MARK COLEMAN

Medical Observer Perspective

This was no more evident than in the approach to the two National Competition Policy reviews of pharmacy and poisons regulation.
Both the Pharmaceutical Society of Australia and the Pharmacy Guild joined forces to present a million dollar submission to try and ensure nothing changes.

He says:

"It is interesting to speculate on what will be the state of the pharmacy world when this year's new registrants reach the peak of their careers. Though near impossible to make sensible predictions other than the pace of change is likely to be even more dramatic than in the past, it is possible to look at some of the drivers that will cause this change".

Okay, so it is not possible to predict what will happen but look at some of the drivers of change.
First the PBS.
Rising costs may mean that this

"…Australian icon and a critical element of the Australian National Medicines Policy and indeed of our social fabric"

And which

"We believe that (PBS) expenditure represents very good value for the health care dollar".

May result in the prediction that

"… access to medicines through PBS might well be more restricted than it is now, with consequences for consumers, pharmacies and pharmacists".

Pharmacy and the National Medicines Policy is supposed to be all about giving access at the most affordable price.
It is hard to see how "pharmacy" could allow medicines to be more restricted.
A pricing mechanism that reduces Government subsidy is a possibility, but that would impact on consumers.
It could also mean the number of pharmacies to provide PBS medicines is restricted, thus restricting the access, and making the consumer travel further to obtain their benefit.
Both the PSA and the Guild have a track record of protecting the pharmacist, under the guise of being best for the consumer, but it is hard to fathom how a restricted access could possibly benefit the consumer.
So what is the PSA President on about.
Upholding the National Medicines Policy, or protecting the existing pharmacy business owners.

And then that:

"As the range and purposes of medicines expands, privately funded medicines will assume a greater importance for pharmacy. There has already been a shift of medications from public funding to user pays and pharmacists are responding to community demands and ensuring access to affordable medications".

The next driver of change is seen as:

"…the concentration of power both within pharmacy and, more generally within the healthcare environment. This will be a significant driving force in how pharmacists practise their profession".

Jay Hooper then outlines the reduction in the percentage of the pharmacist workforce that is becoming involved in community pharmacy practice.
He makes reference to Japan where doctors are dispensing, and then draws the conclusion that:

"A change to the private sector model and doctor dispensing would have an impact on the quantum and pattern of sector employment opportunities".

The final driver, according to Jay Hooper is the:

"… paradigm shift in payment for cognitive services which may affect the number of pharmacists that work in 'other' sectors".

So the scenario is for a restriction of access for consumers to medicines due to cost and location, and doctors dispensing to alleviate these possibilities.
Pharmacists to be used in the health care setting for their cognitive skills.
The changing scene is starting to take shape, but then the climax to the presidential message, that:

"While it is interesting to speculate on future practice models, the Australian community is very well served by current pharmacy models".

This means the PSA will continue to support the Guild in maintaining the current system, presumably at all costs, even if it is the high cost of submissions to Government inspired reviews that could threaten the "status quo".
However, to add some profound thought to the article in the AJP, Jay Hooper contends that:

"…pharmacy must excel in meeting community demands by focusing our practice on the needs of the health consumer".

The Australian Consumers Association will be pleased (!).

And then:

"Our highest 'value added' comes from what we know about medicines and how they relate to people's conditions, and from our ability to communicate with people in a meaningful and useful way".

Pharmacy academic educators will be pleased the PSA President has acknowledged that what they are seeking to achieve is there in the "new registrants".
It would be a sad state of affairs if this was not so.

So where is the reader left?

Wondering where the "new and changing world is to come from"?

Probably - let's hope the new PSA President shows more vision, and does not continue to come across as another mouthpiece for the "party line" of maintaining a changeless pharmacy for Australians.