28 August 2019

AMA to push for ‘best-practice’ pharmacy model

AMA Pharmacy Policy

The Australian Medical Association is convening a working group to advocate for a medication-dispensing model in which pharmacists are co-located with GPs.

In consultation with the AMA Council of General Practice, the group will make representations to federal Health Minister Greg Hunt on location rules as he negotiates the 7th Community Pharmacy Agreement with the Pharmacy Guild of Australia, and to state and territory governments on ownership restrictions.

President Dr Tony Bartone told The Medical Republic the AMA’s vision was to have “dispensing pharmacists as part of the team on premises of a general practice with everyone working as part of a team-based model in a collaborative fashion, providing best-practice care, like in a hospital environment”.

“That’s not available at the moment in primary care.”

He said phasing out the community retail model altogether, as proposed by the Productivity Commission two years ago, was an option the group would look at.

“Not having co-located pharmacists is doing patients a disservice in outcomes, in access, in cost and in convenience. So at the end of the day if we come up with the conclusion that community retail pharmacies should be phased out, we will make a call on that.

“We’ll go by the evidence.”

Dr Bartone said the notorious lobbying power of the Guild was irrelevant.

“It’s a question of advocating strongly for patients for the best outcomes,” he said. “It’s not a question of who’s got the biggest lobby group. It’s what’s best for patients and that’s what will be guiding us, and I’m not fazed by the power or strength of any other lobby group.”

But he dismissed as “rubbish” the Guild’s latest advocacy for expanding their scope of practice based on GP shortages, which it says will be compounded by the visa changes for overseas-trained doctors.

“I’m not aware of any such location [that has a pharmacist but no GP],” Dr Bartone said.

“But I can tell you this definitely: there are plenty of places where there are GPs but no after-hours or weekend pharmacists. So that access and location issue the Guild is bringing up is a furphy.”

While location rules that prevent a new pharmacy setting up within 1.5km of another are in the CPA negotiated with the commonwealth, ownership rules are controlled by states and territories.

“It is a complex arrangement, but I have eight presidents and their secretariats across the country who can support me on that,” Dr Bartone said.

Dr Bartone is also chair of United General Practice Australia (UGPA), which last week condemned the Guild’s attempts to expand into traditional GP territory such as immunisations and prescribing.

UGPA agreed at a meeting in Canberra to mount a concerted nationwide effort to “convince governments to resist any attempts by the Pharmacy Guild to undermine and weaken quality primary health care in Australia”.

Rural Doctors Association of Australia president Dr Adam Coltzau said the Guild was spreading misinformation about access in rural areas.

“We understand that running a profitable business in a rural town can be more challenging than in the city, but expanding the pharmacist role into clinical areas in which they aren’t safe to operate is no way to address it,” he said.

“It just puts patients at risk.”