JULY,Edition # 30, 2001

The Tiwi Islands are a group of islands off the coast of the Northern Territory, the best known being Bathurst Island and Melville Island.
Their inhabitants have the distinction of never being beaten in battle, having successfully fended of marauding Indonesion invaders, and the incursion of white settlement, for centuries.
Because of this historical fact, there has evolved a distinct indigenous group of people with a strong sense of community, and who are reasonably happy with their lifestyle.
They manage their own affairs quite competently.
Like most indigenous communities, health needs are a priority, and with the help of the Territory and Federal governments, a network of clinics has been established on the islands.
However, over the years and despite numerous opportunities, community pharmacy involvement has been minimal and at "arms length", in the delivery of pharmaceuticals, and this has been of some concern to the Tiwi Islanders.
This forced the Tiwi Island Health Board to come to the conclusion, that if they were to obtain an efficient pharmaceutical service, they would need to set up their own pharmacy and staff it appropriately.
Accordingly a process was commenced to secure the services of a consultant, to advise them and specify a system, which involved the use of remote technology as well as "hands on" processes.
When initial plans were finalised, an application to the Australian Community Pharmacy Authority (ACPA) was made for an approval number, some of the obvious grounds being the uniqueness and remoteness of the location with a clearly identified community need.
The plan specified a dispensary to be established on Bathurst Island and a bulk depot to be established in Darwin.
It should be noted that in the Northern Territory there are no legal constraints as to who can own a pharmacy, and when this project was first mooted, the Northern Territory Government revisited their legislation, and in May 2001, decided not to change existing policy.
In a statement issued by government, it said,
"Cabinet has specifically directed that no restrictions on pharmacy ownership are to be included in the new legislation".
So the way appeared clear for the first group of indigenous Australians to take direct responsibility for their pharmaceutical care.

The ACPA issued an approval with some reservations for the Heath Insurance Commission (HIC) to investigate. The Pharmacy Guild of Australia and the Pharmaceutical Society of Australia were contacted by the Tiwi Health Board and asked for support.
Both initially agreed, but one month later the Pharmacy Guild changed its mind and lodged an objection.
This led to the HIC sending a team of senior officials to examine all aspects of the proposal at first hand. On the 25th June through to the 27th June, HIC officials visited the clinics on Bathurst and Melville Islands and also interviewed the Tiwi Health Board.
They also met with the Health Professions Licencing Authority, and the two registered pharmacists who had agreed to operate the project as employees.
In anticipation of a positive outcome a research grant application has been made to the Third Agreement Research program for a grant to fund the UNSW School of Community Medicine to evaluate the project.
Further, an additional grant application has been made to the Rio Tinto Aboriginal fund to finance the development of the pharmacy project.
An extra application has also been made to the APMA Aboriginal Health Initiative. A result is still awaited on the application for a grant from this fund.

It has now to evaluate Aboriginal Health Worker education through Batchelor and Danila Dilba, and to establish an ongoing fund for scholarships, awards and other grants.
Two final year Sydney University pharmacy students will be in Darwin from 1-19 July. Their clinical placement program will be to review, plan and recommend a training program for Aboriginal Health Workers.
They will look at what is currently being done with Batchelor and Danila Dilba, and make recommendations for the future.
The Tiwi Health Board clinics will be used as the test sites, and recommendations will be to the Batchelor Curriculum Development reviewing the content of the new extended degree course for AHWs.
A workshop has been organised as the first step in the planning process after HIC approval is notified.

Given the history of the Tiwi Islanders in battle, it would be a "courageous" government (or its instrumentality) to deny what appears to be a legitimate application to allow them to continue their traditional mode of independence.

STOP PRESS:

Tiwi Health Board Darwin NT Media Release Monday 16th July 2001

APPROVAL FOR PHARMACY GRANTED BY HIC
The Health Insurance Commission has granted an Approval Number to dispense Pharmaceutical Benefits to an Aboriginal community controlled health organization in the Northern Territory.
The Tiwi Health Board has met the rules required of Section 90 of the National Health Act to operate a community pharmacy in the township of Nguiu, on Bathurst Island, 80 Kms north west of Darwin by sea and air.
Board Chairman, Marius Puruntatameri, and Chief Executive, Bill Barclay, said the granting of the Approval Number opens the way for the development of a model of pharmacy practice for Aboriginals living in remote communities.
"This is a precedent in Australia and an opportunity to re-define the meaning of "community pharmacy" as it applies to remote Aboriginal communities." according to Mr Puruntatameri.
"The pharmacy at Nguiu will operate in a manner to reflect the health care needs of the Tiwi Islander people. It is unlikely to resemble pharmacies in the suburbs or towns of the rest of Australia." he added.
Mr Barclay commended the Australian Community Pharmacy Authority and the HIC for being able to apply the new rules, which came into effect on July 1, 2000, for "new" approvals to remote locations, to the Board's application.
"There is no doubt this has been a ground breaking exercise for all concerned. We welcome the opportunity to join other "community" pharmacists in the NT and across Australia, in helping to find a way towards an improved health status for Aboriginal people." Mr Barclay said.
The pharmacy is expected to commence operations on 6th August.
It will be developing, in conjunction with a pharmaceutical supplier, an IT system to ensure its clients are given the same, if not better access to information and medication, as their counterparts in urban Australia.
For further information and comment contact:
Bill Barclay Chief Executive Tiwi Health Board
08 8941 5331 (Business) 08 8941 7697 (Home)
Ends
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