An uncertain future


question mark

Community pharmacy has repeatedly shown its value as the front line of health in 2020, so why are there question marks over its future, asks Catherine Bronger

I’m a very proud community pharmacist. I come from a family of pharmacists and indeed grew up under the dispensary. I know and love my profession intimately and the passion for where our future lies rumbles deep within me.

That is why I almost vomited at the feet of a top adviser to one of the highest offices when he tutted and told me not to worry my pretty little head about the role pharmacists could play in this COVID-19 crisis – when it was on the cusp of emerging in Australia – because pharmacists would make millions from it….

When supermarkets were ramping up the media over the panic of stockpiling for toilet paper reeling in the cash, we were out there advocating for a one-month supply of medicines.

Indeed, community pharmacists across the country had already implemented this well before the Health Minister made the announcement that “pharmacists fell into line”. We didn’t fall into line. We led the charge and boy; did we cop some abuse for it. We led the charge because we are healthcare providers with scruples. We know stockpiling of medicine is dangerous and unnecessary. We also know that the most vulnerable are the ones who suffer. We copped abuse but we stood firm because it was the right thing to do.

Standing tall

I have never stood taller and prouder than in recent weeks when standing beside my teams in the face of this adversity. They work tirelessly in a rapidly changing and risky environment with very little regard for themselves – and all for the patients they are dedicated and committed to. In fact, as an owner it is I who have fretted for the safety of my staff, spending many thousands of dollars putting up screens, investing in PPE and implementing social distancing policies and other physical measures to help ensure their safety.

These are not the actions of a money hungry retailer but those of a concerned owner who has the responsibility of keeping my staff safe and well. But where is the support to essential small business that is pharmacy to keep the workforce operating? Does the Government not understand that loss of service that will occur if the only community frontline health service is crippled with sickness and forced to partially close. If you want to know, look to the UK. It’s happening there.

The telehealth disaster

We get no protection, yet the Government buckled under the pressure of GPs who seem to forget the reason that they trained was to see sick patients. Doctors who are now hiding behind telehealth while the Government backtracks and offers danger money in desperation to keep some doctors seeing patients. We and our staff are being treated with no such consideration, offered no protection, yet the sick are being funnelled out of medical centres and into pharmacies in droves.

Telehealth has been a disaster to pharmacy over the past few days. The immense problems of how patients access their scripts was flippantly ignored and costs us dearly in increased workload and workarounds. We have yet to see what these impacts truly mean for community pharmacy and are only a taste of what electronic prescriptions will bring but that’s tomorrow’s story.

Today I’m telling the story of a government that has no regard for what we do because it suits them. A government that openly announced a delivery service through community pharmacy that will cost us, small businesses on the frontline, to deliver. It was announced at $5, less than an Uber, until logistics companies refused to do it for under cost only then was raised by a mere $2.77. Which is still not enough; once more we are being told to do more for less.

A lack of acknowledgement

We are healthcare professionals and we can play a much greater role. With access to NIP and funding in line with nurse practitoners we could vaccinate the Australian population against this season’s flu. Now the RACGP has called for early vaccinations, just as the NIP stock hits the medical centres.

But you can’t give a flu vaccine by telehealth, and by the very nature of moving to telehealth medical centres are dangerous places to be right now. Just ask the GPs. We have not asked to hide behind a telephone – we are ready willing and able to help,

But why are we busting our guts? We have had no acknowledgement of the role we play. But most disturbingly we have no certainty after June. The entire network has been given no security and no agreement. That is how little regard they have for us and it is also the real reason we are being positioned as retailers – it is little more than the Government’s negotiation tactic.

These childish tactics must end. Playing our role now is too important. Australian lives and the safety of our staff depend on it.

Catherine Bronger is a Pharmacy Guild NSW branch committee member and a national Guild councillor

 

 

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7 Comments

  1. Kevin Hayward
    03/04/2020

    Pharmacists across the board play an essential role in ensuring our population are supplied with appropriate medication, and that the risks associated with pharmaceuticals are minimised. Medicine-related problems lead to 250,000 hospital admissions each year costing $1.4 billion annually.

    At this point in time, the last thing we need is a population of elderly and vulnerable patients being admitted to hospital with preventable medicines related admissions.
    We also cannot afford for our front line pharmacy workforce to be out of action through lack of support, the UK reports around a quarter of NHS doctors are off work because they are sick or in isolation, this would be a disaster if repeated in the Australian pharmacy workforce.

    So why are we, the most visible of the primary care providers so invisible to politicians?
    As an example recently I wrote to my own MP and the Minister for Health, suggesting that the medication review service could be modified to reduce the risks posed by the pharmacist having to conduct a face to face interview…. the response…. still waiting.

    I work in general medical practices, they have issues too, but as one GP said to me recently, at least we got telehealth, you guys got absolutely nothing.

    • Karalyn Huxhagen
      03/04/2020

      I had a GP do a telehealth consult yesterday to an elderly couple I know well. After the consult he sent me a HMR referral as the wife has all of the tablets mixed up. I have been saying for months that this pair are at high risk of medication misadventure.
      So he gets to talk to them safely and I get to go in and try and not bring in any contamination.
      It makes no sense except that telehealth is only for those practitioners who are paid by MBS numbers. We are paid by CPA funding and the business rules are negotiated between Govt and the PGA as part of the CPA negotiations. Currently the minister is overwhelmed with other issues and we are tiny in his big picture issues.
      Another reason that medication management services need to be MBS item numbers?

      • Big Pharma
        08/04/2020

        Absolutely bizarre that telehealth has not been extended to accredited pharmacists. Not surprising though given what we have endured since 2014. Another slap in the face. Medication reviews reduce hospital admissions…..hospitals are quickly reaching capacity….less hospital admissions=less fatalities. Pretty simple equation.

        I have personally suspended my service until a time when telehealth is available or the health crisis is resolved despite it being an essential potentially life saving service. I believe it is irresponsible to be conducting in house reviews during a pandemic when a reasonable service (although not ideal) can be done remotely.

        1) The safety of the accredited pharmacist is compromised. It’s one thing to review a patient in the sterile confines of a medical practice (with additional danger money payments and fully kitted out with PPE)….its a different scenario altogether entering a patient’s home, an unknown entity, and remaining there for an hour. Houses also often have multiple occupants.

        2) Its not fair on the patient whose safety is compromised. To send a pharmacist into the home of a compromised vulnerable patient with comorbidities with the risk of contaminating their “clean zone” is ridiculous.

        Every accredited pharmacist conducting reviews at this point (if there are any) should be, at a minimum, wearing a gown, gloves, goggles and mask. These should be discarded upon leaving the dwelling and replacing before entering the next house (“clean zone”).

  2. Michael Ortiz
    03/04/2020

    Congratulations to Catherine Bronger and the leadership at the Pharmacy Guild for finally standing up to the short sighted bureaucrats in Canberra. They have no idea of what it is like to be a frontline health professional. Patients can expect to be restricted to their homes for the next 3 months, so the Government needs to allow pharmacist to make a greater contribution by removing unnecessary restrictions and paperwork to support patients isolated in their homes.

    I was disappointed by the Federal Minister of Health’s response to a question about the reskilling of retired Doctor’s, Nurses and Pharmacists on the ABC yesterday. He seemed to intentionally omit Pharmacists in his response. This response suggests that he does not see the value of Pharmacists on the frontline. The Health Minister should be asked to clarify his views on the role of Community Pharmacy in the Covid pandemic.

    If we are restricting the public to their homes, then we need to find ways to look after them. Doctors are reimbursed for telehealth, while pharmacists are not. Let pharmacists do more to help the Australian public by suspending unnecessary regulations and eliminating excessive red tape (like the documentation for PBS home deliveries). If Government can fund free childcare during the pandemic, why can’t they eliminate or at least reduce patient copayments?

  3. Andrew Rather Not Say
    03/04/2020

    A couple of points on the 60-day dispensing;

    – Had it been implemented pre-Covid the rush on medicines may have been stretched out and the wholesalers may have had the opportunity to adjust to the new stock flow.

    – Encouraging a return visit to a high-traffic location every 30 days is not in the public health interest when we have govt mandated isolation policies due to an infectious disease in the community.

    Also, if that advisor you spoke with actually said not to worry your “pretty little head” you should name them. What a pig.

  4. Michael Post
    03/04/2020

    Well said Catherine.

    It is individual pharmacists putting themselves on the line.

    Now is the time for Guild and government to recognise pharmacist provider numbers in recognition of the service individual pharmacists provide in this country.

  5. Debbie Rigby
    05/04/2020

    Great comments, Catherine.
    So why does perception not reflect reality?
    Thinks needs to be critically and honestly unpacked by our elected representatives, thought leaders and every pharmacist

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