NZ pharmacy deregulation won’t foster collaboration, GPs told

New Zealand parliament buildings

The proposed deregulation of pharmacy ownership in New Zealand is unlikely to foster collaboration and trust between GPs and pharmacists, says the editor of NZ Doctor.

Barbara Fountain wrote in a blog today that while New Zealand’s medicines regulatory regime needed updating, she was surprised by the inclusion in Health minister Jonathan Coleman’s plan to deregulate ownership.

Current New Zealand legislation permits non-pharmacists (including supermarkets) to part-own pharmacies, which each must be majority owned by a pharmacist (minimum 51%). Pharmacists can hold a majority stake in up to five pharmacies.

Earlier this year Minister Coleman described this as “an anomaly”.

Under the proposed changes, any “fit and proper” person could own a pharmacy – not, however, including doctors, which Fountain pointed out.

“Although this separation of prescriber and dispenser is a long-standing ethical totem, dating from the 1800s in the UK, it seems ironic that doctors are undesirables in a proposal that welcomes multiple pharmacy ownerships and allows supermarket chains to get more involved in healthcare,” she wrote.

Fountain detailed the experience of a friend, a pharmacist who had worked in the UK, who needed to “run interference” and correct information given to customers by her pharmacy’s owner, a non-pharmacist.

“A pharmacist remembers loitering in a pharmacy within hearing distance of a white-coated colleague who was dispensing advice to a customer,” she wrote.

“The white-coated ‘colleague’ was, in fact, her boss and, despite his attire, he was not a pharmacist.

“My friend, the pharmacist, loitered in case she needed to  ‘run interference’ and casually engage with the customer as they left, to correct any misinformation provided by her boss.

“It was a daily stress and part of working in the UK pharmacy sector, where regulation does not require a pharmacy to be majority-owned by a pharmacist.”

Fountain says that as with GP ownership, pharmacy ownership is not the issue: “funding and relationships of trust are what drive new models of care”.

“Will the pharmacy profession be able to provide better patient care if it is unhitched from ownership? Will supermarket ownership of pharmacy improve the chances of collaborative patient care?

“Pharmacists might be the fellow health professional you grumble about most (or is that hospital registrars), but you have a future together in primary care – it’s what patients want. It is hard to see how this proposal would smooth the path.”

Earlier this year, Pharmacy Guild of Australia – Victorian Branch president Anthony Tassone told the AJP that New Zealanders will not be better off under the proposed changes.

‘There is likely to be a concentration of ownership by larger corporate players,” Tassone said at the time.

“Ultimately the consumer will lose over a lack of choices and lack of access in regional areas. This has been demonstrated repeatedly in a number of overseas jurisdictions.”

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