The AMA’s national president has accused the pharmacy sector of bullying the Health Minister and selling old vaccines
In an often-fiery debate about scope of practice and the Community Pharmacy Agreements, Pharmacy Guild national president George Tambassis has gone head-to-head with AMA national president Dr Tony Bartone, telling ABC Nightlife’s Philip Clark that there is no turf war.
Also joining the discussion were the Grattan Institute’s Stephen Duckett and Jennifer Doggett, chair of the Australian Healthcare Alliance.
After Mr Tambassis discussed pharmacist vaccination and said the Guild believed that pharmacists should be able to prescribe and administer all vaccines on the Australian market, Dr Bartone said that this would fragment care.
He added, “if we really want to be blunt about it, let’s talk about the flu vaccine. Let’s talk about the competitive pressures that saw old vaccine stock being vaccinated…
“We had an episode where the government-funded National Immunisation Program trivalent vaccine for the population which would be delivered free to that target population that qualifies it, in excess of five million Australians available at the moment and probably going north of that in years to come… the trivalent stock that was based on the previous year’s formulation was being offered prematurely to a group that would be able to access it free… at an appropriate time for a matter of a few weeks,” Dr Bartone said.
He said that this is part of the “breakdown of care” which can happen when pharmacists offer services such as vaccination.
Mr Tambassis asked for evidence to support this claim.
Following Dr Bartone’s comments to Nightlife, a Guild spokesperson told the AJP that the claim was incorrect.
“The suggestion that pharmacies were administering out-of-date flu vaccines is rejected outright by the Guild,” the spokesperson said.
“Dr Bartone has no evidence for this slur. He knows or ought to know that fresh 2019 vaccines stocks were distributed to pharmacies ahead of the roll-out of National Immunisation Program vaccines.”
Dr Bartone may also have been referring to an MJA InSight piece published in March 2017. This article incorrectly stated that leftover 2016 stock had been used to vaccinate people in pharmacies.
Head of the Clinical Research team at the National Centre for Immunisation Research and Surveillance Professor Robert Booy later clarified to the AJP that his comments for InSight had gotten “scrambled”.
“There is supply already available in the private market, and someone mistakenly thought it was last year’s product. It’s this year’s product that’s currently available,” he said at the time.
The MJA issued an update and correction which stated, “An earlier version of this story incorrectly stated that chemists were selling 2016 vaccine stock. This is incorrect. All 2016 stock had a use-by date which prevented it being used this year, and it is likely that most leftover 2016 stock has been destroyed. We apologise for the error, and any misunderstanding that it caused.”
Back on Nightlife, after Ms Doggett said that the point should be whether the evidence shows pharmacists can provide services such as vaccination and other services safely, Mr Tambassis and Dr Bartone disagreed on whether the Guild and AMA were communicating effectively.
“I’m happy to meet you any time, anywhere, whenever you want,” Dr Bartone said.
“I’ve asked you to come and see me on numerous occasions, and you refused,” Mr Tambassis replied.
Mr Tambassis asked Dr Bartone to communicate with the Guild more often and show him evidence to support his stance on pharmacist prescribing.
“This is typical of the pharmacy where you have this bullying type arrangement,” Dr Bartone said.
“It might work with the minister. It’s not going to work with me.”
The debate also saw Dr Bartone reiterate the AMA’s support for GP-owned pharmacy services co-located in surgeries, and Ms Doggett call the community pharmacy sector “over-regulated”.
She also said she supports the concept of wider pharmacy services being on offer.
She cited Consumers Health Forum research which found that consumers do value choice of provider as well as the option of receiving some services from their pharmacist.
“That doesn’t mean that every consumer will want to do that, obviously. Some will still want to receive these services from their doctor, but they do value that.
“That does not mean that we need a Community Pharmacy Agreement that ties up 18, 20, 22 billion dollars in a non-transparent way to receive those services,” she said.
“They should be either funded in a transparent and accountable way, so we, the community who is paying for these services, knows what we’re getting from our money.
“We don’t need the Community Pharmacy Agreement for that, but yes, I think there’s clear consumer interest in looking at expanding what pharmacists can do on an evidence based way and giving consumers the option and evaluating.
“Then, if Tony is right that there are some safety or quality concerns, then it should be evaluated rigorously. If that happens, then clearly it shouldn’t go on.”
Listen to the full debate here.