Pharmacists can carry GP load

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A new report by the Grattan Institute calls on the government to roll back location rules – but also to give pharmacists a bigger role in healthcare

Public policy think tank the Grattan Institute has released a new report called the Commonwealth Orange Book, which rates Australia’s performance against similar countries and proposes policy reforms to various areas – including budget spending on health.

Its authors, which include Grattan Health Program Director Dr Stephen Duckett, have argued that the PBS is “completely bound up in red tape”.

“Who can own a local pharmacy is regulated by state governments; so too how many pharmacies they can own,” they write.

“There is no rhyme or reason about how many pharmacies can be owned in a state, and maximum numbers vary across the country.

“Where new pharmacies can be located is regulated by the Commonwealth Government, with strict rules limiting competition by specifying minimum distances between pharmacies.”

The Grattan Institute argues that this regulation benefits pharmacy owners more than consumers.

“The powerful voice of the owners has stymied proposed reforms by both state and federal governments,” it says.

“Governments should roll back these regulations, starting by relaxing location rules and ownership controls in metropolitan areas to promote competition to reduce prices and improve services.”

The Pharmacy Guild points out that the purpose of the location rules is “to ensure that all Australians have high levels of access to PBS medicines and related services, delivered through a well-distributed network of community pharmacies.

“The location rules were introduced by the Federal Government in 1990. They are designed to ensure the optimal distribution of pharmacies – essentially to discourage clustering in urban areas while encouraging relocations to rural areas, with minimal increase in the overall number of approved pharmacies.”

In addition to location rule changes, the Grattan Institute says pharmacists should be given a “bigger role” within the healthcare system.

“Pharmacists are highly-trained medical professionals. Australia under-uses their skills,” it says in the report.

“Care that could be delivered by pharmacists is instead reserved for general practitioners, which unnecessarily increases the load on GPs, at a cost to taxpayers.”

Grattan says the Commonwealth Government should empower local pharmacies, as part of a team with GPs, to:

  • provide repeat prescriptions;
  • give drug information to patients and adjust their doses when required; and
  • work with GPs to help patients manage chronic conditions.

“Patients would benefit from the increased convenience that comes with seeing a pharmacist rather than a GP, and the increased coordination of care that comes from having a team of health professionals managing their care.”

Just last month, the institute recommended to the Pharmacy Board of Australia that pharmacists should be able to prescribe under all three suggested models: autonomous prescribing; prescribing under supervision; and under a structured prescribing arrangement.

Dr Duckett wrote in the submission that pharmacists’ role in Australia is “far more limited” than in many countries.

“Australians miss out as a result,” he says. “People have to wait longer and travel further to see a GP for a service that their local pharmacist could just as easily have provided.

“Evidence shows that pharmacists can safely provide repeat prescriptions to people with simple, stable conditions, and work with GPs to help patients manage chronic conditions.

“Allowing pharmacists to do so would improve the Australian health system by reducing pressure on the primary care system and improving people’s access to care.”

See the Commonwealth Orange Book here

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