ABC NEWS 24: David Quilty responds to The Commission of Audit recommendations – ‘One of the great things about pharmacies is that they are owned by pharmacists … the person who’s running that business first and foremost has their health care uppermost in their minds.’
Transcript: The Commission of Audit recommendations
May 02, 2014 Station: ABC NEWS 24
Date: 02/05/2014
Program: ABC News Breakfast
Time: 08:05 AM
Compere: Paul Kennedy, Virginia Trioli, and Sharelle McMahon
The commission of audit has recommended increasing pharmacy competition.
Interviewees: David Quilty, Executive Director, Pharmacy Guild
VIRGINIA TRIOLI: Now, one of the recommendation made by the Audit Commission is to increase competition among pharmacies by easing rules about ownership of pharmacies and their location. Now it’s also been suggested broad changes be made to the Pharmaceutical Benefits Scheme For his response, we’re joined now by David Quilty, the executive director of the Pharmacy Guild. He joins us now from Canberra. David Quilty, good morning and thank you for making time.
DAVID QUILTY: Good morning Virginia.
VIRGINIA TRIOLI: I understand that the Pharmacy Guild is very, very angry about the suggestions made in the Commission of Audit. What’s the problem with suggestion of relaxing rules about the ownership and location of pharmacies?
DAVID QUILTY: Look I think one of the great things about pharmacies that they are owned by pharmacists and every time that a patient goes into a pharmacy they know that the person who’s running that business first and foremost has their health care uppermost in their minds. I think we have a system that works exceedingly well. Time and again we have research that indicates that 90 per cent or higher satisfaction in pharmacy so it’s not as if there’s something here that’s broken and needs to be fixed.
VIRGINIA TRIOLI: Well, you actually go on to make some pretty serious comments as a result of a very simple very suggestion that the idea of competition be extended to the area of pharmacies which does seem to be one of the last bastions of a pretty much closed shop. You say the changes would deprive patients of access to medicines, force many patients to pay more for medicines, cause medicine shortages and rationing and deprive patients and doctors of choice of medicines. What’s your evidence for any of that?
DAVID QUILTY: We need to remember that the Commission of Audit has not only advocated changes to the ownership rules, it’s also looking to change absolutely how the PBS works and in terms of those concerns, they relate to the recommendation by the Commission that there be a New Zealand-like tendering system put in place and anyone who knows that system recognises that there is really no choice either for doctors, pharmacies or patients themselves. There’s less access to new medicines, there’s less chance that when new medicines come on to the market that medicines companies will look to bring them into the market so overall the system is certainly deficient compares with the Australian system so that’s the reason for those concerns.
VIRGINIA TRIOLI: I don’t think you’ve answered my question though. The question was how do you provide any evidence for these very, very strong, terrifying suggestions really, that the changes would deprive patients of access to medicines, force patients to pay more for medicines, cause medicines shortages and rationing – echoes of the war there – and deprive patients and doctors of choice of medicines? I’m just going to ask you once again, what’s your evidence for any of that?
DAVID QUILTY: Well, firstly, the Commission of Audit proposes that there be increases in the co-payments that are paid by patients so clearly they’re looking for patients to pay more [indistinct].
VIRGINIA TRIOLI: [Talks over] That’s when they – I’m sorry, I’ve got to bring you back to this. It’s when you go and visit a GP, it’s nothing to do with medicines that are bought at a pharmacy. If there’s a co-payment there that doesn’t cause shortages or rationing.
DAVID QUILTY: Well, certainly there is an increase in the co-payment that is proposed by the Commission of Audit. The reason why we’re concerned about the New Zealand system is that what it does is it tenders out and there’s no choice in terms of different brands of medicines. In New Zealand there’s been an absolute decimation of the medicines sector which means that the sector is not bringing new medicines into the market so, for example, new chemotherapy medicines are brought into the market much more slowly, if at all in New Zealand. There’s been evidence that other medicines such as vaccines, that there’s been potential for shortfalls there, so really there is a lot of evidence that…
VIRGINIA TRIOLI: I’m sorry to do this again but I’m going to have to jump in there because actually know that the TGA, Therapeutic Goods Administration here in Australia is looking at much closer ties with New Zealand and actually has looked at the New Zealand experience very closely and those fears clearly aren’t founded because of the ties and the joint administration that is probably going to be set up between the two countries. But again you’re not really addressing those points. Rather than labour it, I’ll ask you a more broad question. The Commission of Audit is suggesting the idea of actually opening up to competition what seems to be a very closed shop at the moment. Why should you be the only area of commerce not open to competition? Is this just about protecting your turf?
DAVID QUILTY: No, it’s not, it’s about actually providing better patient outcomes and the fact of the matter is that the public thinks that the system works very well. There is lot of competition between pharmacies. We have a system where there’s a very equitable distribution of pharmacies around Australia and it means that pharmacies are very convenient and people have ready access to pharmacies and I think above all we have a situation where the people that own pharmacies are pharmacists and they’re healthcare professionals and they’re vitally interested in providing the best health outcomes for their patients. And I just think that’s a very good thing.
VIRGINIA TRIOLI: But it’s true to say, isn’t it, that a pharmacist can own a pharmacy but there’s actually no requirement for that pharmacist owner to spend a second in their shop or not. They’re not necessarily there behind the counter providing that service.
DAVID QUILTY: Well, the reality is that, as the owners of that pharmacy – and in the majority of cases they are actually working very hard in those pharmacies but they’re making the decisions about those businesses and as pharmacists they’re making decisions based on their very strong commitment to healthcare and the reality is that in most cases the pharmacy owners are the pharmacists that are working in their pharmacies not only during the week but often on weekends and after-hours so I don’t think it’s fair to say that these pharmacy owners are hands-off at all.
VIRGINIA TRIOLI: David Quilty, this is what the Productivity Commission has had to say about the pharmacy – the situation of pharmacies in Australia, the way the area is protected. It said back in 1999, it found restrictions on competition accordingly inflate the cost of pharmacy services and reduce consumer convenience. They’ve also retarded the development of alternatives to conventional pharmacy services including mail order pharmacy which is widely used in a number of other countries. The Productivity Commission doesn’t agree with you when you say that there’s no problem with the system, that the system isn’t broken. So, I ask you again, why not open up the pharmacy sector to the same sort of competition that exists everywhere else?
DAVID QUILTY: Oh look, I think the reality is seen every day on the ground. The fact of the matter – the people that really do matter in this are the patients and they are overwhelmingly very positive about the role that pharmacy plays and certainly there are economically rational ideas that are put forward by people who in the main have very little understanding of what happens on the ground. I think pharmacy…
VIRGINIA TRIOLI: But, David Quilty, an economic rationalist view would actually be to let competition flourish. At the moment chemists face no competition from supermarkets. New entrants are banned from opening a store within 1.5 kilometres of an existing business.
DAVID QUILTY: Well, the reason for those location rules is actually to make sure that there’s an equitable distribution of pharmacies for the patients so that patients all round Australia, no matter where they live – and many of them are older and can’t get around easily – can have ready access to pharmacies. And in terms of supermarkets, look I think both sides of politics have made very clear, that they do not want supermarkets owning pharmacies. The fact of the matter is that supermarkets are in the business of selling cigarettes and the business of selling alcohol and in the business of selling all sorts of confectionery. Whereas pharmacies – their job is to actually provide healthcare as healthcare professionals to Australians and I think that’s a very good model.
VIRGINIA TRIOLI: Alright. We’ll leave it there.
Source: Pharmacy Guild of Australia