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Thursday, 16 February 2012
Page: 1613


Mr EWEN JONES (Herbert) (11:50): I rise to speak on the National Health Amendment (Fifth Community Pharmacy Agreement Initiatives Bill) 2011. This bill makes two significant changes to the pharmaceutical industry that expands the responsibility of pharmacists. The first of these is to introduce the Continued Dispensing of Medicines in Defined Circumstances initiative. This will allow pharmacists to supply prescription medicine without a script under certain specific conditions. These conditions are that the patient has been prescribed the medicine for at least six months, that they have been taking the medicine right up to the point of requesting the new prescription and that they do not use this continued dispensing provision for consecutive refills. These are important caveats to ensure that safety and medical monitoring continues under this new framework. This set-up will also be used for low-risk drugs, being initially used only for oral contraceptives and cholesterol-lowering drugs. I spoke to a few pharmacists in Townsville about this measure to get feedback from those who will actually be affected by it. Christine Richardson, who runs Poole's Pharmacy at Fairfield Waters, outlined to me her support of this change, stating that it will help pharmacists meet the duty-of-care obligations under which they already act by allowing them to supply these drugs to patients who need them but are not able to see their doctor for a new script. She pointed out that it is important that we continue to bring pharmacists into the healthcare process. They see patients every time a script is renewed—which is more often than a doctor does—and have the opportunity to discuss with them how the treatment is going and to monitor their progress. For example, Christine will often measure patients' cholesterol when they come in to renew their script to make sure there are no problems. As Christine said, given the frequent face-to-face interactions of pharmacists, it is a waste to not allow them to play a greater role where it is appropriate and in areas in which they have been trained.

George Fotinos from Terry White Chemists in Stockland was similarly supportive of this measure. He stressed the opportunity it presents for the patient, with people no longer having to go without medication because they ran out and could not get to their doctor in time. As he said, as long as it is done in a controlled environment this increased flexibility is a positive step.

Finally, Chris Boyle from Payless Chemists at Willows Shoppingtown pointed out that pharmacists have a detailed understanding of medication and are more than capable of expanding their role. As he said, pharmacists in other countries, like the UK, are doing a considerable amount of prescribing, so this is a logical expansion of the pharmacist's role in Australia.

The second initiative outlined in this bill allows for medicine to be supplied to those living in aged-care facilities based on a standardised medical chart. This is an important step in reducing the administrative burden on aged-care facilities so that patients have easier and faster access to the medicine they need. To meet this new provision, the Australian Commission on Safety and Quality in Health Care has begun its development of a standardised chart, with continued consultation due throughout this year. The Australian Medical Association has come out in support of this measure as a means of reducing bureaucracy for doctors. Any measure that reduces the amount of time medical practitioners have to devote to jumping through unnecessary bureaucratic hoops, without reducing patient care, has to be considered a good thing.

The pharmacists to whom I have spoken also threw their support behind this measure, emphasising the removing of red tape and the doubling up where a doctor writes a medication order on a patient's chart but still has to issue a prescription. Those in aged care are usually in a fragile state of health. It can only be a good thing that this measure will allow these people easier access to their medication when they need it. When I talked with George about this particular measure he too gave his support, saying that more was needed to ensure greater uniformity among aged-care facilities in the way they approach standardised medical charts. Some doctors and facilities are able to use an electronic system that instantly transmits any updates to medication back to the pharmacist, while others are still reliant on the more old-fashioned methods.

Chris Boyle described this as a long-overdue move. Pharmacists have been doing important work with the elderly in aged-care homes for a long time now. Chris told me about home medicine reviews, in which he and other pharmacists go into the home and do a full review of medication that a patient is taking and has on hand. He said it is common to find that patients are still taking leftover medication from old prescriptions, or that patients have changed brands of a medication and are accidentally taking a dose from each packet of the same medication, therefore doubling their intake. These visits can fix these high-risk problems but also allow a better understanding of a patient's habits and health needs, and how they are living. A pharmacist's visit to the home is able to be more thorough than a patient's visit to a surgery. Allowing pharmacists to work off a standardised chart is a logical next step in taking advantage of a pharmacist's more personal interactions with a patient, which a doctor's position simply does not allow.

I have close to 20 pharmacies in my electorate, so any bill that affects their operation is important to me. The consistent message I picked up from speaking to Christine, George and Chris, along with other pharmacists, is that their prime focus is always on the patient and how any change affects them. The message I am getting is that safely increasing flexibility is a positive thing for patients and that pharmacists want to see that happen. It is good to see the government taking these steps with this bill, given its poor record in this area. Until last year the health minister was unable to list medicines on the PBS that were over $10 million. It required the entire cabinet to approve that. Not only did this lengthen the process of making these medicines available to those who needed them but it was completely out of step with almost all previous governments, who were able to make listings based on the advice of the independent Pharmaceutical Benefits Advisory Committee, or the PBAC.

The government last year dealt a further blow to the supply of much-needed medicine when it deferred the list of seven new medicines and a vaccine that had been recommended by the PBAC because of 'fiscal concerns'. It took seven months for them to do the right thing and backflip on this initial decision, which had been made a matter of months after then Minister for Health and Ageing, the Hon. Nicola Roxon, signed a memorandum of understanding with Medicines Australia to provide policy predictability and speed up the listing of new drugs to the PBS. So on one hand they are removing red tape and on the other hand they are backing it up.

Given this chequered history, the coalition is putting forward amendments to require a review of continued dispensing, which is to be made publicly available, and to have information on pharmaceutical products that are supplied by these initiatives published annually. As health minister, Minister Roxon outlined that these two measures would take place. But this has not been followed through in this bill and it is crucial that the measures are included.

We do support these measures as they will make it easier for patients to safely access medication, but it is important that the government remain accountable and that the information be made available so that we can monitor these changes and make sure patients are getting easier access to their required medication without the compromise of safety. These amendments that the coalition have proposed are needed to make this possible. So I am recommending the bill. It is a good start, but we can do so much more here. I thank the House.