Editor's Note: Currently there is a greater focus in respect of Indigenous health. And
about time, some would say.
Only very small pockets of the pharmacy profession have attempted to come to terms with this major problem, and they genuinely need your management assistance.
Rollo Manning could well be regarded as the pharmacy expert in indigenous health, and he vigorously defends the rights of indigenous people to enjoy good health - just like the rest of the Australian community.
Rollo's sympathetic insights reflect his long association with, and understanding of, the issues surrounding indigenous health.
May 2009 of i2P e-magazine
By Rollo Manning PhC MPRIA GradDipPR
Consultant to Aboriginal communities and organisations in economic and social development.
“Health information is fundamental to developing evidence on which health policies and programs are based.” Australia’s Health Report 2008 (AIHW)
The starting point in trying to rectify a perceived problem is to gather all the facts to determine the extent of the problem and try and pinpoint where the pressure points are that can be addressed in trying to formulate a plan of action.
In the case of Aboriginal health and pharmacy it traditionally lies in the supply of medicines and more recently those funded through the Pharmaceutical Benefits Scheme. And yet after 12 years of effort from the supply side there is still no evidence of improved health outcomes.
But what do we really know about the supply let alone the outcomes?
What value of PBS listed medicines is being consumed by Aboriginal Health Services through the Section 100 arrangements?
What value of PBS is being dispensed for the urban Aboriginals accessing the normal Section 85 PBS mainstream system?
We do know that the PBS spend on Indigenous Australians is about half of what it is for non-Indigenous Australians.
Through PBS claims it should be easy and in fact when the Section 100 arrangements were first being “sold” to the States and Territories by Commonwealth officers in 1998 the availability of data was being promoted as being a benefit from the program. It would have been possible through claims data to see comparisons of drug use between regions and down to individual health services.
This has not happened. The reason given by the bureaucrats is that the claims process is manual. So what? It is manual to the extent of an Excel file from pharmacy to Medicare Australia. That is no excuse and if the pharmacies supplying PBS to Aboriginal Health Services wanted to display a social conscience they would make the stats available to some central agency for data analysis. And don’t bring on the “commercial in confidence” line because we are talking about the spending of public money. And don’t bring on the “privacy” line because with s100 claiming there is no patient identification.
So the stats are there – but who is bringing them out? – Answer – nobody.
In terms of urban Indigenous people who attend an Aboriginal Health Service there is NO evidence on the number of prescriptions issued by doctors at the AHS getting dispensed. The Provider Number of the doctor working at an AHS identifies all prescriptions written by that doctor and it is possible for Medicare Australia to see how many of those prescriptions get presented for dispensing.
With all the huff and puff of QuMAX we still do not know how many people are actually making it to a pharmacy to have their prescriptions dispensed.
Surely it is not too hard. However when it comes to pharmacy and the co-operation of officers from the profession to work with health planners the record is not good. We don’t even know the value of non PBS dispensing in Australia.
The head has to come out of the sand and something done to provide the basic information needed so health policy planners can get on with the business of programs towards better health outcomes.
Comments to Rollo Manning at email@example.com