A complex negotiation

PSA is confident it will be able to work with the Guild on service delivery in upcoming 7CPA negotiations, but how does it plan to secure more funding for proposed higher wages upwards of $100,000 for employee pharmacists?

Speaking at PSA19 in Sydney, Health Minister Greg Hunt confirmed that PSA would be a co-signatory to a pharmacy agreement, however due to the 7CPA legislative framework, the Pharmacy Guild of Australia will remain the only pharmacy signatory on remunerative matters.

“The heads of agreement under the National Health Act has to be done with the Guild on the remuneration elements. They’re actually a legal requirements,” said Minister Hunt.

“In terms of the code of ethics, the services delivery, the practice delivery, they’re the elements that directly relate to the pharmacists and the PSA. We’re already working on those elements”.

In light of its new Pharmacists in 2023: Roles and Remuneration report, released on Saturday, the PSA is confident it will play a key role in the negotiations around professional programs, leading to new roles and better wages for pharmacist employees.

The report suggests minimum salary bands for pharmacist pay based on level of experience and qualifications – from $80,000-$100,000 for general pharmacist registration, up to $140,000 and above for pharmacists with more than five years’ experience in a defined area of advanced practice.

 “The roles and remuneration report sets the goal target for 2023,” PSA national president Dr Chris Freeman tells AJP.

“We must work together as a profession to understand how we might start to achieve that. For example, when we’re going to negotiate the agreement, looking at MBS funding and funding from other sources, part of that planning and economic analysis will start to ask—how much do we need to invest in this service? And part of that planning is how much will the pharmacist requires to be paid.

“There is no better time than at present, at the eve of the agreement being negotiated, to have a discussion around what pharmacists should be paid.” – Dr Chris Freeman

“It’s really important that we actually take leadership in this area. Rather than lamenting on how poorly pharmacists are paid, it time to start saying: this is what they should be paid.

“There is no better time than at present, at the eve of the agreement being negotiated, to have a discussion around what pharmacists should be paid,” he says.

But where will the money come from to pay for these higher wages, and how does PSA plan to secure this funding?

Proposed minimum salary bandings. Source: Pharmacists in 2023: Roles and Remuneration report, PSA.

Dr Freeman is adamant that the Community Pharmacy Agreement (CPA) is just one piece of the puzzle.

“The agreement is not a panacea for all the problems in the pharmacy profession at the moment, whether that be wages, services or scope of practice,” he says.

“It is one component of looking at how pharmacists should be remunerated but it’s not the panacea – we’ve got to start looking at other areas of funding as well.

“Relying on a sole source for funding for pharmacist activity in primary care is also a really risky strategy with the government’s focus on savings through the PBS, whether that be through accelerated price disclosure, dual listing… there are rounds and rounds of savings being targeted towards the PBS.

“By diversifying where pharmacists and pharmacies and drawing income from, that reduces that risk slightly. It’s actually a strategy to strengthen the community pharmacy and pharmacist practice in primary care more broadly.”

Avenues for drawing income outside of the CPA include through the Medicare Benefits Schedule (MBS), Primary Health Networks (PHNs), aged care, and from private health insurers, explains PSA interim CEO Dr Shane Jackson.

“We’ve put all our eggs in the CPA basket, and we haven’t looked more broadly towards having a suite of services that we could develop,” he says.

“We just try to jam everything in[to the CPA] and it does the profession a disservice because the way that the CPA is looked at is through the prism of a cost centre, not the prism of investment – whereas some of those other areas are seen as investment.”

A decision on pharmacist MBS access rides on whether a recommendation will be made by the MBS Review Taskforce later this year, and the PSA and the Guild are continuing to work with the Minister on the issue.

Trials for embedded pharmacists are currently underway.

Meanwhile within CPA negotiations, the PSA’s success depends on their collaboration with the Guild and the Federal government.

Minister Hunt has acknowledged that “PSA will not only be a co-signatory but also a critical part to the design.”

PSA confirms it is regularly meeting with the Guild and other interested parties including the Consumers Health Forum, NACCHO, the Society of Hospital Pharmacists of Australia, and any other interested parties.

When asked whether the legislation should be changed so the PSA is also able to sign off on remunerative matters, Dr Freeman says they’re staying focused on the upcoming agreement for now.

“What happens after that is a discussion that we need to have for a later time. We can’t look too far forward in this process, we’ve got to get through this current agreement before we start looking at what might happen in the future.”

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