Let’s move beyond the turf wars


Pharmacists’ union calls for reform in its 79-page submission to the King Review

In publicly releasing its submission to the Review of Pharmacy Remuneration and Regulation, Professional Pharmacists Australia (PPA) national president, Dr Geoff March says the group wants to work closely with governments, doctors, nurses, allied health professionals and the community to unlock the benefits of the greater integration of pharmacists across the health system.

“The existing remuneration model needs reform, work practices need to better respond to patient needs, pharmacists’ skills better utilised and integrated, and we must embrace technological change to enhance the health consumer experience,” says Dr March.

“We owe it to patients and the community to move beyond the usual turf wars between health professionals. PPA is looking forward to the release of the Review’s recommendations and the opportunity of reform that could follow.”

Improving remuneration

The submission begins by looking at employee pharmacist remuneration.

“There needs to be significant rethink in the current pharmacy remuneration system. We need a system built around patient outcomes rather than a process that prioritises the supply of a product,” writes the PPA.

While the focus of the current CPA is based on payment for dispensing, it says a new remuneration system should be focused on services based on patient need, and remuneration based on the pharmacist’s time to provide service including follow-up and monitoring.

“Pharmacists need to be seen as an integral part of the health care team, not as at the moment a separate case funded through the CPA and therefore funding avenues should reflect this team care requirement.

“Unlike other many other health professionals, the historical ‘small business’ nature of pharmacy has led to a situation whereby the employment arrangements in pharmacy are underpinned almost exclusively on the ‘safety-net’ wage rates in the Pharmacy Industry Award, whereas other areas in health are underpinned by much more robust and detailed arrangements contained in negotiated enterprise agreements.

“The growing scope of pharmacy practice and medicine complexity is not adequately reflected in the value of pay rates in the Pharmacy Industry Award,” says the PPA, adding that it is currently pursuing changes to these rates in the Fair Work Commission.

Scrapping location rules

PPA also states it is open to the removal of location rules in metropolitan areas “as a first step” towards increased funding for professional services and better access for patients, with maintenance of location rules for rural and regional areas.

“PPA is concerned that location rules as they are currently formulated may not effectively or efficiently ensure a network of pharmacies in Australia … More efficient potential providers may be able to reduce the need for significant government subsidises of distribution. The economies of scale could also lead to an increase hours the community can access the support of pharmacists.

“Initiatives that drive more efficient pharmacies with lower medicine supply costs may liberate funding that can be better directed into professional services: improving patient outcomes, and delivering benefits to future health budgets,” it writes in its submission.

Reforming Community Pharmacy Agreements

The PPA asks for negotiations to be broader, including bodies such as the Consumer Health Forum, Pharmaceutical Society of Australia, the Pharmacy Guild and PPA.

“An alternative approach could be to establish a governing panel comprised of the Guild, PSA, PPA and community representatives for the purposes of negotiating with the government for pharmacy supply and services,” the group says.

A greater role for pharmacists

PPA says it supports measures that would enhance the role of pharmacists in our health system and the overall experience of patients.

It specifically welcomes greater investment in medication reviews, being the only evidence-based professional service currently available for pharmacists.

“Pharmacists are an untapped resource who are able to effectively monitor and advise patients on managing chronic conditions, and multiple medications,” says the submission.

“We must ensure that the pharmacy network is rebalanced that places a greater emphasis on health rather than retail outcomes.”

Read the full submission including feedback from PPA members here.

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