How might a GP-owned pharmacy work?


doctor shaking hands

Greg Hunt has again said no to non-pharmacist ownership, but a leading doctor has condemned “protectionism” in the sector

This week, the AMA announced that it had created a working group aimed at lobbying the Government to scrap or loosen the ownership and location rules, saying many pharmacies and pharmacists should be co-located within GP surgeries.

AMA vice president Dr Chris Zappala has now told ABC Radio Queensland’s Sheridan Smith that patients’ desire for convenience would be better served with such a model.

“I think one of the most common things we hear from patients these days is not only do they want high quality care, which fortunately we can largely take as a given in this country, but they want it to be convenient and accessible as well,” he said.

“And so the whole notion behind this is that if we create hubs centred onto the GP practice where primary care is going to be delivered to all patients, then it’s going to be more convenient.

“So, if you’ve got a dispensing pharmacy as part of the general practice, or co-located, and integrated in so they’re doing, for example, medication checks and so on, and liaising with the general practitioner, then that whole model of health care is a lot better.

“And there is actually evidence that that’s more efficient and gives better outcome.

“So, it’s about creating a hub centred on the GP that becomes a one-stop shop so the patients can get everything they needed done at their usual local general practice.”

Dr Zappala said that by bringing pharmacists and pharmacies into the GP team, alongside other health professionals such as psychologists, dietitians and physiotherapists, patients would benefit from not needing to attend different venues.

He said that the current pharmacy ownership rules are a “problem”.

“The current pharmacy ownership laws are very restrictive, and allow pharmacies to be owned only by a select few, which of course are then set up for… other reasons, and not necessarily integrated within a general practice.”

Dr Zappala said that the GP should “always be the focal point and the cornerstone of good community care for all patients”.

In areas such as the rural and remote towns which have a community pharmacy but no GP, models such as telehealth consultations with GPs could be utilised, he said.

When asked whether pharmacy hubs in GP surgeries could make it less viable for traditional community pharmacies to exist in some areas, such as regional areas, Dr Zappala said he hoped such pharmacies would not close down, or not be opened in the first place.

“But again, I think we have to be more innovative in those instances and use, for example, telehealth or telemedicine, and online options,” he told Ms Smith. “For example, online pharmacy options for patients, telehealth appointments with general practitioners.”

He also restated that visits to GPs instead of pharmacies for vaccination, for example, are a good opportunity for health interventions.

“When you’ve got a general practice that knows you well, you get that end to end seamless care. And that’s when outcomes are better.

“And so any model of care that looks like it might be more convenient or cheaper, but actually takes patients away from GP-centred care, or fragments the care that they’re received into different parts of the community, is not a good thing.

“And we should oppose it strenuously because we should never allow convenience to be a substitute for quality.”

Speaking to reporters this week, Health Minister Greg Hunt rejected the idea of change to the ownership rules, however.

“We have a very, very clear set of rules regarding pharmacy ownership which follows in fact the recent reviews and we, through a bipartisan approach, reaffirmed those rules in the Parliament in the course of the last two years,” the Minister said.

“So we’ve only just re-legislated in this space and there are no plans to change that.”

Dr Zappala also said that Mr Hunt and other decision-makers “got it wrong” about retaining the pharmacy ownership status quo.

“Anyone can own a doctor’s practice; anyone can own any business really in this country. I mean, why pharmacists should be so protected that a pharmacy is only owned by an elite small group of pharmacists is beyond understanding, to be perfectly honest.

“And it seems to be that there’s a bit of protectionism going on, and I’m not quite sure how the community is served by having that to be the case.

“If we believe in free market forces and convenience and all the rest of it, then that means that if there are alternate models of dispensing and pharmacy that are actually good for the community and good for patients, then we should look at them.

“And if the current rules of restrictive ownership block that sort of innovation and evolution, then they are a problem.”

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