King’s views: 10 key quotes

Jo Watson (centre) with fellow review panelists Professor Steven King (l) and Bill Scott.

10 quotes from pharmacy review chair Professor Stephen King on CWH, pharmacy viability and more

Professor Stephen King, chair of the Pharmacy Remuneration and Regulation Review, did not hold back on his forthright opinions of what are the key questions and issues that the review is considering, during his speech at Pharmacy Connect last weekend.

Here are ten quotes from Professor King’s presentation

  1. The aim of this review is not simply to suggest cuts to government expenditure. We are not under any mandate to save costs, We will be recommending if we think there are areas where increased government expenditure would create better health outcomes.
  2.  This review is not about the viability of community pharmacy per se, rather it is about the health of Australians. The network of community pharmacies is an extraordinary asset, but this does not mean every pharmacy can be, or should be, propped up.
  3. Chemist Warehouse has a great business model – as do a lot of other discount pharmacies – they do what they do very well. They have a great logistics chain, and are able to, in a sense, bring supermarket into pharmacy.The debate is whether this is a desirable model
  4. During the course of our consultation around Australia we’ve seen lots of pharmacies that I would classify as being stuck in the middle – between the discount model and the professional service model. They’ve been disrupted by the discount model and sometimes try to compete with it – to their cost. They also dabble with services, but can’t or won’t charge correctly for these services. The aim here is to help these pharmacies evolve to the benefit of consumers. No one benefits if they disappear.
  5. The process of the community pharmacy agreement is really odd. There is no other industry where the government sits down with one set of stakeholders to work out how to fund and regulate the whole industry. In other areas, the government may negotiate with a group of stakeholders to work out the arrangements.
  6. Is the current pharmacy remuneration system appropriate given its based around dispensing rather than provision of professional services? This especially relevant given the dispensing process is becoming more mechanised. Is remuneration for provision of advice a more appropriate way of approaching this?
  7. What is the objective of location rules? Should they be modified? I’d be extremely surprised if we recommend getting rid of location rules, but modifications may be necessary. See here for more.
  8. I’m not sure current wholesaler logistical and remunerative arrangements are working. The CSO is really an odd policy, and again its odd that it is being negotiated by another stakeholder on behalf of the wholesalers. See here for more 
  9. Even with 140 questions included in our draft, we’ve not covered anything. For example, its been put to us that we should have included a question on dose administration aid funding.
  10. Our draft report will be released by November 2016, with the final report to the Minister for Health by about March 2017.    
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  1. Drugby

    I enjoyed this quote from Prof King on HMRs: “too much good stuff going on therefore cap”. He described the caps on HMRs as “lazy policy”.

    I agree, this review has an opportunity to remove these caps and other administrative barriers to enable equitable access to HMRs by all consumers in a timely manner. HMRs are backed by evidence, they are collaborative with GPs, they are one of the most patient-centred services provided by pharmacists and have been shown to be cost-effective (when targeted to high-risk patients).

    So we need the remove bureaucratic rules, which in my understanding were only meant to be short-term to the end of 5CPA, and make changes to the model (both in CPA and MBS rules) to enable future uptake in the gorwing number of people with complex medication regimens.

  2. Simon O'Halloran

    Absolutely agree with Debbie’s comments. I have been accredited for the past 2 years and have found that the response form my local GPs to be highly encouraging. It is also highly rewarding on a professional level as it provides a greater understanding of my patients I see in-store on a day to day basis. Managing a pharmacy as a sole pharmacist it can be challenging to solve all patient related problems at the coal face, so HMR allows those patients that may otherwise fall through the cracks to be better cared for. I also service a pharmacy depot of which the main contact with a pharmacist is otherwise via AV-link and in this environment HMR has proven to be of vital importance. The current pharmacy climate re: caps on evidence based services and reliance on PBS income and retail sales to prop up remuneration is proving a challenge to successful implementation of services and the development of a service model. The caps and poor policy implemented on the HMR program looks to be deterring any otherwise interested pharmacists to enter the field of patient centered care. There will only be 2 styles of pharmacy in the future, a discount/supermarket model, and a professional services model. Pharmacists will also be defined by the roles being performed: ie. dispensing pharmacist vs professional services pharmacist. Make your choice people.

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