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Do we genuinely think anyone from the Grattan Institute has ever been in a supermarket? Its latest report – Future pharmacy: A better deal for patients and taxpayers – says our much-loved community pharmacy model is on the nose because, allegedly, it can’t deliver drugs at down, down prices. Whatever down, down might really mean.
So, no thanks. While I’d love cheaper medicines, I definitely don’t want my community pharmacy to turn into a supermarket – or even to be located in one. That’s exactly where Grattan wants them to head. I get that we all want cheaper, faster, looser. But what we would lose is far greater.
My formerly independent local pharmacy was a beauty. The pharmacists and staff knew everyone by name, and ailment. They knew all your kids and their foibles. They’d ask if you’d had a flu shot yet. I remember being sick as a dog before I had to give a talk, and Tina, one of the small contingent of regular pharmacists, knew exactly what I needed to protect my voice and also stop sounding as if I was talking under a puddle of snot. Honestly, super-competent and super-warm. Big brain and big heart. You have to be smart with a heart to be a good pharmacist.
Then my local was taken over by a chain. I was suddenly beset by staff members wanting to sign me up to receive shoddy discounts and worse “newsletters” (no actual news, barely literate). Tina and her lovely colleagues were gone. The new chain pharmacists had no idea who I was; no problem because I’m still mostly all there. Mostly. But sadly, no personal skills with the huge contingent of the elderly, the infirm and the substance addicts, who needed more care, more love and better personal skills than the rest of us put together.
I lost my mind briefly, and my patience eternally, when the new broom lost an entire clutch of brand new scripts and pretended no knowledge.
Do we know what good pharmacists actually do? And do we, as a nation, understand the absolutely necessary role they play in keeping us healthy? No cost. No appointments. No worries. I know we brag about Medicare but seriously, many of our pharmacies are gold-level health provision.
Which doesn’t mean that I want the Pharmacy Guild of Australia making decisions on my behalf either. Grattan clearly has issues with the guild and I get why. It’s a lobby group for small business and I don’t always think it has the best interests of the community at heart either. Remember when the guild manufactured a red-hot panic when the federal government changed the way scripts were dispensed back in, was it, 2023? Anyone remember the ridiculous anti-government posters adorning pharmacies around the country? So tiring. Believe me, when I’m in a pharmacy I’m tired already. What changed after their red-hot panic? Evidently, they are still all doing very well.
So a word from John Jackson, a recently minted PhD in his 70s, who did an analysis of the community pharmacy model. He’s an adjunct professor at Monash University and has been a pharmacist himself for decades. That’s probably why everyone pointed me in his direction when I was searching for experts on the community pharmacy model. Even Grattan interviewed him in advance of writing its report. Shame they didn’t send it to him for a bit of a looky-look.
I told him I thought the Pharmacy Guild was more about protecting its profits than protecting people. He rightly reminded me that it’s registered with the Industrial Relations Commission.
“I think a lot of unionists would love to have an organisation as strong as the guild because they are very strong in the space,” he says. Don’t they wield their power excessively?
“There’s a lot of money at stake, a lot of power at stake, and they will tell you that they’re doing this as much for their members as for the community.”
And actually, who could argue with the guild’s national vice president Simon Blacker: “Medicines are not ordinary retail products, and community pharmacies should continue to operate as healthcare providers first and foremost.” Hundred per cent.
I guess that’s because it’s so hard to separate the success of the local pharmacy from the health of the community. If it goes broke, we break. We lose the local who can help us with a multitude of afflictions, from cradle cap to urinary incontinence. When you have a local pharmacy, you get access to someone with expertise.
“But none of that is recognised in our health system. None of that is funded in our health system other than through cross subsidy from prescription dispensation,” says Jackson.
Is anyone actually counting that work? No, they are not. Thanks to US geographer Joni Seager, anyone who understands social policy knows what gets counted counts. If we don’t count it and put a value on it, it will disappear.
Too many local pharmacies have disappeared into those massive ownership structures, the Pricelines, the Chemist Warehouses – what experts call the “banners”. Sure, it makes it possible for the suburban pharmacist to make bigger profits and survive in a competitive space. But then they no longer act in quite the same way as Tina down the local. These banners, these co-operatives formed to take advantage of bulk-buying, are commodifying healthcare, and we’ve got quite enough of that already. We know it never ends well, from private health insurance to public-private hospital partnerships.
Grattan has honed in on the Community Pharmacy Agreement. They have argued for deregulation of pharmacy ownership and location. Pharmacy ownership is not part of the Community Pharmacy Agreement. That’s a state-run thing. Three states have already reviewed community pharmacy and have not elected to deregulate ownership. Thank heavens.
Ownership is just one tiny part of a much more complicated, complex regulatory space which protects us all.
Jenna Price is a regular columnist.
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