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Diluting PGA Dominance - Where is the Peak Body for Pharmacy?

Mark Coleman
Medical Centre Pharmacist Perspective

Issue 73: July 2008
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Australian Pharmacy continues to seek a solution as to how it can re-engineer itself to become a meaningful player in primary health care and make the transition from a dispensing role to an expanded clinical role.
The solution is complex because there is no “one size fits all” and is unbalanced because the role of the two major pharmacy political organisations is unequal and overlaps.
The Pharmacy Guild of Australia (PGA) sees itself as the solution for the “whole of pharmacy” and recent derogatory media statements by senior PGA officials against the Pharmaceutical Society of Australia, illustrates the deep divisions that exist.
This lack of respect does not accumulate credit for the officials concerned, or to the organisations in total, and it is illustrative of the lack of vision and leadership skills currently in place.

Division is not a good quality to observe within a profession.
It allows others outside of pharmacy to opportunistically exploit pharmacy to their advantage, it creates destructive competition for resources and ultimately fragments pharmacy to the extent that it becomes financially and professionally unrewarding.
Some would say we are at that point right now.

And because the PGA is the dominant organisation in the unequal tussle for leadership control, it must bear the consequences of the bad decision making being observed.

This must cease before the damage becomes terminal.

The PGA does not speak for, or represent, a majority of pharmacists.
The PGA does not represent a holistic view of pharmacy.
The PGA, in being a trade union of employers is exceeding its brief by going beyond its legal role of Industrial Relations (IR) representation for its members.
The PGA sees itself as “the profession” instead of part of a peak body alliance of all the organisations, that if combined, would truly constitute “the profession”.

Because there is no peak body for pharmacy, we see government dealing and negotiating with what it perceives as the leading organisation within pharmacy.
The way in which the federal government interacts with the PGA is unhealthy for pharmacy as a whole, because it enriches that organisation through commissions on grants to all areas of pharmacy, further propping up an unhealthy power base.

A peak body is required urgently to coordinate a vision for pharmacy as a whole, and to deal with the opportunistic groups that are successfully exploiting the pharmacy profession and competing for resources that should logically fall within the province of pharmacy.
Such incursions include:

* The activities of manufacturers as they attempt to open up a direct dialogue with patients through spurious public relations campaigns involving major media programs such as “A Current Affair”, or direct to consumer advertising that is being finessed in the US e.g. as drug information signposted in supermarkets incorporating follow up telephone calls
This bypasses a legitimate informational role for pharmacy, often utilising nurses and doctors in a process that could operate more efficiently through pharmacy.

* The activities of manufacturers who lobby governments worldwide to inhibit the role of pharmacists in the legitimate roles within their profession e.g. as in compounding.

* The activities of medical practitioners who seek to limit legitimate professional roles for pharmacists, while simultaneously developing dispensing roles for themselves.

* The activities of major retailers who seek to take over the entire function of pharmacy.

* The activities of government bureaucracy who limit the roles of pharmacists on key government committees, many of which are vital for the survival of pharmacy.
Even when representation is given, it is quite commonly a PGA representative that only serves to reinforce the imbalances of pharmacy.
Seemingly, the PGA has become a policy instrument for the Department of Health and Aging - so don't be too surprised, if at a later date, you see existing PGA officials accepting "rewards" in the form of a coalition safe seat.

* The activities of clinical nurse practitioners who seek an expanded prescribing role as well as a dispensing role.
The notion that a doctor diagnoses and a pharmacist prescribes, is a notion that seems to have lost traction. Why?

* The activities of the PGA in tying a consultant pharmacist to a pharmacy structure is both limiting professionally and financially. It is not a proper consultancy infrastructure and the model is too expensive to be rewarding for the person actually providing the skills.

The above points all require to be urgently addressed. And there are more emerging.

But which pharmacy peak body is available to address all these issues and show an acceptable balance in the provision of a solution?

One of the major squandered opportunities that still exists in pharmacy is the consultant pharmacist – independent, unfettered and with the patient as the client (not the GP or community pharmacist), best subsidised through the Medical Benefits Schedule (MBS) – a model that the current president of the PGA is vehemently opposed to.

Consultant pharmacy groups would be delighted to belong to a peak body, to keep in harmony with the profession as a whole and make a valuable and creative contribution.

And if they were structured like the Divisions of General Practice (a regional organisation with a central policy body), a mechanism becomes immediately available for local training of consultants, in conjunction with the PSA.
Consultants can then become an intellectual resource to provide continuing education to hard-pressed community pharmacists, form independent clinical practices within community pharmacy settings that can concurrently form an income stream for the pharmacy and generally get out from under the depressing and uncreative constraints imposed by the PGA.
And the strange thing is that what has been inflicted by the PGA does not necessarily reflect the real wishes of the majority of their members.

Pharmacy has been on notice to get its act into gear since the Wilkinson Report in 2000.
It appears that this opportunity has been well and truly squandered.

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