Pharmacy deregulation OK by us: AMA


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Co-location of pharmacies with either supermarkets or medical centres would be welcomed by the AMA, as long as a registered pharmacist remained responsible for dispensing

In its submission to the 6CPA Review of Pharmacy Remuneration and Regulation, the AMA said it supports “high-quality primary health care services that are convenient to patients, enhance patient access and improve collaboration between healthcare professionals”.

“Co-location of medical and pharmacy services would clearly facilitate this.”

The AMA said current restrictions on co-location only when there are at least eight full-time prescribers in the medical centre are “inflexible and difficult to justify in terms of public benefit”.   

The doctor’s group also said it had “no concerns” about locating pharmacy premises within or adjacent to supermarkets, as long a registered pharmacist remains responsible for dispensing.

A spokesperson for the Pharmacy Guild of Australia said “It is disappointing that the AMA would openly support pharmacies within supermarkets, given the clearly adverse impact supermarket pharmacies would have on the standard of care and accountability provided to patients, left to the whim of big supermarket shareholders.

“In the face of creeping corporatisation of medical practices in Australia, it is baffling that the AMA would want to see more of the same in the pharmacy sector, where community pharmacies are proudly and responsibly owned by pharmacists”.

The AMA also restated its opposition to the expansion of pharmacy professional services, except in areas that support medication management and adherence, such as HMRs and DAAs, and programs that enhance improve rural and remote and ATSi health.

“Over the last few years, the Pharmacy Guild of Australia has pushed for a range of additional services to be funded under the framework of the Community Pharmacy Agreement to generate additional sources of income for pharmacies. These additional services represent an expansion of pharmacists’ scope of practice beyond their core education and training,” the AMA submission said.

Proposed services they take issue with include: prescribing Schedule 4 medicines; early detection and intervention for mental illness; advice on nutrition, weight loss, smoking cessation, pregnancy and baby care; chronic disease management, e.g. asthma and diabetes.

“By lobbying for these types of services to be funded under the Community Pharmacy Agreement, the Pharmacy Guild of Australia, representing for-profit business owners, is trying to drive the scope of practice of a health profession. The Pharmacy Board of Australia has not been involved in any way.

“This is not an appropriate way to design a health care system to meet the future needs of the  community.”

Click here to see the submission

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15 Comments

  1. Karalyn Huxhagen
    23/09/2016

    the last statement that AMA has issue with ‘early detection and intervention for mental illness; advice on nutrition, weight loss, smoking cessation, pregnancy and baby care; chronic disease management, e.g. asthma and diabetes.’ is an interesting statement. As a practicing community pharmacist and an accredited pharmacist these are the very areas that the GPs and myself and my phcy team and other HP’s work very collaboratively and harmoniously with the GPs .My experience is that if a GP has knowledge that a pcist is specialising in one of these areas e.g. mental health then they do refer patients to you and they establish protocols for how the collaboration is to occur. This is not how we practice in the 21st century in Australian pharmacy. The collaborative modelling of the GP payment system pushes the GP to use every partner that they can. Only problem for pharmacy is that we missed being made a part of the payment system when EPC, Collaborates, health care planning etc were designed. BIG MISTAKE. has always been hard to fix this issue.

  2. Simon Sponza
    23/09/2016

    AMA are seriously deluded here. Once deregulation occurs, and Ramsey and the big boys from overseas (Walgreens & Boots) take control, watch political donations skyrocket and more and more GP work go into these corporate pharmacies. Be careful what you wish for.

  3. Anthony Tassone
    23/09/2016

    In addition to Karalyn’s comments about the AMA position not being in tune with modern day practice, the AMA position on acceptance of co-location of pharmacies in supermarkets and deregulation of pharmacy ownership to allow supermarket control is out of step with consumer views.

    This was evidenced by a consumer survey conducted by the ‘Institute for Choice’ (a research institute as part of the University of South Australia) that was part of the Pharmacy Guild’s submission to the Competition Policy Review (aka Harper Review) which found of those surveyed that the majority of consumers supported health professionals/practitioners owning their own practice (rather than corporate or other ownership).

    Based on conversations that I have had with senior elected officials of the AMA, they privately do not support corporate ownership of medical centers. One has to wonder why they feel the need to wade into the pharmacy ownership debate. Yes, a pharmacist can own a medical center and a Doctor cannot own a pharmacy.

    However, as a profession we never advocated for this occurrence. I would personally support only doctors being able to own medical centers. Duplicating a deficit in legislation in another industry is not the solution.

    Put simply, two wrongs don’t make a right.

    It is also interesting that the AMA seem to have a shift in position from 2014 when Woolworths were proposing health checks to be conducted in their stores; The AMA came out strongly and slammed the proposal, their National President at the time Associate Professor Brian Owler was quoted as saying:

    “It would be highly inappropriate to conduct health checks in a location that sold alcohol, cigarettes, sugary drinks, energy drinks, and high-fat foods – the things that contribute to ill health in the first place.

    “This is a dangerous idea that should be stopped before it gets off the ground.

    “Good health is not something that you can pick off a supermarket shelf,” A/Prof Owler said.

    Their full release at the time can be accessed from:

    “Woolworths health ‘checkouts’ belong in the bargain bin” https://ama.com.au/media/woolworths-health-checkouts-belong-bargain-bin

    I wonder how the PSA feel about this position taken by the AMA considering their recent collaboration on budget submissions for pharmacists in general practice and PSA’s position on ownership and location rules.

    Anthony Tassone
    President, Pharmacy Guild of Australia (Victoria Branch)

    • PeterC
      23/09/2016

      It just vindictiveness Anthony.

      • Big John
        23/09/2016

        Exactly and pharmacists should NOT support the AMA’s desire to have funding approved for pharmacists within surgeries. It’s just too easy for them. Pharmacists should be the masters of their own policy and profession and not slaves to those those that seek to dismantle it. I have always maintained this.
        Remember: Turkeys shouldn’t vote for Christmas!

        • Jarrod McMaugh
          27/09/2016

          Funding of Pharmacists working with GPs in the clinic is quite important – so long as the source isn’t coming from the CPA

          • Bob
            27/09/2016

            It should be MBS and pharmacists should have their own provider numbers. If doctors want pharmacists they can subcontract them for their services.

          • BJ
            27/09/2016

            Well done Bob. Nice suggestion. As mentioned above: “Pharmacists should be the masters of their own policy and profession and not slaves to those those that seek to dismantle it”.

  4. Lance Emerson
    23/09/2016

    To be clear – PSA supports the retention of the current provisions relating to ownership of pharmacies and State and Territory legislative restrictions on the co-location of pharmacies and supermarkets.
    We also strongly support pharmacists delivery of evidence-based services within pharmacists’ scope of practice, that meet consumer health needs. Advice to consumers on a range of conditions, including smoking cessation and some other services mentioned in the AMA submission are well within the current scope of practice for pharmacists, and covered within the Competency Standards required of all registered pharmacists. Such services make good use of the available health workforce, and should be supported as important public health initiatives.

    Regarding General Practice pharmacists, PSA broadly supports AMAs proposed model, however as previously stated, PSA firmly believes that the pharmacist hourly rate modelled in AMA’s submission is too low, and there is still much discussion to be had on the best model for payment.

    • Big John
      23/09/2016

      And exactly how much was the hourly rate proposed by the AMA for a pharmacist worker? And was that rate including or excluding the $25k funding proposed? This is an important detail as it will tell us how much the AMA actually value pharmacists and what happens when funding is dropped? Unbelievable that the PSA would support an organisation such AMA who clearly do not have the pharmacy profession’s best interests at heart!

    • Jarrod McMaugh
      23/09/2016

      Every service that the AMA mentioned is within the scope of practice of pharmacists.

      I don’t believe that working with the AMA means that PSA agrees with everything (or anything) that they put in the media release, but it is extremely important to keep in mind that the AMA is continually critical of pharmacists and pharmacy services.

      While the progress towards pharmacists working collaboratively with GPs is a great thing, this goes to show that it is a good thing that 6CPA funding will not be used (or lobbied to be used) for any pharmacist service provided in a GP clinic.

      Not only would this be an inappropriate use of funds designed to support the pharmacy industry and the pharmacists that are employed by them, but it would also alienate every member of the PSA who owns a pharmacy, every PSA member who works in community pharmacy, and every PSA member who is working towards the development of pharmacist-led services that could be funded with this model.

  5. Neville
    24/09/2016

    If deregulation is OK with the AMA, it should apply to doctor’s also. For example, allow pharmacists to receive Medicare payments for clinical services that currently Medicare only pays surgeries to do – vaccination, writing sick notes, taking blood pressure etc. Pharmacies could sure use the $80 for each consultation, that Medicare currently only pays to doctors. Thanks AMA. You’ve just opened up a whole new ball game. Oh, you meant deregulation of anything BUT payments to surgeries? Too bad – it’s out there now.

  6. Mouhamad Zoghbi
    26/09/2016

    Unfortunately, the health care industry has become a turf war.
    No one values the other unless it brings value into the cash register.
    I believe that de-regulation is inevitable, but once it happens, the government will target the AMA for the wastage of resources such as scans, MRI’s and lab tests that GP’s get kick backs from.
    There will be no immunity from governmental cuts, pharmacies, GP’s, hospitals and ambulances will feel the heat.
    Finally, there are very few angels in this industry, many of you need to dig deep into your souls and remember that we are in the profession of supporting people’s lives.

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