Should general practice have location rules?

A leading pharmacist has hit back at AMA vice president Dr Chris Zappala’s claims that GP-owned pharmacies would be more convenient for patients

Following the Australian Medical Association’s announcement that it had formed a working group to lobby the Government to loosen pharmacy ownership and location rules, its vice president featured on ABC Radio Queensland with Sheridan Smith to discuss the rules, including the AMA’s push for GPs to own pharmacies.

“I think one of the most common things we hear from patients these days is not only do they want high quality care, which fortunately we can largely take as a given in this country, but they want it to be convenient and accessible as well,” he told Ms Smith.

“And so the whole notion behind this is that if we create hubs centred onto the GP practice where primary care is going to be delivered to all patients, then it’s going to be more convenient.

“So, if you’ve got a dispensing pharmacy as part of the general practice, or co-located, and integrated in so they’re doing, for example, medication checks and so on, and liaising with the general practitioner, then that whole model of health care is a lot better.

Anthony Tassone, Victorian branch president of the Pharmacy Guild, has responded to the remarks.

He told the AJP that Dr Zappala’s comments that general practice-owned pharmacies would increase convenience for patients “are at odds with the substantive evidence that formed a key part of the Guild’s submission to the competition policy review”.

This evidence demonstrated that community pharmacies are more accessible for the Australian public than other services, including supermarkets, banks and medical centres, Mr Tassone said.

“You would be hard pressed to find a general practice in a town and not a pharmacy, and that’s largely thanks to pharmacy location rules that have helped disperse the PBS-approved community pharmacy network promoting equity of access,” he said.

“Maybe general practice should have location rules, instead of allowing itself to be corporatised? 

“Maybe that would help distribute their network more effectively to place Medicare billing providers in areas where the public most need them instead of being clustered in higher density areas?”

Mr Tassone’s comments are the latest in a series of observations regarding the corporatisation of GP surgeries; on ABC’s Nightlife this week Guild national president George Tambassis told Philip Clark that he would argue that “that doctors should only be owning their own GP practices. We as healthcare professionals put our healthcare of our patients first, corporates don’t do that”.

And last week another spokesperson for the Guild told the AJP that “the pity for the AMA is that it sat like a moo cow watching the passing traffic as medical practices all over Australia have been corporatised – reducing levels of service, and condemning many GPs to be mere cogs in the corporate wheel.”

Mr Tassone said that pharmacy ownership and location rules regulation is in place not for the benefit of community pharmacies, but for the public.

“They have resulted in a community pharmacy network that the public have a high level of trust and confidence in and is highly accessible,” he said.

“Next time an AMA elected official is in the media calling for relaxation of pharmacy ownership laws, a simple question is: name one benefit corporatisation of general practice has delivered for patient care? 

“I haven’t met a doctor, let alone an elected representative from a doctors’ group, who can hand on heart say corporatisation of general practice has been good for patient care. 

“If they’re prepared to see that happen in pharmacy knowing the negative consequences from first-hand experience, then nothing could be further from ‘patient-centred care.’

“We need to be looking for solutions to the problems we are facing in our healthcare system, and a concern from consumers is about access to GPs – not access to pharmacies or their local community pharmacist.  The sooner we can have a mature conversation about the issues and challenges being faced by the Australian public in accessing healthcare, the better for patients.

“Otherwise, the public tit for tat can rage on till the cows come home and nothing changes from the current issues that patients are facing in terms of access.”

Meanwhile Mr Tambassis has had a piece published in Fairfax media in which he argues that pharmacists should be able to take the load off GPs.

“This should not be a “turf war” between health professionals, it should be a discussion about improving access to, and affordability of, low-risk healthcare for Australians,” he wrote.

“Australia’s health system is struggling to adapt to our aging and growing population. We urgently need to undertake real and practical fixes to our health system and make use of the frontline health professionals we already have.

“This means allowing pharmacists to do more, so doctors can spend more time with their patients.”

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