Review must avoid change for the sake of change

Forefront

Date: 14 December 2016

Call me a small “c” conservative if you like, but when it comes to community pharmacy the adage that you don’t change things that aren’t broken for the sake of it, rings very true.

I well remember former Prime Minister, John Howard, who also happened to be a strong supporter of community pharmacy, regularly testing his Ministers and advisers to justify why they wanted to change something if there was no clear problem to fix and a proven alternative that would be demonstrably better than maintaining the status quo.

So it is with the Pharmacy Remuneration and Regulation Review.

Community pharmacies continue to enjoy astoundingly high levels of support with patient satisfaction levels of 95 per cent. As Bill Shorten poignantly pointed out at the Guild’s recent annual dinner, you could add the satisfaction levels of the Liberals, the Nationals, Labor and the Greens together and the sum total would still be lower than the public satisfaction levels enjoyed by community pharmacies.

PBS expenditure through community pharmacy is the most sustainable part of the health system with growth rates a fraction of the MBS and public hospitals, in spite of the ongoing listing of new medicines. This fiscal sustainability is a direct result of the Government’s ongoing PBS reforms to which community pharmacies and the broader medicines sector have contributed, arguably to their own financial detriment.  

Australians enjoy very high levels of access to affordable PBS medicines with high-quality, professional support from their community pharmacists, a fact lauded by the Health Minister on a regular basis. Patients are also increasingly accessing their local pharmacies for a broader range of medicine and other health-related services and support.

This is hardly a scenario that a small “c” conservative like me would conclude is fundamentally broken and desperately needs a radical overhaul.  It is not a system one would put at risk without clear proof of a superior alternative and a thorough understanding of the broader implications for all affected parties.

On the contrary, the sensible approach in this instance is to recognise that community pharmacy – like Medicare – is one of the outstanding successes in our public health care system and find practical ways to build upon this record of achievement.

The Guild has never said that the Pharmacy Remuneration and Regulation Review should not recommend improvements where there are real opportunities to deliver enhanced outcomes for patients.

In fact, our comprehensive submission to the Review details a range of solutions in areas where we believe improvements can be made, including:

  • Utilising the community pharmacy network as a primary health care hub
  • Enhancing patient access to high-cost medicines through community pharmacies
  • Integrating pharmacy and medicines into the broader e-health ecosystem
  • Ensuring the medicines supply chain is sustainable and maximises patient access
  • Abolishing the $1 discount and reforming the PBS safety net system
  • Real time monitoring for controlled drugs
  • Enhancing public awareness of the services available in community pharmacies
  • Improving medicines outcomes for Aboriginal and Torres Strait Islander patients

If the Review recommends sensible enhancements in these areas, it will deliver real and practical value, to the ultimate benefit of patients.

But, if it sees that its job is to turn the system on its head by undermining the value of medicine dispensing or abolishing the location rules, it must provide irrefutable evidence that its untested alternatives are superior to the current successful community pharmacy model.  

Recent political debates in relation to Medicare have shown that the Australian public doesn’t like government tinkering with parts of the health system that they trust and know they can rely upon. When it comes to their health care, Australians are overwhelmingly small “c” conservatives like me.  

Christmas message

A very Merry Christmas and a Happy New Year to all the readers of Forefront.  Thank you for your support this year and we look forward to delivering more insightful and thought provoking content to you in 2017.  

Contact: Executive Director, David Quilty

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