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Friday, 3 December 1976


Mr DEPUTY SPEAKER (Mr Lucock (LYNE, NEW SOUTH WALES) -Is leave granted? There being no objection, leave is granted.

The tables read as follows-

 


Mr HODGES -I thank the House. The first table is taken from the annual report of the Director-General of Health 1975-76. The second table shows figures expressed as percentage reductions. The first table shows that in the 4 years from 30 June 1972 there were 387 fewer pharmacies approved by the Commonwealth Department of Health for the dispensing of pharmaceutical benefits scheme prescriptions. It can be seen from the second table that, with the exception of Tasmania where the decrease has been minimal and Western Australia where a slight increase of 1.01 per cent occurred in 1975-76, the general trend has been one of steady decline. The overall reduction for the 4 years is 6.57 per cent. The closed pharmacies fall Unto 2 categories. There are those which were closed with the stock and fixtures and fittings sold for whatever the owner could get, usually at a major loss on cost. Then there were amalgamations where two or three pharmacies' stocks, etc., were pooled either in one of the existing premises or in new and usually much larger premises.

This amending Bill is a major achievement for pharmacy and the 5500 retail pharmacy outlets in Australia. In addition to the number of pharmacies forced to close over recent years, it must be realised that there are hundreds of existing retail shops whose owners are barely making a living. In some instances pride keeps them from closing the doors. In other instances it is purely a desire to remain in business and to continue to be one's own master. This Bill signals the culmination of 1 5 years of bitter argument and counter argument between officials of the Pharmacy Guild, officials of the Department of Health, Ministers for Health and politicians. Bitterness on the part of some senior Guild officials in past years has seen them openly and publicly advising their members not to support a government. Knowing the frustrations of these people, I can well imagine their feelings and how they were motivated to such drastic measures.

I believe that it would be remiss of me not to pay tribute to the senior negotiators of the Pharmacy Guild. Their fight for many years past has been led by the National President, Alan Russell of South Australia, and by John Scown of Victoria and Alan Grant-Taylor of Queensland. They are to be commended for their tenacity and patience in times when Guild members throughout the country were edgy, dissatisfied and often highly critical. This Government is to be praised for taking a sane approach to the problem and for recognising something which was unfair and unjust and then moving to rectify the anomaly. It should be recognised by all that governments do not have bottomless pits from which to draw money, as is popularly thought by the public at large. To relinquish such a control over an area where substantial expenditure occurs is quite a feat and illustrates the fairness and goodwill of this Government. This speech would be incomplete if I did not commend the Minister for Health (Mr Hunt) who was prepared to listen, to identify the problems and then to act so swiftly to rectify the anomalous situation.

On a number of occasions over the past 3 years I have spoken in the House and outside it about the difficulties of the profession. I have always been genuine in my expression that I do not carry any special brief for pharmacy, although I retain some retail pharmacy interests. I have criticised various aspects of the profession before; no doubt I will do so again. On this issue I was convinced that justice was not being done. I mention this point because in politics people have the knack of saying: 'He is only in it for himself. I feel that my colleagues on the Opposition side would confirm my non-partisan approach on many issues and, in relation to this issue, would agree that my support for this measure is not motivated by self-interest. I have oft stated that I am first and foremost a representative of the people; that being a politician is my prime duty. I might add that no political pressure has been brought to bear on the Government to have this decision made, in the sense of any standover tactics or threats of withdrawal of support by the Pharmacy Guild. If that sort of thing had been possible, this move would have been made many years ago.

Pharmacists are not a pressure group. On the contrary, they are a highly respectable band of professional people, basically docile, who perform a tremendous duty in all communities for the general good of mankind. They have no political muscle. There are only 5500 retail pharmacy outlets in Australia. I suggest that they could muster no more than 20 000 votes at best. It is my impression that there is little or no public sympathy in the community for a particular professional group when there is a suggestion that the professional group is inadequately remunerated. It has been a popular misbelief for decades that all master pharmacists are wealthy. Some are, most are not.

So far I have examined the background to the problem and have spoken in some depth on the issues that have occasioned the bringing forward of this amendment. I now turn to the substance of the Bill itself to explain how the changes to the system will be implemented. In essence, independent arbitration is to replace government or political dominance. For the first time the determination of the level of remuneration to pharmacists for dispensing prescriptions will be taken out of the political arena and vested in a body of 9 people who will meet as the Joint Committee on Pharmaceutical Benefits Pricing Arrangements. It will comprise a chairman being a deputy president of the Australian Conciliation and Arbitration Commission, 4 members nominated by the Pharmacy Guild of Australia and 4 officers of the Public Service. The Government has shown good faith in the Pharmacy Guild by giving it complete autonomy with the selection of people it nominates to the Joint Committee. If the Pharmacy Guild desires to terminate the appointment of any or all of its nominees to the Committee, the Minister shall so terminate the appointment or appointments on the recommendation of the Guild. The independent chairman must make his determination m accordance with the Committee's recommendations, provided the Committee reaches a unanimous decision. If there is dissension the chairman has the power to arbitrate and hand down his personal decision. That decision is binding on both the Pharmacy Guild and the Government. It cannot be meddled with by either side. This is the form of simple arbitration which the Guild has been seeking for years, but to date it has been denied.

The Joint Committee will conduct such inquiries as are necessary to determine dispensing fees to be paid to pharmacists, and cannot meet until all 9 members are present. In other words, a quorum is the full committee. In spite of this excellent measure which should give pharmacy much greater stability, it is really only the beginning of the era of stability for the retail pharmaceutical industry. Much more has to be done and a careful rationalisation of pharmacies must be carried out. It is over to the profession to act sensibly and rationally to ensure that outlets are maintained at a level where the public purpose and, convenience are served while maintaining a fair income for the pharmacist. Pharmacy must learn from the bitter lesson it has attended over the past 15 years.

I am concerned that the qualified pharmacist, a person with valuable training and possessing skills obtained at a tertiary education institute, is wasting a great deal of those skills carrying out present duties. Is the community reaping the full benefit of the pharmacy education dollar? The obvious answer is no. What point is there in training people to a high standard, which should improve with years of experience, if those skills are to be wasted and diminished with the passing of the years? The profession must diversify for the good of the health of the community and for the morale and mental outlook of the individual pharmacist. The pharmacist's more meaningful role could be achieved in many areas such as the dissemination of information to the community in health education programs and assistance to the medical profession by providing more pharmacological information. 'Prevention is better than cure' is an old cliche not to be dismissed lightly. A health education program conducted through the 5500 pharmacies to our 13.5 million people could save much suffering and reduce the quantity and cost of medical and hospital care. Busy doctors often cannot find the time to study pharmacology, which deals with the specific actions of drugs on the organs and tissues of the body. The pharmacist could develop more expertise in this field and assist doctors.

Already some chemists keep patient medication profiles to avoid drug interactions, allergies and incompatabilities. This is a simple but valuable service much appreciated by the patient and I believe that it would be welcomed by the medical profession. Family planning is another area where the pharmacist could play a useful role. There is surely no need to divert the present quantity of resources into a field like this when the understanding pharmacist, with a little more specialised training in this area, could be fulfilling the function at little cost. I hope that the matters I have raised can be studied in some detail by the Pharmacy Guild, that some plan of diversification can be evolved in consultation with the medical profession and governments and that this Government and the States will take more advantage of the skills and integrity of the pharmacy profession. It is a resource ready to be tapped for the overall benefit of our communities at little cost.







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