Are pharmacists the most defensive, insular and change resistant of all the health professions?

It’s a reasonable question to ask in the wake of a pharmacy organisation’s recent withdrawal of an invitation for health reform advocate John Menadue to speak at a professional meeting.

Menadue was due to speak to the Queensland chapter of the Australian College of Pharmacy in Brisbane on December 1.

But the invitation was revoked after his sock-it-to-them speech at the Pharmacy Australia Congress in Sydney last month (reported here at Croakey) which included the prediction that the “highly protected pharmacy business model which is comfortable and financially rewarding for owners up to this point is going to come under challenge”.

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While Menadue’s talk (available in full here) was provocative, in many ways his criticisms reflected concerns that have been around for years, if not decades. These are that pharmacy’s potential to contribute to population health is held back by its focus upon retailing rather than professional services, and by the power of the community pharmacy lobby.

Senior pharmacists have told Crikey they are appalled by the withdrawn invitation, which many see as a reflection of the Pharmacy Guild of Australia’s extreme sensitivity at a time when the community pharmacy agreement between the Federal Government and the Guild is up for renegotiation. You can read more of their comments at Croakey.

Menadue was informed of the withdrawn invitation in an email from Trevor Clarkin, national president of the Australian College of Pharmacy. The decision was made without consultation with the Queensland chapter president, Phillip Woods, who had extended the initial invitation to Menadue.

Woods, a lecturer at Griffith University, has subsequently resigned from the College, and some other members of the Queensland committee are also understood to have done so.

Menadue told Crikey that the withdrawn invitation reflected the power wielded by “bully boys” within pharmacy.

His email reply to Clarkin stated: “In 50 years of public life I have been engaged in debate and some controversy. But this is the first time in my whole public career that I have had an invitation to speak withdrawn.

“You say in your letter that I would not ‘necessarily contribute fresh material to the discussion’ with my speech in Brisbane. That is not so. In the advertisement for my address which is still on your website you say ‘Special guest speaker, Mr John Menadue AO, will be addressing the central issue of the need for systemic reform of Australia’s health sector’. The advertisement sets out the five issues that I would cover with pharmacy as the fifth issue. The advertisement also said ‘Queensland’s must not miss event!’.

“I thought my address to the Pharmacy Congress had been well-received even if it did not attract unanimous agreement. Could you please advise me of the real reason for the withdrawal of the invitation.”

Menadue has not had a response.

Many assume the Guild, which has a history of muscling individuals and organisations that speak out publicly against its members’ perceived interests, had some role in the decision, whether directly or indirectly.

The Guild’s president, Kos Sclavos, said he had not known of the issue until being told of it by Crikey.

The College of Pharmacy has not returned my calls, but Clarkin is closely connected with the Guild, being general manager of Gold Cross Products and Services Pty Ltd, a fully-owned subsidiary of the Pharmacy Guild of Australia, which provides Guild members with products and services, and provides an income-stream to the Guild.

The Guild prides itself on its political nous and ability to achieve wins for its members behind closed doors without resorting to the headlines-generating campaigns of rival organisations such as the Australian Medical Association.

So it seems this incident is both a cock-up – Menadue is no retiring featherweight, and is not the type to take such a knockback quietly – and what happens when a professional culture of censorship and self-censorship develops. It’s almost impossible to get a pharmacist to put on the public record what they really think of the Guild but express vehemently in private.

Some of Menadue’s lines to the Sydney conference have suddenly taken on an extra resonance: “The history of protection in Australia is that protected sectors are very vulnerable and risk not fully appreciating their vulnerability until it is too late. Why is it that so much effort goes into political lobbying in Canberra and comparatively little effort into utilising more effectively the enormous professional talents within pharmacy? It seems inevitable that the highly protected pharmacy sector is going to face major changes. The lesson of protection in Australia is that if you want to have a seat at the table when protection is being reduced, you must accept the need to change.”

Visit our health blog, Croakey.

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