This is the question that only the Federal Minister for Health, Sussan Ley, may be able to answer. Why? Because she just attended the Australian Pharmacy Professional Conference and Trade Exhibition where she spread the love to the numerous delegates in her welcome speech: “It’s always a pleasure to talk with the pharmacy sector […]
This is the question that only the Federal Minister for Health, Sussan Ley, may be able to answer.
Why? Because she just attended the Australian Pharmacy Professional Conference and Trade Exhibition where she spread the love to the numerous delegates in her welcome speech: “It’s always a pleasure to talk with the pharmacy sector because I feel we have much in common,” the minister started (applause); “the pharmacist’s role is a special one” (crescendo clapping and foot trampling); “people ask their pharmacist much more than when they go to see the GP”1 (standing ovation, clapping and trampling, so much so that some delegates surly must have lost their balance in the packed ranks).
I wish I could have been there as a neutral observer, but as a GP, I may have been considered as a persona non grata amongst the noble profession of dispensing health workers, neatly organised and lobbied for by the Pharmacy Guild. Thankfully, I was following the unfolding event behind the protective digital firewall of social media. Sometimes it pays to keep your distance.
Distance is what the minister put between herself and 1500 general Practitioners at the GP15 Conference in Melbourne less than six months ago. Her monologue on how the MBS review was going to make all the difference to Australia’s healthcare system (in particular when it came to arthroscopies and other high-cost, low-value procedures predominately performed and billed by any medical practitioner other than GPs) made it obvious that the honourable minister clearly did not understand who the target audience of the day was, evidenced by only polite applause.
“I feel we have so much in common” certainly did not, and still does not, resonate with the 30,000-plus GPs in this country. Why else would she not point out that 85% of all Australians see their GP (yes, their GP) at least once per year; and that despite that, the cost per person per year for general practice care is only $250; and yes, despite all that we have managed to reduce the incidence of Australia’s main cause of death, cardiovascular disease, by more than 25% in the last six years? Now that deserves a standing ovation. It does not seem to count. Why else would you continue to freeze the MBS rebates in general practice (our tertiary-care colleagues don’t mind actually, they just ask private health insurers or the public purse for bailouts), while making lofty announcements of “expanding the role for pharmacy”, and funding the 5500 Guild members with an extra $600 million. To do what, exactly? Give flujabs? GPs already give immunisations, record, report and monitor effects and side effects for zero dollars extra funding.
So, it must be something else. Give out OTC antibiotics, for example, chloramphenicol for (as it seems to me) bacterial conjunctivitis cases of epidemic proportions? Or no, hold on, it must be to provide advice and care for patients with acute or chronic pain who really can’t have anything else but codeine-based formulations unrestrictedly available over the counter. Why else would The Guild oppose the broadly supported and evidence-proven rescheduling of codeine? What is the point of GPs conducting audits and NPS Medicine Wise reviews as well as orchestrating ‘Choosing Wisely’ campaigns, when the retail pharmacist chooses to advise the patient to buy Blackmores vitamins with their PBS-subsidised antibiotics?
This is not healthcare. It is shopkeeping. And it’s unfair to our patients who genuinely ask pharmacists for medication advice.
Why is the minister falling for it? I don’t know. Donations to the Liberal Party, National Party (and Labor) by the Pharmacy Guild in the last financial year were in excess of $150,000 (neatly distributed to State branches, of course).2 Maybe this is why the minister feels that “the pharmacist’s role is a special one”? I’d hope not, because pharmacists deserve better. As the Pharmaceutical Society of Australia points out: “pharmacists prepare or supervise the dispensing of medicines, ointments and tablets; advise patients on how their medicines are to be taken or used in the safest and most-effective way in the treatment of common ailments; advise members of the public and other health professionals about medicines (both prescription and over-the-counter medicines), including appropriate selection, dosage and drug interactions, potential side effects and therapeutic effects; develop legally recognised standards; and advise on government controls and regulations concerning the manufacture and supply of medicines.”3
This is a significant and expansive role of essential value to the community and to other health professionals. It resonates well with GPs, as it is enhances our prime objective: to improve the health of our patients in a sustainable health system. There is just no need for the upsell. At all.
So, oh pharmacist, where art thou?
Professor Bastian Seidel is a general practitioner practising in Tasmania
- http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2016-ley160317.htm?OpenDocument&yr=2016&mth=03
- http://www.abc.net.au/news/2016-02-01/political-donations-parties-data-search/7129064
- http://www.psa.org.au/about/pharmacy-as-a-career/what-pharmacists-do-and-where-they-work
