanced.

For these reasons SHPA, through the usual inclusive PCHR communication mechanisms, endorsed a message to PCHR members to support the call for the Senate Inquiry and the proposed terms of reference.

To reiterate, SHPA believes that consumer interests should be at the centre of health delivery, the health reform agenda and that inclusiveness and transparency should be the hallmarks of decision making.