A Productivity Commission report, tabled in Parliament this week, has recommended community pharmacists be replaced by automated dispensing and a sub-class of “supervisors”
The Shifting the Dial report, sent to government on 3 August, then tabled in Parliament and publicly released on 24 October, has advised the Federal Government to move away from community pharmacy as the vehicle for dispensing medicines.
Instead the Productivity Commission recommends a model it says is “inevitable”, involving automatic dispensing supervised by people with a qualification involving “substantially less training” than is currently required for pharmacists.
“A new model of pharmacy would adopt now-available technology – for example, e-scripts and machine dispensing of drugs – and recognise retailing as incompatible with a genuine clinical function for pharmacists,” the report states.
“Machine dispensing (now a well-proven technology), will, absent government and pharmacist moves to prevent it, overtake retail dispensing simply due to its inherent commercial efficiency benefits.”
The Commission, an advisory body and agency of the Federal Government located within the Treasury Portfolio, says under this new system the role of pharmacists would be defined as part of a collaborative clinical model.
“In clinical settings, pharmacists should play a new remunerated collaborative role with other primary health professionals where there is evidence of the cost-effectiveness of this approach,” says the report.
As there would be less need for pharmacists, it suggests various university departments of pharmacy be contacted and informed about the “reduced need for future supply of pharmacists”.
“This new model would not, under any realistic assumptions require anywhere near the current 20,000 pharmacists who provide clinical services, and so would require a transition to a much smaller employment base.”
It suggests that these changes be phased in after the lapse of the Sixth Pharmacy Agreement, after technologies have been trialled in remote and rural areas.
“Shifting the dial to dumb”
The Pharmacy Guild of Australia has completely rejected the recommendations of the Productivity Commission, which is says are “ill-informed” and would lead to “the dumbing down of a revered health profession”.
“In an astounding piece of short-sightedness, the Commission actually recommends a reduction in the qualifications and training required to become a pharmacist, creating a sub-class of under-qualified people to ‘supervise’ automated dispensing.
“This displays an appalling misunderstanding of the complexities and responsibilities required in the safe dispensing of prescription medicines.”
The community pharmacy model in Australia services healthcare consumers “remarkably well”, says the Pharmacy Guild.
“This irrational recommendation to deprive Australians of this direct personal care from highly trained medicine specialists should be roundly rejected by governments and by the community.
“The complete lack of meaningful consultation with relevant stakeholders – let alone the Australian consumers who make 350 million visits a year to local pharmacies – before making such radical and unworkable recommendations is breathtaking.”
Reflecting UK’s changing pharmacy landscape
The Commission’s proposed approach mirrors elements of the automated hub-and-spoke dispensing model being pushed in the UK.
Last year, the UK’s Pharmacy Minister said he expects to see between 1,000 and 3,000 pharmacies – up to nearly a quarter of pharmacies in England – close based on the new model.