Pharma-Goss - With Rollo Manning - July 2009

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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.

Comment to the Editor or email Rollo Manning on rollom@iinet.net.au

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THE ANSWER TO EMPLOYEE PHARMACISTS PAY PROBLEMS

It is not possible in 2009 to continue a business structure that worked in 1960. Back then pharmacists were registered on the basis of their ability to dispense. No question about that. The knowledge of the product forms (mixtures, creams, emulsions and suppositories) was an imperative. The drug knowledge avoided incompatibilities in compounded medicines and the indexing system of the script book allowed medication reviews to be done routinely.

Fast forward to 2009 – anyone can read a typed script, select stock from the shelf, enter details into a PC and produce the repeat authorization and label.

And yet – the staff deployment and wage structure is still the same.

Today the pharmacy graduate has a vast knowledge of Pharma... – all sorts of things – cology, kinetics, cotherapies, codynamics and so on.

This is NOT the knowledge required for dispensing – it is knowledge to act as a true allied health professional in a primary health care (PHC) system that needs all the multi disciplinary input it can find in the best interest of the client (patient or consumer).

How can pharmacists ever expect to be recognised in the 2009 PHC setting while they are still working with a model of the 1960s?

All concerned with a future of prosperity for the profession must attend gatherings to talk again about where the profession is heading and advocate for a change in the paradigm of pharmacy practice.

Have the retail shops but do not expect them to be propped up by a National Health Scheme that must concentrate on the best interests of the consumer (and taxpayer).

Stop tying PBS Approval to a successful retail business model.

Start establishing professional agencies (Pharmcare agencies) that are the provider of pharmaceutical care to its clients at a cost to the taxpayer for a quality service.

There are too many messiahs out there calling on the wisdom of the past to determine the future.

In the words of Professor Dexter Dunphy – “you can only understand the future when you start living it”.

Pharmacy must start living a future – not just talking about it and living in the past.

BIG PROFITS BRING BIG CRITICS

The recent media sniping at the Pharmacy Guild strengthen the call for a review into the infrastructure for supplying PBS medicines to the Australian public is need of a review. It is the opinion of this writer that this must be done before any future agreements are entered in to between the Government and community pharmacy interests.

It is the late 1980s since there was a review of “pharmacy earnings costs and profits” with the base established then being updated by subsequent agreements ratified by the Pharmaceutical Benefits Remuneration Tribunal.

The fact that excessive charging for under co-payment PBS dispensing is happening as revealed in the Daily Telegraph is a sign of the times. However back in 1988 the co-payment was only $11 and hardly a factor in creating significant profits.

But in 2009 with a co-payment set at $31.90 there is a huge market of non-subsidised PBS medicines that are being paid for by consumers. It is not known how big this is despite there being a commitment in the 4th CPA for this information to be made available. A “research” project is underway to determine how this can be done. Really? This is a joke! The answer is on the PC of every dispensary computer - take a sample agreed with the stats experts and you have it.

The generic drug market has also expanded in the last 20 years and this too needs to be factored in.

When a supplier can buy in at $2 and sell for $15 it is a good profit. No wonder there is criticisms of these profits being made by an agency working for the Government in supplying an essential component of a National Health system.

Pharmacists expect more so long as this situation exists.

ALAN JONES AT IT AGAIN

Sydney broadcaster Alan Jones went back in time four years when he supported community pharmacy against the recent calls for change especially the Daily Telegraph mentioned above and then following the front page in the Financial Review pointing to the 5th Agreement and likely problems for the Guild.

As far as Alan in concerned this is all part of the big plot to allow Woolworths and Coles to have pharmaceutical products in their supermarkets.

The rhetoric is the same as in 2005 when the same broadcaster went on the offensive for pharmacists against the threat of NSW legislation (allegedly) opening the door for Woolworths to have pharmacies.

So strong is the opinion of this voice in forming public opinion in Australia that one wonders how such a voice can be so far off the beam.

Sensitive area as is the pharmacies in supermarkets push by the Pharmacy Guild, that one could be excused of thinking that the Alan Jones button on the defence of pharmacies was pushed after the Guild alerted him to the need for another rant.

Money in the past has proved to be no barrier to telling a good story – as false as it may be. However back in 2005 when this writer suggested to Alan Jones that he may be getting paid by the Guild a quick response came back saying the suggestion was “idiotic”. The same will not be tried again in 2009 although the suspicions are still there.

BILL C OPENS PHARMACY OWNERSHIP DEBATE

The introduction of the new National Registration Authority for Health Professionals provides the opportunity for the question of who should own a pharmacy to be opened up as new legislation is needed in every State to ratify the status quo. However the introduction of a Bill to a Parliament always opens up the subject for debate and gives proponents for change the opportunity to put forward an alternative case.

The new Acts of State Parliaments to cover registration will only have the registration and assessment of professional standards. A separate Bill will have to be introduced to retain all those other factors that were in the previous Pharmacy Act and covered subject areas not included in the new laws. Expect some activity from the retail lobby that wants to see a loosening of the rules associated with the ownership of pharmacy.

One thing that one could be excused for putting money on is that Alan Jones will be in the mix somewhere.

The time has come for these business aspects of a retail small business to be included in legislation administered by a business or trade area of the legislature and NOT of a Health Department. That is if there needs to be legislation at all.

The old argument that pharmaceuticals are not ordinary items of commerce fails to draw interest while the discount stores flourish. Also the marketing aspects of pharmaceuticals are debated around the schedule of poisons register which is moving to a wider range of medicine products available in supermarkets.

It is possible to have a supermarket in a pharmacy but NOT a pharmacy in a supermarket. This has to stop and the market place used to decide who succeeds and who fails.

Send your subject suggestions to Pharma-Goss for comment.

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