Keep an eye on the bigger picture

Joe Demarte, PSA national president

Pharmacy is confronted by a spate of vital government reviews, says PSA national president Joe Demarte 

Last month, while PSA was preparing its response to the Review of Pharmacy Remuneration and Regulation (King Review) Discussion Paper yet another Federal Government health reform paper quietly arrived and slipped below the radar without much media attention.

The Medicare Benefit Schedule (MBS) Taskforce Interim Report is another piece of the growing jigsaw of health reform happening in Australia.

Other parts of the jigsaw include the MBS Taskforce Review, the Medicare Health Care Homes initiative, the Review of Medicines and Medical Devices Regulation chaired by Emeritus Professor Lloyd Sansom AO – and the Federal Government’s response – and the My Health Record trials.

Not to forget the biggest of them all for pharmacists – King Review and its Discussion Paper.

They are all interrelated and represent the most significant proposed changes to the health system in our lifetime. With all this change happening we need to focus on where our profession will sit in all this.

First however, some comment on the MBS Review interim report. It highlighted a range of reforms and cost-saving measures, including the need to optimise high-value care and minimise low-value care.

It is part of a clinician-led review of all 5,700 items on the Medicare Benefit Schedule (MBS) and included consultation with more than 2,000 health professionals and patients across stakeholder forums, written submissions and an online survey.

According to the health Minister, Sussan Ley the MBS Taskforce’s interim report is designed to provide an update on consultations and what Australian patients and health professionals think about current Medicare-funded health services. Further consultation will be undertaken as individual MBS items are identified for removal or rule changes.

Ms Ley also said – and this is where all of the pieces of the review/report jigsaw start to fit together – the MBS Review, combined with the Medicare Health Care Homes and My Health Record, aimed to cut down on low-value use of MBS items through a greater focus on integrated care and stronger rules, education and compliance.

The present Review of Pharmacy Remuneration and Regulation by Professor Steven King, Bill Scott and Jo Watson can be added to these. While it is more directly related to pharmacy, it should not be forgotten that Professor King and Minister Ley have repeatedly pointed out that the review’s purpose is to identify how pharmacy can operate in the best interests of consumers and of public health.

When looking at all the bigger picture and trying to see where all of these reports and reviews fit, it is useful to take a step back and try to look at the whole thing not from a purely pharmacy or pharmacist perspective, but from the wider perspective of – how should government and the Australian health sector shape itself to provide the healthcare Australians need in the coming decades?

The plain truth is that of all of these reviews and reports are searching for solutions to that simple question. This has to be the starting point for pharmacy when responding to all of these reports and reviews.

PSA is determined that pharmacists will be an integral part of the solution.

In the case of the MBS Review, PSA believes it is an important opportunity to improve outcomes for patients with chronic diseases by optimising the contribution of pharmacists in multidisciplinary care teams and primary health care settings.

Pharmacists can play an active role in strengthening evidence-based health policy, services and payment systems, to deliver better health outcomes for consumers.

PSA recently called on the Government to ensure that pharmacists’ skills were maximised and highlighted the integral role pharmacists can play in national healthcare reform including:

  • Ensuring the Health Care Homes initiative is appropriately funded and based on best practice, evidence-based models of care which utilise pharmacists
  • Exploring interprofessional collaboration, particularly between General Practitioners and pharmacists, for Australians with chronic and complex conditions
  • Involving pharmacists in Residential Aged Care Facility (RACF) teams to reduce medication misadventure, medication error and resulting medication-related hospital admissions
  • Supporting culturally-responsive pharmacist care for Aboriginal and Torres Strait Islander people to improve medication adherence and reduce chronic disease
  • Investing in preventive health programs delivered through the highly-accessible network of community pharmacies, including immunisation and smoking cessation services.

PSA has also urged the Government to commit to ensuring that Australian community pharmacies remain viable and accessible hubs of preventive and primary health care.

All of these services are well within a pharmacist’s current scope of practice.

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