A discussion panel on the Pharmacy Review had some interesting things to say, from location rules and risk share arrangements to appropriate remuneration for services
The panel session looking into the Review of Pharmacy Remuneration and Regulation included a combination of pharmacists, Guild representatives and wholesalers.
“The Guild’s position is that we should be building on the existing system,” said facilitator Greg Turnbull on opening the panel session, who then asked delegates to send their questions to the panel via the APP2017 app.
Hundreds of questions came through to the panel and conversation quickly turned to appropriate remuneration for services and providing certainty for the pharmacy industry.
“I would love if every time a patient came into my store and asked, ‘can I speak to my pharmacist?’, out would come their Medicare card, they would swipe and I would come out and speak with them,” said Lucy Walker, owner of Lucy Walker Chemmart in Goondiwindi and winner of the Pharmacy of the Year award.
Her suggestion was received with applause from the delegates.
“What does that patient want?” she continued. “They want accessible healthcare advice and they don’t want to spend a lot of money getting it. We are accessible and we are free. We are being the gap in our healthcare system but getting no direct remuneration for it.
“Now if we knew we would get even $5 for every time we answered a question, we would build our business with structures in place to handle the gain we would be getting for it. If we want to grow and innovate with the idea of pharmacists being accessible health professionals, we need to put that to the government and get that value for it.”
Ms Walker added that while she would love to keep charging whatever she wanted for services, “there is competition out there”.
“I don’t want to price myself out of the running,” she said.
Meanwhile, Elise Apolloni from Capital Chemist Wannissa said that she wanted more government funding and better support for pharmacy prevention services.
Wholesale industry representatives chimed into the discussion with a request for fixed floor prices to guarantee returns.
“There was unfinished business around the 6CPA for wholesalers,” said Richard Vincent, CEO of Australian Pharmaceutical Industries (API).
“Clearly the margin that we’ve had over the years has been a good mechanism but on its own is no longer sufficient for us to have a sustainable model. We need a minimum fee … that would guarantee returns,” he said.
“I think we need everyone in this room should lobby as hard as they can to have floor prices put in place,” said Brett Barons, executive general manager of Symbion.
“We’re public companies, we need to share with our shareholders and boards that the future is bright. Then there will be less impost on the individual pharmacies.”
Risk sharing “cuts both ways”: Guild
Pharmacy Guild panel representatives, executive director David Quilty and national president George Tambassis, were adamant about the importance of location rules, funding from government and removal of the $1 discount.
There was also a call on Health Minister to follow through on his optimistic speech on the opening day of the conference.
“The agreement [for $6 milion in government funding] makes it clear the money for new and expanded programs should start from 1 July 2017 … For the viability and transformation of pharmacy, it’s vital that this money flows in full and on time. I think the Minister recognises that, I think he made that clear yesterday,” said Mr Quilty.
“Greg Hunt is very genuine in terms of wanting to get solutions to issues for pharmacy, but at the end of the day, it’s delivery that counts. Words are easy for politicians.”
Minister Hunt had yesterday told APP delegates that he was aware of the need to address risk share arrangements and location rules.
“I know, I hear how absolutely important this is from [Guild representatives], and each and every one of you. I want to repeat, I absolutely hear how fundamentally important those things are,” he said on Thursday.
“The progress externally and internally has been very good. The PM has been exceptionally supportive. It’s the job of those who count the beans to challenge every minister but my view is that working with [everyone] we will find an outcome on location [rules] and risk share to strengthen community pharmacy.”
Mr Tambassis reiterated that the risk sharing arrangements were part of an agreement that affected both sides.
“It cuts both ways. If we go over our volumes, the government can come to us,” he emphasised.
And location rules were a hot topic for the Guild as well.
“Certainly one recommendation for the review should be that they keep location rules for community pharmacies that is an absolute must,” said Mr Quilty.
“What we’re saying to the pharmacy review is that you need to recommend and understand that location rules are fundamental to the system we have.
However there is currently not much confidence in the outcome of the Review of Pharmacy Remuneration and Regulation, if Guild comment is anything to go by.
Speaking at the State of the Industry Symposium on Thursday, Mr Tambassis said that the King Review panel chair, Stephen King, had made “some major, major mistakes,” having “come in with some serious preconceived ideas”.
“At the end of the day, we’ve lost confidence in this gentleman,” he said.
Mr Quilty reiterated this view at the panel session.
“I can’t say that I’m very confident in this review right now,” he said.
“There are two that worry me. The first is further regulatory impost on pharmacists. Stephen King is a regulatory economist. I think there’s a real concern, particularly in the flaws of their data collection.
“[Also], what worries me is this idea that we don’t need pharmacists any more, if we have machines they can spit out medicines information. And that we should pilot them in Australia, because if we remove location rules then there won’t be community pharmacies anymore and we can trial that,” Mr Quilty added.
“This idea that pharmacists be replaced by robots, we don’t agree with that at all.”
Although while Mr Tambassis said the Guild’s number one priority would be to get rid of the dollar discounts, fellow panellist Ms Apolloni said in her personal experience the dollar discount hasn’t been an issue.
“The dollar discount… it hasn’t been an enormous issue in our pharmacy at all,” said Ms Apolloni.
“We’ve had conversations with people who would be affected by the safety net. Overall it really hasn’t had an impact on our pharmacy specifically.
“I’m very happy we will charge $29.95 for flu vaccinations, I believe our customers believe there is a price for convenience, having private consultation rooms, I’m proud to charge [for our services] but, as Lucy said, it is important to be aware of what’s out there.”
A desire for certainty, stability
“I just want some certainty,” said Ms Walker about what she ultimately wants out of the King Review recommendations.
“I’ve got a huge amount of debt, I’ve got staff. I just want to know what’s going to be happening so I can plan, organise and grow. Without that certainty I don’t have a framework behind how to move forward and dream about what I can do with my pharmacy.”
Unfortunately it is unknown when the report’s recommendations will finally be handed down, Mr Tambassis pointed out.
“We don’t know when the report will be handed down and no there is no fixed date,” he said, responding to a delegate’s question.
“Every single one of the proposed dates have been moved. This is a report to government apart from the issues we need resolved earlier. The majority of the recommendations are to better inform government for the 7CPA.”