Last year, Health Minister Nicola Roxon said:

I say often that we need to develop a patient-focused health system. I mean it — if we do not deliver this through our health reforms, then we will have failed.

There are many stakeholders in health … but it is important to acknowledge that for too long, the voices of patients have been far too marginal in the most important debates.

Later this year Minister Roxon will start negotiating the next Community Pharmacy Agreement with the Pharmacy Guild. This is a perfect opportunity for her to bring the consumer voice in from the margin.

In the past, the negotiations for this agreement have been conducted behind closed doors between the Pharmacy Guild and the Government. The Agreement pays pharmacists for their services in dispensing medicines listed on the Pharmaceutical Benefits Scheme to consumers. It would be nice if the Agreement negotiations also included consumers.

The Community Pharmacy Agreement is important for consumers. As well as affecting the price we pay for medicines listed on the Pharmaceutical Benefits Scheme (PBS), it also affects consumer access to medicines by setting rules about where pharmacies can be located. For example in an urban area a new pharmacy cannot be set up within 1.5 kilometres of an existing pharmacy. This increases to 10 kilometres in regional areas.

In 2005, the Allen Consulting Group reviewed the location rules. They found the rules provided little consumer benefit and recommended alternative arrangements. Unfortunately, consumers weren’t involved in the subsequent negotiations and these recommendations were ignored.

Under the Agreement, pharmacists are paid a minimum of $5.99 each time they dispense a PBS medicine. On top of that they get a retail mark-up and in some cases can charge additional fees. These fees are paid to the pharmacist for dispensing the medicine including providing the professional service to the consumer.

Pharmacists receive the whole fee regardless of whether they provide good service, bad service or no service at all. Evidence suggests the quality and level of service provided vary considerably between pharmacies.

The Pharmacy School at the University of South Australia recently found pharmacists don’t provide written information about medicines as often as they should. The researchers surveyed consumers at 42 pharmacies in six states and found that only 15% of people receiving a medicine for the first time were provided with a consumer medicine information (CMI) leaflet.

This is despite the fact that CMIs are an important source of information for consumers and pharmacists are paid (as part of the dispensing fee) to provide them.

The Government will provide around $15 billion in the next Community Pharmacy Agreement. It is entirely appropriate that they demand a consistently high quality of service in return. Along with the Pharmacy Guild, consumers are important stakeholders and must be involved in discussing their expectations of pharmacies and the Agreement. Anything less would be failing to give consumers a strong voice in this important debate.

Peter Fray

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