Many of the arguments voiced by those in favour of current pharmacy ownership laws are “truly grounded in self-interest being disguised as community care,” says Gance
CWH co-founder Damian Gance appeared before a public hearing being conducted as part of Queensland’s Parliamentary Inquiry into the establishment of a Pharmacy Council and transfer of pharmacy ownership.
He outlined how instead of retaining the current pharmacy ownership rules, owners should instead be subjected to a “fit and proper person” test, which could see corporate owners act more ethically than pharmacist owners.
“Whilst I can appreciate the historical context and at least fathom the rationale for the introduction of these laws, I contend wholeheartedly that they have no place in a modern Australia,” Mr Gance told the panel.
“Regulation governing pharmacy both national and state based has been reviewed and re-reviewed and re-reviewed many times in the past. Almost without fail, the primary recommendation of these reviews is a deregulation of both ownership and relocation laws. And yet legislative inertia continues to prevail.
“I believe one of the reasons for this inaction is a propensity for decision-makers outside of our industry to confuse the provision of primary pharmaceutical services with the proprietorship of what is a retail business.
“Those who passionately advocate for the status quo will deliberately attempt to blur this distinction.
“Yet as the provision of primary medical care from a general practitioner is entirely unrelated to the ownership arrangements surrounding his or her medical practice, so is the provision of pharmaceutical care entirely unrelated to the ownership of a pharmacy.”
The primary societal benefit enjoyed by Australians through engagement with retail pharmacy is “absolutely in no way” coupled to the ownership structures behind that pharmacy, Mr Gance said.
“Society is for the most part ignorant, if not indifferent, to the commercial structures that stand behind the pharmacy of their choosing. Where the final profits of any transaction reside, the public is not ultimately interested.
“The societal engagement with our relationship with the dispensing and counselling pharmacist – that is a primary one.
“The Australian public forge a bond of trust, and one of respect, with the chemist who assists them with their pharmaceutical needs. And in many, if not most, this is not the store proprietor.”
The notion that pharmacist-only ownership results in a better calibre of owner is “misguided and misplaced,” he said, citing a number of recent cases of poor pharmacist behaviour, each of which plainly showed the individuals putting “profits before health” and shown disregard for patient wellbeing as well as the law.
“We are human and we are subject to the same failings and frailties as everyone else.
“The important thing is not whether or not you hold a Bachelor of Pharmacy, but rather that you are ethical, you are responsible, you are of a high moral standing and let me tell you, a pharmacy degree by default does not confer any of these traits.
“The test should be one of a fit and proper person. A fit and proper person test is neither novel nor new but a well-established principle in many areas of the economy.
“The test could include a requirement to demonstrate appropriate upstanding financials, criminal, business and professional histories and I would suggest to you that this is a far superior test in order to establish appropriateness of a person to own a pharmacy business than a simple degree.”
When business and health interests diverge, many pharmacist owners have been found wanting, he said, citing the case of the controversial $1 script copayment discount.
“The vast majority of pharmacies other than Chemist Warehouse do not pass this on. Why? They do not because it is not profitable for them to do so.”
Yet medicines compliance are directly related to cost, he said.
“If failing the fit and proper person test results in an entity losing its rights to own any and all the pharmacies, is the owner of a hundred pharmacies more likely to act appropriately than the proprietor of a single retail store?”
He asked who was more likely to inappropriately dispense, for example, large amounts of oxycontin: a pharmacist owner of a single store with a mortgage, or a corporation with thousands of staff and shareholders?
“Many an argument voiced by those in favour of the status quo are truly grounded in self interest being disguised as community care,” Mr Gance told the panel.
He said that Woolworths, for example, was a good retailer and that if there was a commercial case that consumers wanted pharmacy services such as vaccination and mother-and-baby care in any potential Woolworths pharmacies, “I actually believe Woolworths is more likely to provide those services than a small independent proprietor”.
“To suggest that pharmacists today exclusively believe that providing service to your customer is a good thing is selling every other retailer on the planet short.”