Smoke on the water


This year’s PSA Offshore Refresher, held in Switzerland and France, continued the tradition of delivering quality education in the most desirable travel destinations – featuring rock stars and film legends

If you love your jazz, or you’re a bit of a rock music aficionado, then you will most likely have heard of Montreux. Prettily situated on the north-east shores of Lake Geneva, surrounded by the snow-capped mountains, the resort town is perhaps best known for its annual jazz festival, held there since 1967, attracting such luminaries as Miles Davis, Nina Simone and Ella Fitzgerald. The musical scope of the festival soon broadened to encompass blues, soul and rock, boasting a veritable who’s who of the music world.

In fact, Montreux’s natural beauty has attracted and inspired artists and the literati for 200 years. The popular success Lord Byron’s poem, ‘The Prisoner of Chillon’, set in the 13th century castle on the lake’s edge, is said to have attracted the first tourists to the area. Today, the region can claim the likes of Dostoevsky, Le Corbusier, Stravinsky, Charlie Chaplin and Freddie Mercury as past residents.

So it was not by chance that Montreux was the chosen destination for the main conference of this year’s PSA’s Offshore Refresher. So accessible is the region to other parts of Switzerland and Europe, that many delegates arrived there having already enjoyed pre-conference tours just over the border to Lake Como in Italy’s north, and the Swiss alpine villages of Flims and Zermatt.

Montreux

No doubt elated by their picture perfect experience of the majestic Matterhorn during their stay in Zermatt, it was a buoyant group of attendees who gathered at the opening session of the PSA’s 44th Offshore Refresher on June 6, to be welcomed by Conference chairman, Warwick Plunkett, along with PSA CEO Shane Jackson and others.

Mornings dedicated to conference sessions were balanced by afternoons spent exploring Montreux and the delights on offer in the surrounding Riviera, from the terraced vineyards of Lavaux to the medieval village of Gruyères, famous for its cheese and chocolate. Tours to the historic cities of Bern, the capital of Switzerland, and Lausanne, headquarters of the International Olympic Committee and home of the award-winning Olympic Museum, were enjoyed by many.

Focus on services

Dr Jackson welcomed delegates on behalf of national president Dr Chris Freeman, and used his opening address to recap on the work of the Society over the past 12 months, and its plans for the immediate and longer term.

“The PSA’s vision for the pharmacy profession is outlined in its Pharmacists in 2023 report,” Dr Jackson said. “It marks out the tangible, practical and necessary changes to be able to unlock the potential for pharmacists to contribute to the health of Australians in a more meaningful way. This is about releasing the shackles of restrictive legislation, it is about investing in pharmacy and pharmacists, and for the government to use Pharmacists in 2023 as a vision for the future.”

Referring to Health Minister Greg Hunt’s announcement earlier this year that the PSA would be a co-signatory to the next Community Pharmacy Agreement, Dr Jackson explained that the Society’s approach to this agreement will be about investment in community pharmacy.

“This is not about the viability of community pharmacy, but actually about its prosperity, not only in a financial sense, but in the health of the industry, including wages, wellbeing, and ensuring that pharmacists are able to practice to their full scope… and that they are funded and supported to do so. Let’s not talk about viability, but let’s talk about the prosperity of community pharmacy.”

Prior to the federal election, Dr Jackson said the PSA has received an undertaking from the Coalition Government that it would “provide ongoing support for patients through the continuation and expansion of community pharmacy programs in the Seventh Community Pharmacy Agreement. This agreement will also seek to strengthen the frameworks to enable pharmacists to be utilised to their full scope of practice.”

The PSA’s approach to the next community pharmacy agreement is about fulfilling our scope of practice, Dr Jackson told delegates.

“It is about recognition of our primary healthcare role in common or minor illness care, it is about investing in that role. It is about funding pharmacist consultations for medication management of patients with chronic disease, because we have $700 million of healthcare savings that we can contribute if we are supported to do so.

“Our focus on the next agreement is on services. This focus is in recognition of where the Society’s expertise lies. We will gladly support the work of the Guild in ensuring that dispensing remuneration is viable—our focus on services is not at the expense of dispensing remuneration, again, for PSA this is about investment in the services that community pharmacy can provide.

“We must make sure that pharmacist wages reflect our training and expertise, otherwise we will lose our best and brightest from the profession. There is no better time to address pharmacist remuneration than 12 months out from the agreement, so it can be reflected within the agreement.

“PSA wants pharmacists in general practice, but this should not be funded out of the community pharmacy agreement. The community pharmacy agreement should be focused on getting the best value healthcare delivered from community pharmacy.

“This is why we have focused significant effort over the last 12 months on ensuring that pharmacists are included on the Medicare Benefits Schedule. We are the only healthcare professional that is not on the list of eligible allied health professionals who can receive referrals from GPs for consultations. This must change. We have worked tirelessly over the last 18 months, and there are interim recommendations to include funding for pharmacists to participate in case conferences, and to be able to conduct two consultations per annum for medication management related issues on referral from a GP. 

“Our approach to government going forward is to align pharmacist services and supports to those of other healthcare professionals. Don’t treat pharmacists any differently to other groups, so therefore don’t exclude us from the support that is offered to others, including student training, professional development, rural support, and funding for programs,” he said.

Montreux Palace

A global perspective

The location of this year’s conference, at the other end of the lake from Geneva, afforded delegates the opportunity to hear from Dr Peter Salama, Deputy Director-General of the World Health Organisation’s Emergency Preparedness and Response Program, on emerging trends in global health. Dr Salama is a medical epidemiologist and the most senior Australian working within WHO. He has the daunting responsibility for WHO’s strategic priority to keep the world safer.

Dr Salama also led UNICEF’s global response to Ebola and this was the focus of his confronting and inspiring keynote address to delegates—its causes, management, challenges and medicines used to treat the virus. 

The ongoing Ebola outbreak last year in the Democratic Republic of the Congo, a country that has been ravaged by violent conflict for decades, is the second deadliest on record. However, approval to use an unlicensed vaccine from Merck just a week after the outbreak was declared was, he said, “a game changer which stopped transmission of the virus to other continents beyond Africa”. WHO data shows the Merck vaccine had a 97.5% efficacy rate for those who were immunised compared to those who were not. There remains no known cure for someone once they are infected with Ebola.

“Ebola portends the future of global health trends,” he told delegates, and poses “explosive threats in countries where health systems have collapsed.”

Excellence in education

This year’s main conference program was led by education director Professor Peter Carroll delivering the therapeutic update stream on the causes and treatments for conditions ranging from osteoporosis, gastro-oesophageal reflux, nausea, vomiting and constipation, and COPD.

Leading rheumatologist Professor David Hunter delivered a series of updates on the latest developments in treatment options for osteo and rheumatoid arthritis, back pain, hyperuricaemia and gout, and musculoskeletal conditions. His lectures were very much focused on the role of the pharmacist in the prevention and/or treatment of these various conditions.

Professor David Cameron-Smith is an international authority on nutrition and health, so it is unsurprising that the focus of his series of updates was around nutrition, including the myths and controversies that come with it; the science behind digestive irritability, intolerances and allergies; the role of proteins in building and sustaining muscle function; nutritional needs of ageing; and the complex world of dietary fats. 

Long-standing conference presenters Dr Jenny Gowan shared her insights into medication management through a series of workshops, and business consultant Bruce Annabel delivered his annual update on the state of the ‘retail pharmacy’ nation and presented his business case for innovation to avoid competitive convergence—where everyone is doing the same thing and therefore competing on the same basis (of price).

Statue of Freddie Mercury in Montreux

“…it’s all so beautiful
Like a landscape painting in the sky”

—from ‘A Winter’s Tale’ by Freddie Mercury

Montreux’s recent history is strongly associated with music. In 1971, a fire that destroyed the Montreux Casino while Frank Zappa & The Mothers of Invention were performing at the Jazz Festival, was later immortalised by Deep Purple in their track, ‘Smoke on the Water’. That song was written and recorded in Montreux. A state-of-the-art recording studio, appropriately called Mountain Studios, was incorporated into the new casino when it re-opened in the 1976. For the next 25 years, Mountain Studio attracted some of the biggest names in music, including AC/DC, David Bowie, Iggy Pop, The Rolling Stones.

Freddie Mercury and Queen recorded their ‘Jazz’ album at the Montreux Jazz Festival in 1978. He is said to have fallen in love with Montreux and decided to settle there. Queen owned the studios from 1979 to 1993 and their last album, ‘Made in Heaven’, was recorded there. It included ‘A Winter’s Tale’, the last song he wrote. A larger than life bronze statue of the singer, erected in 1996, celebrates his relationship with the town and has become something of a mecca for his fans.

Lyon

After six days, attendees said goodbye to Montreux and travelled across the Alps and the Swiss-French border to Lyon, the regional and gastronomic capital of France, for the final two days of the extended main conference.

Situated on the confluence of the Rhône and Saône rivers, Lyon is a vibrant, real city, and such a contrast to the Montreux Riviera. The city’s 2000-year history can be seen on each of its distinctive arrondissement or districts in the various architectural periods of their buildings, from the ruins of the Roman amphitheatres which are still used for live music and theatrical events, to the Confluence, where whole areas have been transformed by modern commercial buildings and contemporary residential projects.

While Lyon is a large city—France’s third largest—it still maintains a human scale and it’s very easy to walk or cycle around. You can see a lot in a few days, though just two was never going to be long enough!

Of course, it’s impossible to talk about Lyon without mentioning the food. Local chef Paul Bocuse has become even more of an icon since his death in January last year. His presence is still felt in the city, in his restaurants and the food market—Les Halles de Lyon – Paul Bocuse, and in Lyon’s building-sized mural paintings in the trompe l’oeil style for which the city is famous. Many gourmands would argue that Lyon is the culinary capital of the world. And who I am to argue?

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