The Way Ahead
The Sixth Community Pharmacy Agreement has presented an opportunity for community pharmacy to secure its future. What transpires over the next three and a half years until negotiations for the Seventh Agreement would be expected to commence, will clearly set the benchmark and direction our profession will take into the future. There is an unparalleled opportunity within this agreement to expand and enhance our role within the primary healthcare system, which is paramount to the direction the profession must take.
Traditionally, community pharmacies have been regarded as allied healthcare providers, whereas in reality should be recognised as true primary healthcare providers. The truth is that community pharmacy is not only the most accessible health infrastructure in the country, but pharmacists are amongst the most trusted health professionals who are on the frontline of the health system and are often under-utilised.
The Agreement has not only delivered much needed and welcome reform for dispensing remuneration after the pain of PBS reforms, but has also presented key opportunities for the provision of professional services, and through the pharmacy trial program hopefully an incorporation in the Sixth Agreement funding envelope. It is self evident that pharmacists can deliver better, more cost-effective health outcomes through a range of different examples.
Since remuneration for professional services was first included in the Third Community Pharmacy Agreement, we have seen a development of this key role that pharmacies play. However, the need to not stay stagnant and to continue enhancing this role has never been more critical than now. The Commonwealth Government must understand that pharmacies stand ready and willing to increase our role, and that the trial program should commence as soon as possible and not be at risk of further delay, which will, as a result, have an impact on the health of the community.
The next four and a half years will consequently present the opportunity for pharmacies to transform into true healthcare destinations. The move away from a purely ‘supply’ model that began after the Third Agreement was put in place, has matured and developed, and not only does the broader community realise this, they clearly want and need community pharmacies to step up and do more. Pharmacies must present a professional image of primary healthcare providers and move away from the image of being focused on product and price. Moreover, pharmacies can take the opportunity to put in place more sophisticated systems and processes relating to the provision of professional services.
Parallel to this, the next year and also beyond will be crucial to ensuring that the broader community and importantly the Government continue to have confidence in the model and regulations surrounding community pharmacies. The Review of Pharmacy Remuneration and Regulation due to hand down its report in only a year from now, signals a growing urgency for the profession to be more vociferous and to clearly articulate the case for the vitally important regulations relating to location and ownership that will be closely examined.
The next year must not be a time for acquiescence or inaction, as it will be a pivotal moment in the profession’s history. Pharmacists, staff, owners, and pharmacy groups must take the opportunity to make submissions to the review once its discussion paper is released in April this year. Obviously there is a strong likelihood that the panel will not take favourably to the model of pharmacy ownership or location rules, with two of the three members either having, or being part of, an organisation that has views in favour of liberalisation of these rules and regulations.
The next year leading up to the release of the Review will also be a critical time for pharmacies to engage and build relationships with their local Members of Parliament and Senators. It is evident that there is a great level of support for our profession within Parliamentary ranks, and these relationships can continue to be built upon and progressed. Pharmacies must demonstrate the case that not only are they small businesses and health professionals delivering a vital service, but importantly that the model of community pharmacy has served the country extremely well and is the envy of the rest of the world. One cannot take the view that ‘the Guild will look after that’ in this instance as support from the wider profession will be needed.
Furthermore, we must do our utmost to engage with local communities and community groups, particularly those relating to disease state management. One of the key strengths of community pharmacy and one that has helped withstand many headwinds, is that pharmacies are considered to be part of the fabric of the communities they serve, often seeing hundreds of people per day and developing strong ties and links with their local communities.
The anecdotal view among some that ‘deregulation is inevitable’ must be quashed and fought against at every possible instant. The rise of the Chemist Warehouse group has produced a different dynamic within the industry today; however, they must not be looked at as the yardstick for our profession, rather a compromised model that focuses more than anything on product and price, and less on service and primary health care. There are a copious number of complaints every single day around the country relating to Chemist Warehouse, and although their foot traffic may be seemingly large, it does not necessarily mean that consumers are happy with the service they are receiving, and are not looking for a better alternative.
If our profession does not take the opportunity over the next three and a half years to secure our future, then the consequences will be dire and potentially swift. The Minister for Health has already introduced policies, such as the dollar discount, that she knows will have an adverse impact on pharmacies and favour the large discount chains. She also has selected a panel for the Review that comprises of only one member who is in favour of existing pharmacy regulations. The Minister’s remark that she makes ‘no apologies for the one dollar discount’ policy at the Guild’s 2015 annual dinner were enough to send shockwaves down the spine of most present. The Harper Review is further reason to eradicate any thoughts of complacency, in addition to the pro-deregulatory views produced by the Productivity Commission, as well as the Audit Commission in the last three years.
It is imperative that the profession unite, and convey the message to the Review Panel, the Government and the broader Australian community in the vital times ahead to ensure that community pharmacy can continue to evolve and be a key pillar of this nation’s health system into the future without any threat to its viability. Providing our profession makes the most of the opportunities that are before us, we can be sure that our future will be secured and any threats can be put to bed once and for all.