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The cause of New Zealand pharmacy was recently threatened when the NZ government embarked on a program of legislation, which involved the deregulation of pharmacy ownership.
This process began in January 2002, and it was obvious from the beginning that the logic behind the moves had not been properly thought through.
In the first article, we reported that a press release plus "A letter of information was sent to pharmacists on the same date, and it appears that this may have been the first communication to pharmacists, regarding such drastic and dramatic changes.
The choice of words such as "Government-mandated move" we have all heard before, and it seems that once again, government has failed to understand the essence of pharmacy.
The letter (but not the press release) to New Zealand pharmacists is a well thought out (from the government perspective) document which attempts to thwart any potential arguments from community pharmacists.
This means that this was no spur of the moment decision, and the preemptive strike through the media, illustrates the strategy that they will use to bludgeon pharmacists into submission.
This article is the first in a series, alerting Australian pharmacists to an extremely serious situation, and the potential for duplicating New Zealand changes within an Australian context, is a very real issue."
So began a very interesting saga in NZ Pharmacy political history with the Pharmacy Guild of Australia playing an active advisory role.

Well, i2P is happy to report that the NZ government has been forced to "about-face", and events have well illustrated how hollow the so-called government "mandate" to effect change actually was.

The story begins with the NZ Pharmacy Guild organising a petition to parliament calling on the retention of pharmacy ownership. Under Guild direction (and one can almost feel the guiding hand of the Australian counterpart here), community pharmacists set about mobilising their patients and customers to sign the petition, with only the colour and flair that community pharmacists can muster, when aroused.
One pharmacist reported 300 signatures on the first day, another caused people to think by creating posters, which basically said that if a future complaint was to be made, then it would have to be posted overseas to the head office of the organisation because "we don't actually know the owner".
Others reported that people were walking in off the street to deliberately sign the petition, because they had not come to make a specific purchase.

This was a good start to the campaign and the various comments were passed on to the Health Minister at every opportunity.

The next leg of the Guild's strategy was to prepare a media campaign designed to whip up support and potentially damage the government's chances at the next election. Political support from the Nationals and the Greens emerged when they publicly opposed the ownership deregulation proposals on the issue of safety.
The Minister of Health and the Guild entered into discussions, with the result that the Minister agreed to work with the Guild to present its proposals to cabinet.
For its part, the Guild agreed to hold back on its publicity campaign.
The minister commented that her assistance was stimulated by her belief that the Guild had a sincere desire to advance the government's primary health objectives, and that the publicity campaign was not a factor in her decision.
She also stated that she had been encouraged by the Guild not opposing the concept of Primary Health Organisations (PHO's) owning pharmacies, despite the fact that the Guild president, Gray Maingay stated that PHO's were not mentioned in its current proposals.

The Guild television campaign is set around a number of advertisements advising the general public of the uncertainties surrounding the deregulation of pharmacy, and directly called for public support. They were set to run in the event of an unsatisfactory outcome from the meeting with the Health Minister.
To pay for the advertising, the Guild levied their members, believed to be in the range of $1000 for a turnover of up to $1 million, $1500 for a turnover of up to $2 million, and $2000 for turnovers greater than $2 million dollars.
As the campaign unfolded, the Pharmacy Guild of Australia requested a list of resources required to fight deregulation.
The NZ Guild proposal to cabinet included the following:

* That every pharmacy be under the effective ownership and control of pharmacists.

* At least 75 percent of the business must be owned by a pharmacists or pharmacists who will have effective control of the pharmacy.

* Multiple ownership by pharmacists of up to five pharmacies, although this figure was negotiable.

While the Guild proposals were under discussion by cabinet, pressure increased in the various lobbying efforts of MPs and the public petition was further promoted and extended.

Early this month, the NZ government announced that it was retreating from its planned deregulation of pharmacy ownership, which appears to give pharmacy a stunning victory, considering government plans were well down the track at the point of their "stealth attack " back in January.
Pharmacy leaders were applauding the decision to back down as a good one and a safe one for the general public.

There are still a few issues to be determined.

The following appears to be agreed:

* Pharmacy owners must be New Zealand registered and hold a current practicing certificate.

* Ownership will be regulated through an annual licensing regime.

* A pharmacist owner must own at least 51 percent of shares.

* Multiple ownership of up to five pharmacies will be allowed.

* There will be no limit on the number of minority shareholdings as long as effective control lies with the licensed owner.

* The Minister of Health will have the discretion to make exemptions for a non-pharmacist to own and operate a pharmacy.

All the above changes are currently being written into the Health Practitioners Competency Assurance Bill expected to enter Parliament later this year.

The government entity to manage the licencing system has yet to be determined (whether it will be a new entity or utilise the structure of the current Medsafe organisation).
There will be a provision for Primary Health Organisations to own pharmacies at the Minister's discretion, also community trusts, and at this stage it is unknown as to the extent of that discretion i.e. whether it is limited only to Primary Health Organisations, or whether it can actually embrace a Woolworths down the track. This area of legislation appears to have as its direction, that of providing services to rural and isolated areas

At the time of the announcement, the Health Minister was visiting Australia, and when asked for comment had nothing further to say following the "constructive" dialogue with the Pharmacy Guild and Society.
From the points negotiated above, the government has still left itself in a position to expand into a deregulation mode, should the political opportunity present itself.

The Guild has asked for all petitions to be returned to its offices, and pharmacists have been requested to remove posters, and cease distributing campaign brochures. Refunds are also being considered for those who have already paid a levy.

It is gratifying that the NZ pharmacists were able to mount an effective campaign, and no doubt, this experience will keep them vigilant against future ownership attacks. There is still a fair amount of detail to be established in support of "effective ownership" and the grey area of ministerial discretion also needs to be tightened up.

Had the NZ pharmacists lost their battle, there is no doubt that this precedent would have been utilised against Australian pharmacists, as illustrated by the thinking of the COAG Working Group comments published in previous editions of this magazine. The effectiveness of the campaign, almost lost from the start, will ensure that those who would seek to deregulate pharmacy in Australia, do not assume that they have the "mandate" that their NZ counterparts thought they had.

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