The Government’s desire to control community pharmacy is starting to look dangerously Soviet, writes Peter Feros
As I listened to the Health Minister’s speech, I couldn’t help but feel that I was, in the words of the Beatles, back in the USSR.
The Minister lectured community pharmacists on our need to “evolve and innovate to meet the changing needs of society”. Apparently just how we are to evolve and innovate will be dictated by the outcomes of the Pharmacy Remuneration and Regulation Review. How Soviet.
The Minister’s words make one thing pretty clear: that through this review, Minister Ley thinks she can direct the progress of community pharmacy. Surely the future of the profession should be defined by pharmacists – not by authoritarian diktat!
Sussan Ley is not a pharmacist; she simply heads a Department that has, for decades, set policies based on flawed analyses of how the community pharmacy sector performs.
At the dinner, she said that the Review will “also ensure that the investment in pharmacy represents value for the taxpayer (my italics)”.
The Australian Government has not invested in community pharmacy. It’s individual pharmacists who have invested more than a billion dollars in creating the Australian community pharmacy network, the most accessible network of health providers in the country.
A more accurate description of the Australian Government’s involvement in the Pharmaceutical Benefits Scheme is to provide subsidies to Australian consumers, so that financial barriers are removed from their ability to access prescription medicines.
Community pharmacy, meanwhile, has managed to evolve and innovate of its own volition over the past 40 years.
There are many examples of pharmacy innovating without the state stepping in. Here’s a just a few.
In 1982, pharmacists Colin Trevena and Ted Crook installed the first dispensary computer in Australian community pharmacy.
In 1988, a Pharmaceutical Benefits Remuneration Tribunal time and motion study of dispensing with and without a computer found that a computerised dispensary shaved a whopping 30% off the time taken to dispense a prescription.
It’s no wonder that within 10 years, Australian community pharmacy was fully computerised. This delivered productivity gains of 3% a year, against the national average of 1.1%. These gains, however, were not the most significant benefit of dispensing computerisation.
Some readers will remember that prior to computerisation, prescriptions were recorded in chronicle order of dispensing. As a result, it was virtually impossible to assemble a workable record of a patient’s prescription medicines.
Computerisation allowed us to record each prescription, as it was dispensed, into each patient’s file, thus providing an instant record of all the patient’s prescriptions and facilitating reviews such as MedsCheck and HMRs.
Computerisation also provided drug-to-drug, drug-to-condition, drug-to-allergy and children’s dosage checks. According to Professor Charlie Benrimoj, the computerisation of Australian community pharmacy was a good 10 years ahead of our colleagues in the US and the UK.
In short, it was nothing less than a revolution in pharmaceutical care, and it originated within community pharmacy, not handed down to us from on high.
There are numerous other examples of innovation within pharmacy. Here’s a few more.
- Pharmacy was the first private entity to provide electronic data transfers to the Australian Government, through prescription electronic claiming. Colin Trevena and Ted Crook’s company worked to develop this electronic data communication. And because community pharmacy dispensing computerisation occurred thanks to pharmacists’ own initiatives, the Australian Department of Health was able to downsize by around 800 employees.
- Pharmacy was the first retail outlet to transmit orders electronically and receive electronic invoices in return. This was thanks to pharmacist John Tacey’s CDC computer systems with Andrews Laboratories.
- Electronic entitlement checking was adopted in a mere two years when the Health Department had expected it to take four to five. Pharmacist Paul Naismith’s Fred computer system, with over 50% of the Australian community pharmacy computer market, played a leading role in this achievement.
But in spite of these and other examples of Australian community pharmacy’s efficiencies and innovation, Minister Ley thinks we need to be checked up on, to make sure we’re doing the right thing.
She showed a complete lack of understanding of these innovations, productivity gains and efficiencies when she told the Guild dinner that the review is “important to also ensure the sector is working efficiently, effectively and continues to meet consumers’ needs”.
“Consumers’ needs!” Every day, in community pharmacies across Australia, pharmacists are engaging with our customers, attending personally to their needs and offering them more professional services than ever before. Consumers’ needs are key for pharmacists.
Clearly the Minister has never absorbed the consumer surveys that, year after year, confirm that community pharmacists are ranked first or second among professions in terms of consumer trust.
Over the 40 years I have been a pharmacist, Health Ministers and the Commonwealth Department have always spoken from a position of ideology. Again, community pharmacy has an Australian Health Minister indulging in ideological posturing.
What community pharmacy really needs is a move away from a totalitarian state.
Peter Feros is a pharmacy consultant and has financial interests in Cincotta Discount Chemist.
Note: To measure the cost-effectiveness of community pharmacy in October 2014 on 48 top selling products, I conducted a comparison of the online prices from Woolworths, Coles, Chemist Warehouse and Cincotta. Woolworths and Coles were 25% and 20% dearer than Chemist Warehouse and Cincotta Chemist respectively. See http://competitionpolicyreview.gov.au/files/2014/12/Ventura.pdf