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KEVIN
MCANUFF 1945-2004 : CAREER
Kevin McAnuff graduated in 1969 from Curtin University's School
of Pharmacy.
He joined the military soon after where he met the AACP's Bill
Kelly who recalled a recent reunion where Kevin was an entertaining
speaker.
He operated a community pharmacy in Shenton Park in the 1980s
and the Brentwood pharmacy since 1991.
In 1985 he was elected to the Pharmaceutical Council of Western
Australia and in 1991 became its president .
The Council has the legislated roles of a board and examiners
combined with control of the Pharmaceutical Society of Western
Australia.
Around 1990 he and Harry Zafer forged links with the Guild reform
group C.A.P.S. (Community and Pharmacy Support Group), formed
in Sydney in early 1989 (Bruce,1990).
In 1992 Zafer was elected president and McAnuff vice president
of the WA Branch of the Pharmacy Guild . They joined Guild national
council with CAPS figures Sydney's John Bronger and John Dornan.
"These placed him in the centre of pharmacy politics"
(Beahan,2004).
His Council, Society and Guild duties required McAnuff to frequently
meet and speak to a range of senior politicians, bureaucrats,
attorneys, university academics, government and hospital pharmacists,
the hierarchy in pharmacy wholesalers and the pharmaceutical industry.
He encountered many entrepreneurial and assertive community pharmacists
who were challenging the status quo of managing, marketing and
franchising pharmacies and a host of other issues such as the
re-scheduling of drugs, the formula for devising the PBS dispensing
fee, methadone dosing and issuing sterile needles, mandatory CE
and widening pharmacy's primary care services.
McAnuff's personality was best conveyed by Michael Beahan, a former
Senator, a 1990s director of the WA Pharmacy Guild and presently
the Pharmacy Guild's national Director of Government Relations:
"..Kevin was often seen as the hard man of pharmacy -
tough , uncompromising, and unforgiving , frequently brusque and
sometimes downright rude ….(with) the twinkle in his eye
as he pursued his cause …this was Kevin's way of pressing
his case" (Beahan, 2004) .
Kevin was intelligent, able to hold statistics and with me was
quick to question research data and the interpretations.
McAnuff's leadership qualities , quick repartee and good grasp
of complex issues prepared him for his most important contribution
to pharmacy nationally - a key member of the negotiating team
for the Third Agreement (2000-2005) and of the management committee
implementing initiatives of the Agreement..
He passed away while in Canberra preparing for the Fourth Agreement.
" He will be sorely missed in the coming negotiations"
(Beahan,2004).
FAREWELL
TO A PHARMACY TRANSFORMER
Western Australia and Australia has lost Kevin McAnuff one of
its key pharmacy leaders who died suddenly in Canberra on Sunday
18th January (The West Australian, 20 January 2004).
Mr McAnuff, 58, was president of the Pharmaceutical Council and
Pharmaceutical Society of WA for 12 years and a national councilor
of the Pharmacy Guild of Australia.
He fought to cut the red tape for community pharmacists.
Mr McAnuff was one of a new breed of smart pharmacy leaders ,
assertive with honed negotiating and public relations skills .
He had a broad grasp of the political, legal, management, professional
and educational components which comprise contemporary pharmacy.
Kevin was never phased by adversaries whether they be high bureaucrats,
eminent academics or pharmacy moguls.
Pharmaceutical Council registrar Bob Brennan said Mr McAnuff had
been a member of the Council for 19 years and had advocated fiercely
for the protection and improvement of the profession.
Pharmacy Guild ( WA branch) president Harry Zafer said pharmacists
had lost a champion whose sense of right was unconditional. "
His commitment to family, pharmacy and the community was huge
and he had a clear and uncompromising sense of values,"
he said.
Pharmacy Guild of Australia national president John Bronger said
Mr McAnuff had contributed greatly to community pharmacy in Australia.
"He could be your best friend but that would not stop
him arguing and hammering a point with you," Mr Bronger
added. "He was a great thinker , a great worker and a
great pharmacist."
Department of Health and Ageing acting secretary Philip Davies
said Mr McAnuff was greatly respected and had a strong interest
in regulatory reform to help community pharmacists.
Mr McAnuff, who lived and ran a pharmacy in Brentwood , leaves
wife Pat and children Michelle a pharmacist and Anthony.
The funeral was held in the chapel at Thomas Aquinas College set
in Australian verdant flora with tall silver gum trees in Manning
a near-south suburb of Perth overlooking the Canning River just
three kilometres south of its junction with the Swan River .
Almost 1,000 attended the funeral from 10 am to 12 noon which
proved a moving tribute to Mr McAnuff's family life as well as
pharmacy career.
Amongst those who travelled across the continent to pay their
respects were national Guild President John Bronger, national
PSA president Jay Hooper, NSW Pharmacy Guild President Si Banks
, Victorian Pharmacy Guild President Bill Scott, the AACP's newly
appointed CEO Bill Kelly and the Queensland Guild's Michelle Bou-Samra.
The Guild's Executive Director Stephen Greenwood , Health Economics
Director Dr Michael Tatchell and the Director of Economic Analysis
Vasken Demirian had flown from Canberra .
Curtin University School of Pharmacy's Prof Michael Garlepp, colleagues
Assoc Prof Colin Marshall , senior lecturer Jeff Hughes and lecturer
Con Berbatis were present along with Graham Greenhill a former
PSA pharmacist of the year.
The pall bearers included Messrs Bronger, Zafer, Scott and John
Dornan (Guild, NSW). Both Scott and Dornan are colleague Agreement
negotiators.
The funeral party moved to the McAnuff house two kilometres further
south situated on the leafy banks of Brentwood Creek a tributary
of the Canning.
The McAnuff family were organised and gracious hosts.
Selected
notices for Kevin McAnuff :
'The West
Australian' January 22-24, 2004
Pharmacy
Guild (WA) president , national Guild vice-president and close
friend Harry Zafer :
"…a pharmacy champion, my champion friend, pharmacy's
fearless warrior, who won so many battles and challenged so many
entrenched views…."
Australian
Medical Association (WA):
"…Highly respected by the medical profession for his
work in areas of common interest, he will be greatly missed…"
NAPSA
"…thanks to a man who fought to secure a bright future
for his profession which will be enjoyed by many for many years
to come…"
Con and
Rita Berbatis
" Tribute to a colleague student…The fruits of your
work will live long in pharmacy practice and research. …Farewell
friend."
Editor's Note:
Mr McAnuff was a member of the Pharmacy Guild's national council,
its Health Economics Committee, a negotiator in the Third Community
Pharmacy (Government) Agreement ( 1 July 2000 to 30 June 2005),
the Management committee to implement its initiatives and part
of the Fourth Agreement team at the time of his passing.
The Second and particularly the Third Agreements transformed pharmacy
practice by revising the formula for PBS dispensing fees and widening
the third party remuneration base for a new set of community pharmacy
services .
Kevin McAnuff has been a key figure in pharmacy and Guild history
for over a decade. The following report is an initial attempt
to explore the unique background and talent underlying his key
role in national and state pharmacy. While elections will determine
his replacements at the State level , finding a new Fourth Agreement
negotiator will be more problematical.
SOME
POST-MCANUFF CONSEQUENCES FOR PHARMACY IN AUSTRALIA
The 1990s was a period of transformation in the structure and
processes of pharmacy and the late Kevin McAnuff was a natural
'change agent'.
The First (1991-1995) , Second (1995-2000) and Third (2000-2005)
Community Pharmacy/ Government Agreements were the instruments
to facilitate the transformation (Tatchell, 2000) .
The Pharmacy Guild's DR Michael Tatchell is unique in having participated
in all the negotiations since 1985 including the three Agreements
and hence is pharmacy's most direct historian of these developments.
In Tatchell's words the Third Community Pharmacy (Government)
Agreement became a "watershed as far as agreements …."
between pharmacy and the Commonwealth government because the
focus moved from a preoccupation with remuneration of existing
services and government savings to a "strong emphasis
on new pharmacy programs and services " ( Tatchell, 2003).
The negotiating team with McAnuff were the PSA's John Daffey (national
PSA president to Dec 2002) and the Guild's John Dornan (NSW) ,
Bill Scott (Vic) and Jeremy Hampton (Tas.) with technical advisers
DR Michael Tatchell and Vasken Demirian of the Guild's Canberra
office.
John Dowling replaced fellow Taswegian Hampton in 2002 and Queenslander
Tim Logan was appointed in late 2003.
The Agreement was " a breakthrough in that it returns
to pharmacy those PBS savings that would previously have disappeared
into consolidated revenue" (Tatchell, 2003) .
It acknowledged pharmacists broadly as healthcare providers with
fees for new services, which was often pressed by McAnuff.
His background impressed on him that community pharmacists' primary
health care role was a long historical one and was much wider
than commonly accepted .
He campaigned for pharmacists to be educated adequately and be
remunerated for these services because they saved the government
health expenditure.
The WA registrar's Mr Robert Brennan's "…. he advocated
fiercely for the protection and improvement of the profession…"
portrays McAnuff's passionate flagging of pharmacists' achievements
in various activities in the Pharmaceutical Council's monthly
newsletter and urging them to strive harder .
The Third Agreement talks commenced in 1999 and continued for
12 months before being finally signed off in May 2000.
Tatchell (2003) lists 10 major achievements of the Agreement including
:
* the Quality Care Pharmacy Program was introduced to ensure within
a few years high uniform standards of pharmacy facilities, staff
and procedures . A magnificent campaign under chairmen Queensland's
dynamic Kos Sclavos and Tim Logan resulted in 50% of Australia's
pharmacies enrolled by January 2002 and over 70% 12 months later
* the Rural Pharmacy Maintenance Allowance has succeeded in attracting
most eligible pharmacies to provide access to pharmacy services
to people living in rural and remote areas and is one of the agreement's
"success stories " .
* fees for residential aged care medication reviews and domiciliary
reviews have become implemented nationwide at a fast rate and
are landmarks of Australian pharmacy.
McAnuff's command of the Third (and Fourth) Agreement issues and
his critical approach to them made his presence an exceptional
one in the negotiations.
This can be sensed in Michael Beahan's tribute " He will
be sorely missed in the coming negotiations" .
John Bronger's recalls McAnuff "… would not stop
arguing and hammering a point…" .
The Commonwealth Department of Health's Phillip Davies a government
negotiator and adversary in the Agreement talks acknowledged McAnuff
had "…a strong interest in regulatory reform to help
community pharmacists…"
Tatchell points
to issues which need to be assessed in 2004 in "..the
lead up to the Fourth Agreement".
These involve a review of the pharmacy location rules, progress
in "inter-professional collaboration in the provision of
healthcare services ", and the take-up by pharmacies of the
" Section 100 program for providing pharmaceutical supplies
and services …" to ATSIC communities (Tatchell, 2003)
.
A large worry
facing pharmacy nationally is supermarket pharmacies .
McAnuff feared the disappearance of independent (pharmacist-owned
and controlled) pharmacies .
He knew this may mean the continuing decline in pharmacy: population
ratios from 1:2,000 in 1965, 1: 3,000 in 1990 to the present 1:4,000
and down to the present USA ratio of 1 pharmacy : >5200 people
(Berbatis, 2003).
This may well occur quickly if the large supermarket public companies
introduce pharmacies in the stores with the deregulation of ownership
and of PBS dispensing as well as the wide rescheduling of S4s
and S3s to S2s.
The Guild and other national and State bodies need to make strategic
decisions shortly if pharmacy is to capitalise on the Third Agreement
achievements and fend off supermarket pharmacies.
The Guild and pharmacy at State and national levels will need
strategists and hard negotiators of McAnuff's ilk to fight these
and other challenges.
The Agreements
have had a number of permanent structural effects on pharmacy.
First, they have made the Agreement negotiating teams arguably
the most powerful force in contemporary pharmacy.
Second, the negotiating process has become formalised into the
Steps of
(1) brainstorming to identify the key issues ,
(2) prioritising the issues ,
(3) strategising the negotiations,
(4) rehearsing,
(5) actual negotiating ,
(6) implementing and
(7) managing the Agreement decisions.
Third, the resulting expansion of staff and resources has stamped
the Guild's national dominance not just in negotiating, but in
lobbying Ministers, vying with medical and other health groups,
implementing national policies, widening the scope of remuneration
for pharmacists and effectively setting the professional as well
as the commercial agenda for community pharmacy.
Fourth, the leaders of pharmacy practice research in universities
such as Sydney's Prof Charlie Benrimoj and South Australia's Prof
Andrew Gilbert have pushed pharmacy practice or population research
out from the shadows and up to the status enjoyed by laboratory
researchers over the past decades.
They are seen as the guiding lights for community pharmacy in
the future.
The Fourth
Agreement is now into Steps 1 and 2.
Time is running short with the federal elections due this year
which means the Agreement outcomes will be decided before November
with the present Cabinet rather than waiting until June 2005.
The Guild hierarchy will need to now review the composition of
the negotiating team and advisers.
With the government side having vast resources and limitless technocrats
at its call, the Guild will look well beyond the confines of its
building in Canberra to match the opponents.
High on their priorities will be to find another McAnuff, "…often
seen as the hard man of pharmacy…hard hitting, incisive,
relentless , irreverent … for the profession he loved and
defended with passion… " (Beahan, 2004) and the
"tough guy" in negotiations.
The
21st century opened with the spectre of the Wilkinson and Galbally
reviews recommendations hanging over Australian pharmacy.
The immediate question looming for the Guild is : Who will replace
McAnuff in the negotiations leading to the vital Fourth Agreement
?
Or, will sources other than the Guild be tapped for future Agreement
negotiators?
It may well be time to invite leading pharmacy practice researchers
or administrators as advisors or negotiators for the 4th Agreement
talks.
After all, the Agreements now demand the best talent our country
can offer.
Con Berbatis , 6th February,
2004.
References
· Beahan M. Vale Kevin McAnuff. www.auspharmlist.net accessed
30 January 2004.
· Berbatis CG. Supermarket and non-pharmacist controlled
pharmacies. Part 1: international comparisons. Pharmacy Review
2003; 27 (4): 29-34
· Bruce J. Pharmacy : profitable profession or prescription
for poverty? GPO Box 447, Brisbane (Queensland) : James Bruce
Publication, 1990.
· Tatchell M. The evolution of Agreements. Aust J Pharm
June 2000; 81:588-590.
· Tatchell M. Third Agreement : mid-term review. Aust J
Pharm 2003; 84: 138-139.
· The West Australian.. Pharmacists' top man dies. January
20, 2004, page 28.
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