I’d like to acknowledge the traditional custodians, the Yugambeh people on whose land we’re meeting today and pay my respects to their elder’s past and present.
Last Sunday, I marked my two-year anniversary as your National President. A role I cherish as a servant leader. It has been an exciting, challenging – and yes at times frustrating – two years.
When I say exciting, challenging and at times frustrating I’m not just talking about myself. I know it has been all these things for you.
Proudly, the Community Pharmacy industry is stronger today than it was a year ago or indeed two years ago. There is no doubt a ‘decade of change’ has commenced, indeed we are already three years in.
We are all experiencing a ‘decade of change’ - in workforce, in scope of practice, in patient requirements – indeed in patient expectations, in medicine pricing, in the type of medicines in market, in pharmacist training, pharmacy assistant training, in Government regulations, in Government funding and indeed in Governments.
Change is exciting and provides great opportunities for our profession and patients.
Your Guild is here to support you through this ‘decade of change’. We stand shoulder to shoulder with you - as your practices change, as your lives change and as your patients change.
Federal Election
As Australia’s most innovative federally funded and state regulated primary health care provider, one of the biggest changes for Community Pharmacy over the past year has been the change of Federal Government.
Before every election, your Guild seeks policy letters from all political parties regarding their commitment or otherwise to the community pharmacy model. These commitments are important as they give you – the community pharmacists of Australia – the security to plan and build your pharmacies to better serve your patients.
In particular, we seek iron clad assurances from the political parties that the ownership and location provisions will be maintained and before last year’s election both the Coalition and Labor committed to this, and we intend to hold them to their commitments.
On behalf of all community pharmacists across Australia, I thank our political leaders for this continuing commitment which helps to ensure patients across Australia continue to receive vital services from viable and sustainable community pharmacies.
Affordable Medicines
At APP2022, I detailed our call for cheaper medicines for patients.
A major development in the lead up too and during the last federal election campaign was the influence of the Guild’s advocacy – and may I say successful advocacy – to make prescription medicines more affordable for millions of Australians – our patients.
Your Guild was joined in this endeavour by the Australian Patients Association, Chronic Pain Australia and Musculoskeletal Australia amongst others, we couldn’t have done it without them.
We didn’t do this to benefit you, in fact there is not a single dollar in it for community pharmacy but rather, we did it for our patients. Without them we have no one to serve and if they can’t pay for their life altering, dare I say it lifesaving medications, then we are not meeting their needs.
The cost-of-living crisis is something that is gripping us all. We were hearing first-hand accounts from our patients of just how damaging the impact was on their ability to look after their health needs.
Increasingly, we were hearing reports from you, of patients unable to afford their medicines, or being forced to choose which medicine they could afford. We were also hearing of families having to decide which family member would go without their medicine because they couldn’t afford it. We were hearing of carers unable to buy medicine for the people they look after.
Community pharmacies are on the frontline and saw – and continue to see - how people are struggling to afford their prescription medicines.
Your Guild knew we had to do something.
Our Australia wide patient research showed that one in 10 people were going without medicines because they couldn’t afford them. Further, the Australian Bureau of Statistics (ABS) found some 900,000 people delayed buying or were going without medicines because of cost. The ABS also found the proportion of people who delayed or did not get prescription medication when needed due to cost increased from 4.4 per in 2020-21 to 5.6 per cent in 2021-22.
Unsurprisingly, but incredibly disappointing, women are worst affected with around a third aged 35-54 saying they find it difficult to afford prescription medicines.
Your Guild’s modelling found that the solution lay in reducing the general patient co-payment down from $42.50. Both the Coalition and Labor committed to a reduction just before the election – the Coalition to a $10 reduction to $32.50 and Labor to a $12.50 reduction to $30.
Prime Minister Anthony Albanese was true to his word and quickly introduced legislation reducing the co-payment from 1 January this year. A clear sign of a Government, determined to keep their promises. This annual, $190 million saving, will go directly to the hip-pockets of our patients. It is the first time in history the PBS, that the general patient co-payment has been reduced by any Government and on a yearly basis it could benefit up to 19 million Australians, who don’t have a concession card.
Make no mistake, this is the single most significant change to the cost of and access to medicines since the PBS was introduced more than 70 years ago.
This is a genuine win for patients.
We thank the Government for hearing the concerns of the community and our peak health industry partners - the Australian Patients Association, Chronic Pain Australia and Musculoskeletal Australia - advocating on their behalf. It is providing relief for patients and their families. This is a step in the right direction - to restore universal access to the PBS.
Your Guild is proud to protect Australia’s universal healthcare system. Medicines must be affordable. Universality is only achieved via affordability. That means medicines should be the same price in every postcode and in every pharmacy. We won’t return to a truly universal healthcare system without more affordable medicines.
This welcomed reduction - is only the first step. We need to do more. We need to get the general patient co-payment down to $19. At this level, 70 per cent of PBS medicines would be more affordable for 19 million Australians.
We all know affordability is critical to medicine adherence, it results in less adverse events and means greater benefits to our healthcare system, as Australians receive and access their necessary treatments in a timely manner. A University of Technology Sydney study, found that medicine non-adherence costs the Federal budget over $10.4 billion per annum.
There is more work to be done and we look forward to working with the Federal Government on further ensuring universal access to medicines with a $19 general patient co-pay.
Workforce
The single biggest member issue brought to my attention on a continual basis is workforce.
Workforce issues are a constant reminder for us all of just how quickly the environment in our sector can change.
To better predict and influence the workforce dynamics the Guild is undertaking a workforce capability project. As we all know, there is no quick fix on workforce issues.
This project is compiling a comprehensive outline on the workforce's capability, capacity and employability needs within and for community pharmacy, from both an owners perspective and pharmacist point of view.
What we see this doing is helping to assist in effective advocacy and strategic decision.
It includes supply and demand modelling, remuneration, career pathways, qualifications, training needs, employment classifications and scope of practice.
It’s a huge project but one which will almost certainly enable you, our members, to better plan and progress your business practices and strategies.
Some of the early data from the project challenges our preconceived notions of workforce issues and the factors driving what we are all experiencing.
For instance, the Australian Bureau of Statistics (ABS) has found that the number of pharmacists increased 21 % from 2016 to 2021. We produce 135 pharmacists per 100,000 head population, the most of any OECD country, but I know we need to do more.
I know these numbers don’t solve your workforce issues, but our workforce capability project will present you with the facts not opinions and we’ll be able to design and advocate for policies to fix the issues we are all experiencing.
We don’t want to turn around in a few years’ time and wonder what the correct strategies could have been and what we could have been put in place to ensure Pharmacy is a desirable career with great employees and employers.
Doctor of Pharmacy
As part of our workforce solution, we must continue to advance the profession, make it attractive to school leavers and deliver a real sense of community and professional purpose. You may be aware that tucked away in the seventh community pharmacy agreement was a commitment to progress a Doctor of Pharmacy.
The Guild believes that use of the title Doctor of Pharmacy for graduates who complete an Extended Masters is appropriate to recognise the additional training undertaken by students to complete an Extended Masters, and recognises the skills, knowledge and experience of pharmacists as medicines and treatment experts. In addition, it will recognise our competency to work at full scope of practice.
Other Australian professions such as physiotherapy, dentistry, optometry, podiatry and veterinary science are covered by this – it’s long overdue for pharmacists to be similarly recognised. It will also bring us in line with our colleagues overseas and make working and studying in Australia more attractive.
Another issue connected to graduate numbers and attracting school leavers is the level of funding our University Pharmacy Schools receive per student.
Currently, an environmental science degree, important as they are, is paid more on a per student basis then a pharmacy degree. This just doesn’t make sense, especially when you consider it in the context of scope of practice and being able to reduce unnecessary hospitalisations and or preventable emergency presentations and the GP crisis in primary care.
Your Guild continues to work hand in glove with our University Pharmacy Schools to push the Pharmacy Degree into a higher band of university funding. Better funded universities will drive investment in Pharmacy Schools and better marketing of Pharmacy as a career path for school leavers will lead to greater student numbers and higher graduate numbers.
Intern Training
Another aspect which is integral to workforce are - interns. The announcement by the Australasian College of Pharmacy that’s providing intern pharmacists enrolled in the Guild Intern Training Program with complimentary medication use review training from this year onwards is a very welcome development.
I want to thank Michelle Bou-Samara, the College Board and management for this great step forward.
We want interns who are fully qualified and able to work to their full scope of practice. They are the future of our profession. The only and best way to be an accredited pharmacist upon general registration is to do so via the Guild’s Intern Training Program. The complementary accreditation offer is especially significant as accreditation supports pharmacists in their provision of Home Medicines Reviews and Residential Medication Management Reviews.
This advancement for interns is only possible due to the strategic partnership between the Australasian College of Pharmacy and The Pharmacy Guild of Australia. Also, due to the partnership, interns are now able to study under the North Queensland Scope of Practice Pilot in cohort 2. This means by March 2024, interns working in the Pilot area will also be able to assist patients with prescribing for everyday health conditions and the chronic disease states covered within the Pilot.
We have over 550 interns enrolled in the Guild Intern Training Program. This is a record number and stand us in good stead to meet future workforce needs.
As the decade of change progresses, we’ll see the intern training program, vaccination training, medication use review training and full scope of practice training wrapped into the university degree under the Dr of Pharmacy Extended Masters and we’ll see pharmacist who want to practices to their full scope in even greater numbers. Ultimately, this will benefit our patients most.
I am putting my hand up and I am hoping you’ll follow. I am going to undertake the Home Medicine Reviews and Residential Medication Management Reviews course via the College and get accredited. I invite you to do the same. It’s part of my work to become a full scope of practice pharmacist, and I know you’ll want to do the same.
Scope of Practice
Last year, at this opening plenary, I spoke about the nonsensical position of being able to sell a vitamin B injection but not administer it. Yet the same injection technique and skill set has been used to deliver millions of COVID vaccines via Community Pharmacy.
While illustrative, the vitamin B injection example is just one case of where Pharmacists are prevented, by State and Territory regulation, from practicing to their full scope of practice. Excitingly, during the past year, we’ve taken several concrete steps to see you practice to your full scope. The decade of change our profession is going through is well and truly under way. And your Guild remains committed to leading this change.
And we are making progress. Momentum is building as State and Territory Government’s respond by announcing practical measures to see patients treated for everyday health conditions in their local community pharmacy.
With the Nth Qld Pilot underway in Queensland, with UTI and Oral Contraceptive Pilots under development in New South Wales and Victoria - set to go live soon, together with the Nth Qld Pilot mirrored statewide in NSW, a review of scope in Tassie and a recent parliamentary committee inquiry into a UTI pilot in South Australia and may more projects underway – the momentum is undeniable.
This is great news for community pharmacy – but even greater news for our patients.
Importantly, full scope of practice makes our profession more attractive and will lead to greater career satisfaction and progression. This is another piece of the complex workforce solutions puzzle your Guild is delivering. It is no secret that the health system is stretched to breaking point. Patients can’t get into to see their GPs in a timely manner. GPs are refusing to bulk bill, while GPs are deserting regional, rural and remote areas in droves.
It doesn’t take a genius to see just how we as community pharmacists can help ease pressure on the system. We are highly trained but under-utilised and having pharmacists practice to their full scope can ease pressure on emergency departments, hospitals and doctors. What we want is to see pharmacists are fulfilling their training, competency and professional accountability to prescribe, dispense, administer and review medicines.
The Federal Health Minister the Hon Mark Butler - who you will hear from tomorrow - is a keen supporter of all health professionals working to their full scope.
Your Guild is working diligently across the nation and in every state and territory to see legislation and regulations amended to enable pharmacist to work to our full scope. It makes sense for our patients and its good public and primary health care reform.
So what do patients really think about Pharmacists practicing to full scope – what do they know about it and do they support it? These are all reasonable questions to ask. It would be of no surprise that, your Guild has asked patients what they think.
In a recent nation wide survey of over two thousand five hundred people, 89 % of patients said they supported pharmacists being able to prescribe and treat patients for everyday health conditions. This is coupled with 88% awareness across the population of Pharmacists doing more.
This isn’t some superficial, top of mind support. This is detailed and considered support. Each patient was given a list of specific conditions and asked about their level of support after receiving the list. These considered patient support levels are unprecedented.
They clearly demonstrate that patients want our services, patients trust our services and are clearly under serviced by a primary healthcare system at breaking point. To my point earlier, the ‘decade of change’ is happening for patients as well.
A learned observation would be that patients need care, governments have a responsibility to provide care, care can’t be provided to everyone for every condition in high-cost settings like hospitals, so the care model is changing because Government’s don’t want to get squeezed been patients who need care and can’t get it. That’s a short way for a Government to become an Oppositions.
And on that note, it would be remiss of me not to mention and quickly move on and ignore the ongoing Chicken Little campaigns of some other professions.
Aged Care
Over the past 12 months we have also increased our advocacy for aged care reform. Australians want to age well and increasingly they want to age at home.
Older people use a relatively high proportion of PBS medicines and health services, with people aged over 65 accounting for 54 per cent of pharmaceutical benefits script volume and people aged 65-74 years accounting for the highest Government expenditure.
In 2020-21, 58.8 per cent of Australians over 65 years old were on five or more PBS medicines and only 5.4 per cent were not on a PBS medicine. In 2020-21, 98.7 per cent of people in residential aged care were aged over 65 years old.
The capacity of the residential aged care sector has been gradually expanding under a target provision ratio in line with the population aged 70 or older, with the ratio at 129.6 places per 1000 older people at 30 June 2021.
Growth in the home care segment has been particularly rapid, indicating older Australians’ desire to age at home for as long as possible.
Your Guild’s aged care reform strategy aims to support people living at home to preserve and restore capacity for independent and dignified living to the greatest extent possible, and to prevent inappropriate admission to long-term and expensive residential care.
It also aims to provide integrated, high quality and safe care based on assessed needs, which allows for personalised care, regular engagement, and a coordinated and integrated range of supports.
Your Guild sought and received a promise from the Prime Minister, The Hon Anthony Albanese, that Pharmacist will not be pulled out of Community Pharmacies and placed in Aged Care facilities and we intend to hold the Prime Minister to his promise.
Your Guild recognises the good a Pharmacist can do for patients in an aged care facility but they don’t have to be employed by the facility and be absent from a community pharmacy to perform this work.
We strongly encourage Community Pharmacies to be linked to aged care facilities and to provide outreach services to the aged care sector, this is especially important when people transfer from ageing at home to ageing in a facility, we want the continuity of service and patient knowledge to continue.
Community Pharmacy Agreement
We are two thirds of the way through the seventh community pharmacy agreement and like all agreements, we continue to tweak and adapt it to the changing environment in which we operate.
This is important. Our community pharmacy agreements are not static documents. That is why your Guild regards the agreement cycles as ongoing and why we are already working on preparations for the next agreement.
I am determined that the next agreement, whose negotiating effort will be headed by Anthony Tassone, is not a mirror of the seventh agreement but rather builds on the seventh other agreements and learns from them, including capturing full scope of practice.
I have no doubt that our negotiating team will emerge after the signing of the next agreement similarly bruised but also happy in the knowledge that the agreement will do everything to ensure your sector remains and grows as a pillar of the healthcare system in this country.
Guild Digest
Something of a milestone occurred in November last year with the 50th edition of the Guild Digest. This is an important piece of work and now more than ever, in this information-rich environment, it is vital that we base our negotiations, decision-making and policy representations on the facts.
The Digest is the largest longitudinal study of the viability of the pharmacy sector, and an essential part of the evidence on which we base our representation of you, our members. It ensures your interests, challenges and opportunities are heard and understood. It ensures we are working with the key facts about our community pharmacies as we negotiate and advocate on your behalf.
The Digest has played a fundamental role in many of our major achievements over the past five decades. A snapshot of these achievements is set out in this special edition – showing achievements that would not have been possible without the Digest data.
For those who contributed to this edition – thank you. And I look forward to your continued support for this important project in years to come. If you’re not contributing, please consider it. The more data we have the better we can ensure the sustainability of your community pharmacy.
I also want to thank everyone who came to our Inaugural Guild, PDL and Australasian College of Pharmacy State of the Industry Roadshow events, which took place across all Australian capital cities last year.
These free events were a huge success, with people from across the wider sector including members, non-members, industry representatives and politicians all coming together to network and discuss issues concerning them. Thank you to the 1,000 people who took time out of their busy schedules to take part in these events. Your feedback has been so positive and invaluable to our deliberations, we plan on repeating the roadshows later this year.
APP is special, not only because I am a Queenslander and I get to welcome you to our great state. But APP has grown and challenged the Community Pharmacy industry to be bigger and better every year and its APP which has given birth to program funding, agreement negotiations, service delivery advancements like vaccines and now our journey to full scope of practice.
And we always have a good time and love catching up with friends and colleagues.
I want to especially thank, Kos, Emma, Brianne (Bryan), Sally, Louise and the marketing and communications team at the Queensland Branch of the Pharmacy Guild for all their efforts putting APP together.
And finally, thank you to you, its great to have you back, I hope you enjoy the next few days.
As I said at the outset, we are three years into a ‘decade of change’- momentum is on our side - it’s an exciting time which provides great opportunities for our profession and our patients.
Have a wonderful time and enjoy APP2023.