A matter of priorities


A prominent GP has criticised what he believes is a political focus on pharmacy funding over patient safety

The business of health has not always kept safety in the forefront of their health services, argues Dr Evan Ackermann in an article published in Health Voices, the Journal of the Consumers Health Forum of Australia (CHF).

He points to the current Royal Commission into Aged Care Quality and Safety and ongoing issues with medication safety, as well as overuse of opioids.

“The rapid expansion of therapeutic options to treat disease, the increasing complexity of patients’ conditions and fragmentation of care has led to significant challenges in managing safety of individual patients,” writes Dr Ackermann, the immediate past chair of the RACGP Expert Committee on Quality Care.

“Now, approximately 2-3% of all hospitalisations are due to medication adverse events. Whilst less than 50% of these are preventable, that leaves a significant number of patients harmed from medication.

“Whilst the PBS has delivered medications, it has not delivered medication safety for patients despite a multiplicity of medication reviews, pharmacist interventions, medication reconciliation or meds checks.

“As recent experience with codeine and increased dispensing medication quantities have shown, the business of pharmacy appears to have higher priority than patient safety.”

However in his article Dr Ackermann makes no mention of the role of doctor prescribing in the context of medication safety, despite several doctors being questioned by the Royal Commission over their prescribing decisions.

Instead he says reform of the PBS to deliver patient safety is essential. 

Dr Ackermann argues that lack of strong clinical governance in primary healthcare has “allowed commercial interests to drive healthcare.”

“More recently drug companies and pharmacies have been pushing ‘increased access to medication’ by down-scheduling many drugs on the PBS. This is to allow drugs to be advertised and sold over the counter without prescription.

“There is no evidence that society is suffering from any lack of ‘access to medication’, but it suits government who are keen to reduce medication costs and it suits businesses who wish to improve profit streams.”

He focuses on taking issue with pharmacy funding, saying it is “concerning” that the Royal Commission has not reviewed the political contribution to the problem, “just as pre-election announcements confirm pharmacy funding is more important than patient priorities.

“No-one wishes anything less for cancer sufferers, but medication related harm is important for society too, yet medication safety hardly rates a mention.”

PSA CEO Dr Shane Jackson pointed out on Twitter that this statement is incorrect.

“Health Minister Greg Hunt has committed in response to the PSA to make medicine safety a national health priority,” he said.

PSA has been lobbying constantly for medication harm to be addressed, including through its release of the Medicine Safety report in January this year.

This report argues that pharmacists have significant potential to reduce the number of medication-related hospital admissions and adverse medication events in Australia.

Recently before the Royal Commission into Aged Care, Australia’s Chief Medical Officer also said embedding pharmacists in aged care facilities was a “priority”, with strong evidence that this can lead to reduction of prescription of antipsychotics and other medicines.

However Dr Ackermann believes the answer lies in general practice, calling for patients to work collaboratively with GPs “to force a change in political priorities”.

See the full article here

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