The Queensland Pharmacy Inquiry has released its findings, saying there is no reason to deregulate ownership
Full scope of practice, a follow-up audit of recent ownership transfers and no Pharmacy Council have been recommended by the Queensland Parliamentary Inquiry into the pharmacy sector.
The findings have been welcomed by both the Guild and the PSA.
AJP takes a look at the committee’s findings below…
Ownership: “No reason for deregulation has been demonstrated,” the Committee found.
“As long as the restrictions on who can own pharmacies in Queensland remain part of the Act, the committee believe there is a clear expectation from the pharmacy industry and other stakeholders that those requirements are effectively administered and proactively enforced.”
The Committee noted that the Queensland Audit Office found in an audit the Department of Health “has not designed processes and controls to ensure transfers of pharmacy ownership comply with all requirements of the Pharmacy Business Ownership Act 2001”.
It said the Department should improve its processes and controls to effectively administer the Act and recommended a follow-up audit.
It said it supported the recommendations of the audit except for one which required the Department to develop and implement a risk-based strategy for testing that existing commercial arrangements comply with key sections of the Act.
“While the intent of the recommendation is clear, the committee is concerned at the potential for its implementation by the department to have significant ramifications for the retail pharmacy industry. If the viability of existing pharmacy businesses is jeopardised, the committee sees potential for flow-on impacts on the availability of pharmaceutical medicines and services to consumers, particularly in remote and regional areas.
“For this reason, the committee believes any review of existing pharmacy ownership transfers by the department, in accordance with the recommendation, should be restricted to recent ownership transfers up to two years prior to the committee’s inquiry. This is consistent with the terms of reference for the committee’s inquiry.”
The Committee recommended the establishment of a Queensland Pharmacy Advisory Council to advise the Health Department in its administration of the ownership Act, and the fulfilment of its regulatory responsibilities.
Establishing a Pharmacy Council: The committee decided there was no public interest case in establishing a separate statutory authority such as a Pharmacy Council in Queensland.
It said there was no evidence that other Australian states with such councils have better community outcomes; that there was no evidence that the existing premises regulation is resulting in unsafe conditions in Queensland pharmacies; and that there was no evidence that more intensive enforcement of ownership restrictions would provide greater consumer benefits in Queensland.
It said a Productivity Commission analysis requested by the Committee did not support such a Council.
“The Queensland Productivity Commission concluded that a separate statutory authority would just add to costs in the form of higher prices for consumers (mainly in over-the-counter medicines), lower profits for pharmacy owners, or lower wages/reduced employment for pharmacy employees,” it said.
“Also, more intensive enforcement of the ownership restrictions is likely to reduce competition and discourage innovation.”
Pharmacist scope of practice: The Committee cited the example of the successful community pharmacist vaccination program in Queensland to highlight that there are “significant” potential community health benefits from “extending the scope of practice of pharmacists further”.
While it heard a number of concerns during the inquiry – “particularly by medical practitioners and medical associations” – it felt that with sufficient safeguards and appropriate additional training, these concerns should be allayed.
“Many of the issues raised by medical practitioners and medical associations could be addressed by shared or collaborative prescribing model,” found the Committee.
“Under this model, the prescribing doctor would need to authorise any repeat prescribing by a pharmacist, and the suitability of the patient to receive repeat prescriptions would need to be assessed by the treating doctor.
“There would need to be limitations on the number of repeats that can be prescribed, or the time lapsed, before a medical review is required, to ensure that the treatment remains effective and necessary.”
The committee recommended that the Department of Health lower the minimum patient age requirement for pharmacist-administered vaccinations to 16 years of age.
It also recommended the Health Department develop options to provide low-risk emergency and repeat prescriptions, such as repeats of the oral contraceptive pill, and low risk vaccinations, including low risk travel vaccinations, through pharmacies subject to a risk-minimisation framework.
The committee also supported greater national consistency in vaccine provision, recommending that the Minister for Health seek support through the COAG Health Council for nationally consistent education and training requirements and scope of practice for pharmacists administering vaccinations.
Such a national approach was supported by the Health Ministers at last week’s COAG Health Council meeting.
Pharmacy assistant scope of practice: The Committee recommended the Department of Health, in conjunction with the Pharmacy Advisory Council (if it is established), explore the benefits and risks of extending the scope of practice of community pharmacy assistants in relation to the handling of dangerous drugs.
A number of stakeholders who made submissions to the inquiry complained about the lack of universal qualifications for pharmacy assistants who work in hospital pharmacies and community pharmacies.
The Committee recommended that the Health Department, alongside any Pharmacy Advisory Council, explore whether community pharmacy assistants and hospital pharmacy assistants should undergo the same basic mandatory training, and whether this would provide community benefit.
A welcome report
The PSA and Guild both welcomed the findings.
PSA National President Dr Shane Jackson said PSA welcomes the Committee’s recommendation to support current provisions relating to the ownership of pharmacies by pharmacists in Queensland.
“The current pharmacy ownership system supports patient safety and helps maintain public confidence in high-quality pharmacy services being provided in Queensland,” Dr Jackson said.
PSA Acting Queensland President Chris Campbell said, “We welcome the Committee’s recommendation that the Department of Health lower the minimum patient age requirement for pharmacist-administered vaccinations to 16 years of age.
“The success of the Queensland Pharmacist Immunisation Pilot (QPIP), which led to pharmacists being able to vaccinate across Australia, has seen significant community health benefits including improved accessibility, patient satisfaction and lower out-of-pockets costs for patients.
“PSA also welcomes the recommendation for pharmacists to dispense emergency and repeat prescriptions, and that any change in pharmacists’ scope of practice should be underpinned by appropriate credentialing and training.
“The above recommendations are a step in the right direction but there are still more opportunities to take advantage of pharmacists’ unique expertise to better support the health of all Queenslanders.
“Pharmacists are one of the most trusted and accessible health professionals in Queensland, but their skills have not been put to full use because legislation hinders some areas of practice.”
PSA says it embraces the recommendation to establish a pharmacy advisory council containing a diverse range of members to provide expert advice to the Department of Health. We also agree with the recommendation from the Auditor-General that the Department of Health should strengthen processes and controls to ensure pharmacy ownership complies with the Pharmacy Business Ownership Act 2001.
PSA says it looks forward to working with the Department of Health and the Queensland Government to continue making the most of the skills and expertise of pharmacists to provide the best healthcare for Queenslanders.
Read the full report here.