King approach ‘radical and untested’


The direction taken by the King Review looks like a calculated attempt to dismantle the current community pharmacy model, says Guild executive director David Quilty.

In this week’s edition of Forefront, Mr Quilty takes aim at the Review of Pharmacy Remuneration and Regulation, saying it’s bad for almost everyone involved.

“The direction laid down by the Review is bad for patients, bad for the pharmacist profession, bad for the broader community pharmacy workforce, bad for the medicines sector, and bad for Australia’s 5,600 community pharmacies which have helped make the PBS the most fiscally sustainable part of the entire health system,” Mr Quilty writes.

“The Review has not produced the evidence to demonstrate how a pricing regime that is used to regulate access to big electricity, gas and telecoms utility networks could somehow be applied to 5,600 small businesses in the health sector to the benefit of patients.

“Its prescription for the future has all the hallmarks of a calculated attempt to dismantle a community pharmacy model that works well and enjoys the overwhelming support of the Australian public, while reducing even further what the Federal Government pays a sector already struggling with cuts that will see PBS expenditure fall by more than 10% in real terms over the next four years.”

The direction taken in the King Review interim paper also “ignores or misunderstands” global health care trends, he says, as it would narrow the role of community pharmacies, rather than taking an integrated, patient-centred approach to health.

This would also commoditise safe, professional medicine dispensing.

“One must ask what community pharmacies, the pharmacist profession and patients have done to warrant being subjected to such a radical and untested approach?”

Mr Quilty says that the review is a strong reminder to all involved in pharmacy that planning for the future is vital to safeguard the sector.

“We cannot afford to blithely sit back and hope the future will look after itself or that we can outsource it to some third party.

“The community pharmacy sector is in the midst of a once-in-a-generation transformation and can no longer rely on the PBS in the same way it has done in the past.  

“Governments want maximum value for money and will direct their finite taxpayers’ dollars to providers that deliver the best and most cost-effective outcomes for patients.”

Trends such as the ageing population, the growth of chronic disease, technology uptake, increased consumer expectations and evolution of the profession all need to be taken into account, Mr Quilty writes.

“As leaders, we must understand these trends and lay down a pathway that will secure the future of the sector and the profession by focusing first and foremost on meeting the needs of patients.

“This is a whole-of-sector challenge, requiring whole-of-sector input, collaboration and buy-in.

“With the next community pharmacy agreement negotiation already looming, the need to plan for and secure the future of community pharmacy to 2025 and beyond is upon us.

“All of us who work so hard for and believe so passionately in community pharmacy and the pharmacist profession need to be working together to take control of this shared destiny.”

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31 Comments

  1. Kevin Hayward
    20/07/2017

    It should be borne in mind that this article is merely a reflection on the viewpoint of an organisation that represents a minority of registered Pharmacists in Australia.
    Paradoxically, others may view the King report as an opportunity to embrace change, and move forwards from the current Zeitgeist to a new, paradigm of professional challenge and opportunity.

    • John Smith
      20/07/2017

      seems like the PGA totally ignores the point of view of the majority of pharmacists. It is very interesting

      • bernardlou1
        25/07/2017

        what is the view point of the majority and where is your evidence that supports your statement?

  2. John Smith
    20/07/2017

    I don’t think the PGA can have a say about patient centred approach after trying to shut down medsassist to save money and not focused on patients’ health and safety (that is only one of many examples). Moreover, still trying to keep codeine containing products available without RX for the sake of profits rather than focusing on patients’ health and safety. I would encourage whoever has a rational response or analysis to kings report to say it rather than attacking persons and/or intentions . Let’s not forget that the kings review was part of the CPA that was signed by the PGA on behalf of community pharmacies.

    • Anthony Tassone
      20/07/2017

      John

      The Pharmacy Guild funded, maintained and operated MedsAssist – a clinical decision support tool at its own cost, after waiting years for state or federal government intervention on real time monitoring of substances of concern.

      This is a real commitment to medication safety.

      The Guild’s move to shut down MedsAssist was not motivated by ‘saving money’ but having the necessary regulatory underpinnings for its most effective use.

      Following Minister Hunt’s high level intervention several months ago to seek urgent advice in this area, the Guild has in good faith held off the shut down until this advice is received at which time it will be assessed with the Minister whether the necessary actions are able to be taken to allow this system to continue operating effectively until 1 February 2018.

      The Guild maintains that there are more cost effective and reliable methods of identifying and supporting consumers who are at risk of codeine dependence without restricting access to the majority of Australians who use these products responsibly and safely.

      For this very reason, the Guild developed and implemented MedsASSIST,

      In terms of cost effectiveness , the KPMG Report “Economic Modelling and Financial Quantification of the Regulatory Impact of Proposed Changes to Codeine Scheduling”1 indicates that:
      – 6% of Australians over the age of 12 purchase at least one pack of low-dose codeine medicine per year (80% of whom were purchasing for treatment of acute pain).
      – the additional MBS costs are estimated to be up to $204.46 million from 2017-26.
      – the additional PBS costs are estimated to be up to $61.4 million from 2017-26.

      Anthony Tassone
      President, Pharmacy Guild of Australia

      • John Smith
        20/07/2017

        Hi Anthony,
        Glad to hear back from you… I quote this “The Guild’s move to shut down MedsAssist was not motivated by ‘saving money’ but having the necessary regulatory underpinnings for its most effective use.”
        This is different to what have been said before on a different forum, when the PGA took the decision to cease medsassist and all pharmacists were upset with the decision. What was said before that PGA works in the favor of its members and protecting their interests.

        Also, it was mentioned that one of the reasons that the number of the pharmacies using medsassist declined and that was another reason for PGA decision. (any stats on what pharmacies) I don’t think there is, which means no transparency

        Lastly, I am going to ignore the cost effectiveness part as when it comes to health and addiction, the government is entitled to spend the money to protect to people from a serious problem like dependence ( that is patient centered approach from government)

        When an organisation lobby to keep codeine containing products without RX while knowing there is a serious addiction problem ( that is not patient centered approach)

        Kings review was part of the CPA, so it needs to be analysed and discussed reasonably rather than just throwing words at the person or attitude. Thanks Anthony

      • M M
        20/07/2017

        Back to the SMART economics part .. I would like to refer you to this general definition of “Societal Value”

        “Social value is a way of thinking about how scarce resources are allocated and used. It involves looking beyond the price of each individual contract and looking at what the collective benefit to a community is when a public body chooses to award a contract.”

        Economics of societal value .. where saving one life is a lot more profitable than saving $$$

        It is clear which side PGA supports.

        • Willy the chemist
          20/07/2017

          To John and MM, would you both be happy to donate $100 individually each year as ‘societal value’ as your contributions to such valued endeavours as MedAssist.

          I’m not being cynical or critical, I’m seriously asking a truthful question. I believe in MedsAssist and it seems you both agree too.

          • John Smith
            21/07/2017

            Hi Willy, I don’t think you’re being cynical. The problem isn’t with pharmacists to donate or not. If you actually truthfully ask all pharmacists as stakeholders to donate, they roll happily donate, and then it might be even$10 or 20 per year or even less. The thing that PGA makes it only about members and protecting their interests, and to that I’ve no problems at all as this is the case with orgs like PGA . However, don’t come and ask for employees help only when you’re stuck . To answer to your question yes I can and not only that but I’m donating already as the fund for the cpa is through our tax money. Cheers

          • M M
            21/07/2017

            I believe that all Australians pay for that now under the new approved budget. This makes your question irrelevant.

    • bernardlou1
      22/07/2017

      You actually have no idea.
      Complaints to the privacy Commission spiked
      AS pharmacists we’re asking for State Issued photo ID such as driver licence.
      Since the recording of Codeine containing products wasn’t legislated and based on legal advice The Guild decided to shut down Medsassist.
      If self interest was at the heart of it then why wouldn’t an organization as he Guild would invest almost $500,000 to build software to empower its members to serve their patients better. And why would members spend time using it and discussing treatment options with patients???

      Hopefully you can see the points

      • John Smith
        22/07/2017

        Hi Mr,
        Just to add some details or stats to your knowledge. Guild didn’t implement Medsassist until they felt the threat of losing codeine sales. FYI the codeine sales is an industry worth about $75 mil a year (according to the president of Pharmacy Guild of Australia ) Now that is a business worth $500k to be protected.
        Also, you are writing your comment and you are actually convinced that the PGA didn’t get any legal advice from its legal team before the launch of medsassist at all?!!! doesn’t make any sense for me at all and if they did without any legal advice, that is a big failure.
        I see your points, but I see the bigger picture and hopefully you can get it 🙂

        • bernardlou1
          23/07/2017

          Hi John

          I see your point.
          It’s big dollars.
          The PGA role is to look after its members. Their members toke is to look after it’s patients.
          What part did anyone party fail their responsibility?

          • John Smith
            24/07/2017

            Both parts as it’s all about profits not consumers. Evidence as mentioned earlier like medsassist shutdown, deal with blackmores back in 2009 to do up selling and same thing now with ethical nutrients, giving course on how curcumin can help with depression. When asked what’s the evidence, get no response. Long list mate… It’s broken system and all review say the same thing but PGA and its members like to ignore the facts and only attack the persons rather than the work done, why? Because as you said PGA looks after its members, not profession in total.

  3. GlassCeiling
    20/07/2017

    Change is upon us. Guild need to be inclusive instead of protectionist- if the Guild seek to relax location rules and enhance professional service they will enjoy majority support from the nations pharmacists and continue to make money.
    If the Guild continue to fight the significant and unstoppable change to the existing community pharmacy system they will be obliterated within 5 years.

    The Guild staff and leadership did not know what was going to happen to their jobs and positions just prior to the signing of the last agreement. That was the shot across the bow.

    Will the Guild be on the right side of history?

    • John Smith
      20/07/2017

      good insight 🙂

      • Kevin Hayward
        20/07/2017

        As a pharmacy owner I was a member of the Guild’s sister organisation in the UK, the National Pharmaceutical Association (NPA), when I sold up I joined the NPA as a non owner member, I continued to get great support, access to services, training etc etc, I even joined them as a trainer and assessor for the courses they ran. No matter which class f membership I had, I knew that NPA was going to look after me and the profession.

  4. David
    20/07/2017

    I would like someone to independently review Mr Kings livelihood and see how he reacts. We have a perfectly good system at the moment. If anything, we need to raise the pharmacist wage, but I can’t see this happening if Mr King passes this devastating blow to pharmacy.

    • John Smith
      21/07/2017

      Why do u think we need to raise the pharmacist wage? Why do you think there’s nothing else need to be improved?

      • David
        21/07/2017

        We need to raise the wages to get good people into the industry! What have young people got to look forward to if they only earn 25 bucks an hour after registering?? How does that pay the bills?? Whats the big push for online pharmacy? I enjoy face to face interaction and getting to know people. Seems like it must be a dying art? If it ain’t broke, don’t fix it!! PBS reform has been happening for years, forward dispensing is happening, pharmacists are actually talking to customers rather than hiding up on pedestals. There is an ubundance of pharmacies and someone says we need to change location rules. Wake up, look around. There is competition on every corner!

        • John Smith
          22/07/2017

          I agree with you but not entirely. Wages have to go up but really it’s too late now for the guild to act as good guys and ask fit increase. The increase has already happened and will go up more, that’s a fact. There’s no push for online pharmacy, the bigger picture is universal portal for all Medicare holders with an option for the customer to choose the online delivery or direct the script to the preferred pharmacy which happens now anyway. The face interaction will stay be the same and even more when reducing the dispensing time and errors. Forward pharmacy hasn’t been proven yet to clinically work, it’s definitely working for front of shop to increase the vitamins sales 🙂 location rules will be relaxed sooner or later for the benefit of society. Reformation has to start from scratch, otherwise the new system will be full of cracks

          • David
            22/07/2017

            Spoken like a true ambassador for chemist warehouse. I would love to see who is funding this ‘independent’ review. Has John Smith written all over it and stinks to high heaven.

          • John Smith
            22/07/2017

            What independent report are u talking about? I also don’t understand the reasons behind calling anyone who doesn’t agree with PGA perspective to be with chemist warehouse? As far as I know all their pharmacies are qcpp accredited and they jointly lodged the submission to reduce the penalty rates . I’m sorry mate to tell you that but you’re being delusional here 😉

          • David
            22/07/2017

            The King Review is the ‘independent’ review that i speak of. I thought someone with your perceived intellegence would have worked that out! Penalty rates are down, so lets put up the rate. What are you scared of John Smith (if thats your real name?) If you dont work for chemist warehouse, where do you work? Ill be sure not to step foot into your business again

    • GlassCeiling
      23/07/2017

      The system is broken . It is a retail focus , volume rewarded , owner pharmacist Guild supported windfall joke with zero health accountability.
      Broken , broken , broken.
      The King review is not finished and at its conclusion it is a ‘review’ and not the final roadmap. Let us comment on a finished product and if it suits the majority of practicing pharmacists and the consumer it is a winner. You must accept there are winners and losers in any reform.

      • David
        23/07/2017

        The system is not broken. I have a huge passion to help patients. I do medication reviews, speak to nearly every patient that comes in, counsels every patient who fills scripts due to forward dispensing. Do free blood pressure and blood glucose checks, meds checks. We do a free deliveries as well. We dont charge for doing webster packs. We are primary health care and need to be rewarded for what we do. Oh yeah, and we do flu and whooping cough vaccines as well. The system is far from broken! What is your name glass ceiling, where do you work, and what are you not doing to make this a broken system. Why does a specialist get paid 200 bucks for a 15 minute appointment. Cause She/he studied a tew more years. No one squirms at that?

        • GlassCeiling
          23/07/2017

          I congratulate you for being a diligent pharmacist in a broken system.
          The free Webster packs , point of care testing and deliveries you speak of are evidence of a broken system.
          Specialists are accountable for their work as their insurance will attest.
          As for my name this is the beauty of this forum- we are free to speak our truths without fear or favour.
          Inequity in the system causes a power inbalance- an employee pharmacist is at a financial disadvantage to that of an owner pharmacist and risks much when challenging the status quo.
          My name is irrelevant when discussing topical issues of relevance to all pharmacists – do not read or respond if you do not approve of my anonymity

          • United we stand
            23/07/2017

            What’s with this obsession about posters information?!?!
            Whenever a Guild member is confronted about their position they’re quick to mention the anonymosity of posters. Bottom line is you need to have an AHPRA registration to access this site. So don’t worry you are speaking to a health professional on this forum.

          • Andrew
            26/07/2017

            I think it’s indicative of the Old Boys Network that exists at the top of the profession. It’s always about who you are rather than what you have to say.

            It’s all a Game of Mates.

          • Jarrod McMaugh
            29/07/2017

            Actually the AHPRA registration is required for the forum, not the articles or comments in the main site

          • David
            23/07/2017

            Lol, I was once a lowly employee pharmacist as well, but instead of whinging about it, I decided to take a risk and have a crack at owning one! Many years of hard work and sacrifice. No one gave me a penny!! Stop whinging and make your own way

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