January Edition # 19, 2001
This is the first edition of Computachem E-Newsletter for 2001.
As promised, the format has changed so that our mailings are less "bulky" and the various links back to the website make for more comfortable reading.
Please feel free to comment if you think we can improve further in any area.
We have decided to recruit some additional columnists for the newsletter, because I wish for this publication to be a truly representative one.
Although I bear the criticism from any material that does not find favour, the truth is that I do not always agree with the columnists, nor they with me.
But somehow we seem to form a happy amalgam.
We have appointed Jon Aldous, a newly graduated pharmacy student from the University of Queensland, to be columnist for education matters. He appears in this edition and his first article covers what he has experienced in the "new course" from an education perspective. He is charged with researching what the future needs will be for pharmacist education, pre and post graduation; what new subjects will need to be learned and what methods of delivery of education will evolve. In particular, he will closely follow the evolution of practice certificates and their potential to be a global qualification.
Because he is just beginning his career, he brings a fresh and youthful perspective to the newsletter.
Rollo Manning is back in good form with some pithy comments on the structure and direction of official pharmacy in Australia. Always a good read.
I have written two articles for this edition:
one on e-commerce, highlighting some of the potentially negative attitudes among some pharmacists, and official pharmacy. However, it is a good news story and we hope that you benefit, and steer your own course.
The second story relates to the short term future of pharmacy ownership and location rules, and how corporate pharmacy may emerge from all the vested interests that are circling in a predatory fashion. This is a more serious story, because the good times promised by the Pharmacy Guild, may simply evaporate like a fragile dream, no matter what agreements have been struck.
Leigh Kibby is back with a management article on the "soft" skills of management and why they need to be reviewed in your pharmacy business.
Finally, our guest columnist representing issues in rural and isolated Australia, points out some of the follies of our decision making bureaucrats, made from their comfortable Canberra armchairs, and possibly with the aid of a map not of this millennium (or the last).
Please feel free to write in on any of our discussion topics, and we promise that your letters will be published, no matter how harsh the comments. If any of our overseas subscribers need further explanation of any of the local issues, please contact us, and we will decipher for you.
Our new free employment listing serice is now available for all subscribers, and if you wish to list a position wanted or a position vacant, follow this link.
Neil Johnston, January 25th 2001
TIME FOR DIRECTION
If the Pharmacy Guild closed tomorrow, would it be missed?
Or would the members of it just set about forming a new organisation(s) more relevant to today's market place?"
Mischievous?
Pot-stirring?
Ludicrous?
Controversial?
Stupid?
Unreal? …yes maybe all of those things. and none the less worth debating.
It is not know what will arise from such a discussion, except one of two things are certain: The Pharmacy Guild will be re-elected with a strong mandate, or Alternative models for "pharmacy organisation" would emerge which are more relevant to the types of pharmacy practice emerging.
There would be an e-commerce group, a medication review group, a nursing/aged care home group, a sports medicine group, and so on…you name a few?
The theme used above was said by an American philosopher 50 years ago in respect of community service clubs.
He said that " If Rotary, Lions and Kiwanis folded tomorrow they would not be missed, their members would just go out and start another more relevant."
Since that time there has been a radical change in the market place for voluntary input to assist others in greater need than ourselves. Governments have introduced programs to aid the needy where the voluntary pitched in years ago.
The Guild was formed in 1928, and now 73 years later, it's reason for being can just as equally be questioned.
This is not to say it IS irrelevant.
This is to reaffirm it's usefulness.
It may lead to the need to redirect or reorganise its activity.
It may force pharmacists to articulate their own needs.
It may create more relevant structures to meet the same ideal for a variety of pharmacy business profiles - but specialising more to suit consumers/pharmacists needs..
In no way should it be seen as a destructive force, but a proactive way of examining future options.2001 should be seen as the year of the specialty in pharmacy practice.
The year 2000 saw the emergence of e-commerce through the Internet.
It also saw the growth of innovation through electronic development with the announcement of the "Better Medication Management" system by the Federal Department of Health. The time is ripe for the "official" pharmacy lead organisations, the Pharmacy Guild and the Pharmaceutical Society, to acknowledge that not all pharmacies can look the same across the Nation.
There must be specialisation for three main reasons.
The consumers are not the same.
Pharmacists have their own personal needs to fulfill.
Manufacturers will position the market image for their product to meet their needs.The Third Agreement between "community pharmacy" and the Government (2000-2005) portrays a pharmacy strong in professional health practice.
This is to be commended, but not for all pharmacies in Australia.
There will be those which want to embrace the "new era" with great enthusiasm, and there will be those which do not want to have any part in the incentive programs for introducing professional services.
The catch is that ALL pharmacies with an Approval Number are funding the new initiatives through accepting a reduction in the payment for each prescription dispensed under PBS rules for the next five years.
This comes about because of the "averaging" method of distributing income across the sectors of retail pharmacy as determined by prescription volume. The pharmacy dispensing 500 scripts a day, is paid the same amount per prescription for the task as is the one around the corner dispensing 50 scripts a day.
Why is this so?
Because the Pharmacy Guild represents the interests of the majority of owners, and represents them all on an equal basis.
How long will this last?
No longer than the term of the Third Agreement (prediction).
While this approach is in, all pharmacies will be encouraged to do the same thing.
But this is not possible for the three reasons given above.
So in this year of the "speciality" make and state your choice of direction, and consider the options.
A good exercise would be to ask pharmacists to describe the model of practice they are aspiring to achieve.
What a multitude of responses would be received.
However from this it may be possible to describe the options to allow new organisations to emerge representing the "type" of pharmacy preferred by a significant number of pharmacists
. .ends
The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles. The editor would be pleased to publish any responses.E-COMMERCE
A recent posting on the Auspharmlist displayed an article, extracted in total from Enterprise Newsletter, which covered a very interesting story on "EPharmacy" and its development.
The caption, inserted by the Auspharmlist contributor said:
"Read it and weep".
Now, everyone is entitled to an opinion, but my immediate thoughts were, why weep?
This is a matter for rejoicing!
For those who did not catch the original story, it detailed the processes by which Brett Clark, the owner of EPharmacy, had evolved himself into a full blown competitor to Pharmacy Direct.
Starting with his original "bricks and mortar" pharmacy at Calamvale, in Queensland, he has built a "hard-core" online pharmacy concentrating on products, price and fulfillment of orders.
He claims his online business is growing at 20% per month and has a current annualised turnover of $500,000, mainly prescriptions, plus a range of common OTC items. Privacy items such as virility drugs, condoms and flavoured gels also feature strongly.
All online products are heavily discounted, and customers are even encouraged to place orders from novel web kiosks located within the Calamvale pharmacy.
Australia Post is utilised to complete the delivery to the customer, many of which come from rural/remote areas.
To establish the brand of "EPharmacy" Brett Clark used inexpensive promotional devices such as fridge magnets and stickers advertising his web address, and also utilised the ninemsn Good Medicine site. He also advertises a 1300 local call cost telephone number.
Future promotion includes extension to the shopping portals of "ClickandEasy" and "CyberRewards".
What is there to weep about in this good news story?
Brett Clark has successfully built an extension to his "bricks and mortar" pharmacy, branded it "EPharmacy", and made it a profitable venture within six months.
The obvious planning has reaped the reward of a 20 percent expansion in sales per month.
I suspect that there are many pharmacists out there, still dreaming about an online extension to their own business and waiting for Official Pharmacy to give some sort of guidance and sanction.
You should not hold your breath, for the organisational resources, particularly those of the Pharmacy Guild, have been utilised to try and suppress the pioneer in the mail order/online field, Pharmacy Direct. Instead of taking the high ground and developing and negotiating guidelines for pharmacists to operate within, they have been heavy-handed and gone down the pathway of legal threats.
They have inspired regulatory bodies, such as the Pharmacy Board and the Therapeutic Goods Administration, to take action against Pharmacy Direct.
Regulations and official policies to this point, were designed for a world where online business was never envisioned.
The practice of pharmacy is that of prescriptions, the sale of scheduled medicines and the value-adding with patient education.
Why is it so difficult to portray these items competitively on a website?
Because the Internet is such a useful tool, and because the federal government is encouraging all areas of commerce to embrace this phenomenon of the new economy, all areas of official regulation need updating.
Policies of official pharmacy need adjusting to accommodate an ethical evolution, thus avoiding the unnecessary conflict that has occurred (and is still occurring, according the Pharmacy Direct).
In taking this punitive direction, the Pharmacy Guild has painted itself into a corner.
In opposing the Pharmacy Direct model, it has said to pharmacists that they should not emulate and compete.
The result has been the successful establishment of Pharmacy Direct as a brand name, and a reach, such that every pharmacist in Australia has the equivalent of a competitor, as if located right next door!
It has also meant that the bulk of community pharmacists have become hesitant and unwilling to embrace e-commerce, because they may incur the wrath of official pharmacy.For this, and only this,you should "read and weep"!
In our last e-newsletter for 2000 (edition #18) we published a series of questions put to a senior Guild official.
One of the questions was:
" When will the Guild enter e-commerce, rather than debate the need for such a move?"
The answer given was:
" The Guild is in e-commerce up to our necks. Can't show our hand yet because as you know 95 percent of e-commerce ventures to date have failed." [Kos Sclavos]
Our further comment on this Guild statement is:
If you are up to your neck in e-commerce, why have you not shared this information with your members?
We go further and ask why have not members been polled and an open debate established as to what pharmacists would envision and prefer?
A "bottom-up" rather than a "top-down" strategy.
And we point out that not only have the two high profile models of Pharmacy Direct and EPharmacy been very successful, but there are a number of other pharmacy models also operating quite successfully, with never a thought of failure.
The only e-commerce venture ever publicised by the Guild, was the MedWeb venture.
A recent look at this site showed quite a few changes, notably that it was now a doctor to consumer site and all traces of pharmacy, including the information that the Guild was a partner in the site, have now been removed.
Does this represent part of the "95 percent" of failures stated in the above Guild comment?
Many manufacturers of pharmaceuticals and medical devices are rapidly mobilising to deliver their products and services via the Internet. They have the capacity to bypass pharmacists and doctors, if they do not have online systems in place to value-add, and also efficiently complete distribution to patients and customers.Through the pages of this newsletter, we have continually encouraged pharmacists to become active in e-commerce.
Not so much that you will miss out, but more as a tool to increase the reach of your business, and develop new types of patients and customers.
Done as an extension of your existing pharmacy, you can operate to service a neighborhood community, a regional community, a national community and eventually, an international community.
The successful online pharmacy models have been established within the last two to five years and have evolved into formidable businesses in their own right.
This means that not only do you have a minimum lead time to establish your model, of say, two years, but this lead time will extend as new competitors enter the market to throw down the gauntlet.
The additional "noise" of new entrants will simply make it harder for you to enter the online market, the longer you leave it.Don't take our word for it.
Ernst and Young, the international management consultants, have published a report for Australian online retailing for the year 2000, which gives insight into opportunities and challenges for 2001.
They state that the acceptance of online shopping by consumers is growing, that people are shopping online more frequently and spending more money across more retail categories. Books, software and music are the high volume sellers, but items such as clothing are beginning to make an impact.
Fifty percent of all e-retailers are extensions of their "bricks and mortar" business, two thirds of all e-retailers have been operating for less than three years and have reported annual revenues of less than A$1 million.
The so called "pure-play" e-retailers are in decline and there has been a resurgence of activity from traditional "bricks and mortar" retailers, with an aim to increase sales.
Consumers complain that many online businesses are not meeting expectations, they want a good range of products at competitive prices, they are concerned about credit card information being stolen, and they don't like freight charges.
While credit card security is not the primary concern of online shoppers, it is still the third biggest factor discouraging online buying. Consumers also worry about privacy.
The most powerful motivation for unplanned online shopping is price.
Online consumers respond to permission based e-mail communications, but turn off all other blanket e-mail postings.
Ernst and Young conclude that for the future:
"The clicks and bricks that will do the best in this new environment are those that have a multi-channel strategy that integrates their online and off-line operations, providing a seamless experience for customers. Attracting and retaining customers will continue to be critical to the success of online retailers in the coming years."This is totally in line with what we have been reporting in this newsletter for the past year, and it is in line with previous surveys.
We must also applaud the EPharmacy strategy of utilising web kiosks within their "bricks and mortar" pharmacy to educate and convert customers to online retailing. Conversely, online retailing can be utilised to direct customers back to the physical pharmacy, for those products and services best retailed in that medium.
While some may argue that it is a senseless strategy to convert customers already inside your shop to online shopping, possible at a lower retail price and margin, remember that the online shop is open for business 24 hours per day, seven days a week. Also, online orders can be assembled in hours outside of busy shop hours.
Online business therefore, may reduce the need to rapidly expand staffing and other overheads, if it is expanding at a greater rate than the "bricks and mortar" business.
That is managing overheads and being efficient.
That is being seamless.
..ends
The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles.EDUCATION
As a recent graduate from the new four-year Bachelor of Pharmacy program at the University of Queensland, I have been asked to provide some insight into the ways in which pharmacy education is evolving, and in particular the challenges we face as a profession, to stay up to date in our rapidly changing workplace.
An overview of the new four year degree program at the University of Queensland (UQ) provides some clue as to modern thinking on education.The course structure is described as "integrated".
In this case it isn't just a buzzword being bandied around for promotional purposes, but the mantra behind the program.
The initial year is mostly concerned with bringing all new students up to the same level of background scientific knowledge in anatomy, biochemistry, biology, chemistry and statistics, and giving them a brief introduction to the background of pharmacy, and an idea of what the profession involves.
Students in my year were given placements in community pharmacies for first semester (one afternoon a week for about half of first semester), and visited one of the major teaching hospitals in Brisbane to see hospital pharmacy.
Years two, three and four of the degree are divided into 6 streams:
Quality Use of Medication - this is the major stream throughout the course, and covers therapeutics, the role of pharmacists and evidence based medicine.
Dosage Form Design - mostly pharmaceutics and microbiology
Social and Professional Aspects - covering ethics, professional responsibilities, and health policy, and in fourth year - a new addition - management.
Drug Discovery - the chemistry of drug molecules, assay techniques and registration processes
Biological Fate of Drugs - pharmacokinetics, pharmacodynamics and toxicology
Data Analysis - initially statistics, but broadens to cover health economics and the principles behind evidence based medicine.
In addition the Physiology and Pharmacology departments provide classes in their area of expertise in second and third year.
Those who went through older degree courses or the apprenticeship system might be asking where the pharmacognosy classes are!
It is now a very minor part of the course and we no longer need to identify plants and extract medicinal products from them (an area which has been missing from the curriculum for some years).
This role seems to have spun off into naturopathy over time, as pharmaceutical medicines gained in popularity, but with the recent public interest in natural medicines, perhaps there might be a shift back that way in ten years time!
Physiology and Pharmacology, Quality Use of Medications and Drug Discovery are integrated as students learn about the same body systems in all 3 subjects simultaneously. (This makes it a lot easier come study time.)
Recent graduates from old 3-year programs often complained they had to learn all the pharmacology or all the biochemistry in one semester, but that has all changed, certainly for the better.
Students are now spending more time in pharmacies in an effort to overcome complaints in the past that graduates were ill-equipped to actually start in the workplace and needed too much training.
After the brief introduction in first year to community pharmacy, students experience a week of rural pharmacy in second year. In third year students spend half-a-day every week in community pharmacy, increasing to 6-8 hours a week in fourth year. In addition two, four week blocks are set aside in fourth year for students to complete Quality Use of Medication projects in an area of interest (community, hospital, industry, government… the variety was astounding).
The shift has very much been from pharmacy's role as the medication distributors, and prescribing auditors, into which we were increasingly pigeonholed until the last ten or so years.
One pharmacist who saw the case studies in my fourth year tutorial book exclaimed "They're teaching you to diagnose!".
That is not quite the case but we are now increasingly encouraged to make differential diagnoses and referrals when needed.
This shift to problem based learning ensures we can be ready when pharmacists gain some form of prescribing rights as is currently being initiated in the United Kingdom.
With the first graduates from four year programs now filtering into the workplace, employers should soon start to feedback on whether the new system is producing quality graduates.
Next time we'll begin to examine the way computers and the Internet are changing pharmacy education.
..ends
The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles.MANAGEMENT
It doesn't take an enlightened executive to know that soft skills make money, just a smart one. Implementing a successful soft skills strategy is not rocket science, just good common (rare) sense.
In these days of bottom-line focus, even the Chief Executive Officer has to justify the money he spends.
So, its hard for senior executives to prove the value of cultural reform.
It becomes a soft option but the results of letting its importance fade can be hard hitting. The fact is, you can't buy loyalty.
Money only gets "so much" commitment and fear about job security soon wears a thin and loses its impact.
If you rely on money and fear to drive performance, you will soon pay the high price of staff who are driven by extrinsic rewards.
If they are, business class travel, having the latest PC and biscuits in the lunchroom become the big issues that generate the most friction and take up the most "emotional time" (ET).
Organisations with extrinsically driven staff also incur the greatest real costs in turnover and performance.
The smart money is on the CEO who knows how much the bottom-line improves with staff who are 5 percent more loyal, 5 percent more committed, 5 percent happier, 5 percent more dedicated, 5 percent less stressed and 5 percent more motivated. The improvement is neither logarithmic nor geometric but it can certainly go beyond the 5 percent.
The time savings on dealing with problems alone can mean real money with the extra freedom that can be achieved. This means you can utilise your resources better, quicker and more profitably. The added benefit is that your staff become your best salespeople with attitudes, styles and approaches that can automatically win more business or achieve better results.
In these days of "word of mouth marketing" the words mouthed by your staff can be mightier than the mouth of your advertising campaign director.
Changing to an intrinsically driven culture is not an overnight phenomenon.
Senior managers might fear change claiming they already know this "touchy feelly" stuff. Staff may also fear the change if past experience has shown that the old hands don't walk the talk.
A clear strategy is needed for implementing change.
It must have a linking philosophy that is easily understood and can be converted into planning, action and performance appraisal.
It must also be bottom up, top down, lateral and a random spread.
But, most of all, it must have the support of the CEO.
Everyone down will mirror the CEO's actions and expostulations.The program IS : TO is one overall program you can use.
It utilises Alignment Plus (A+) methods for enlisting commitment rather than demanding support and can be built into the following steps:
· Identifying - the issues and the situation with qualitative and quantitative methods which also profile the organisational DNA (culture) and esteem;
· Strategising - which means having a game plan the follows a theme (e.g. A+);
· Tactics - the when and where of the real and practical things you will do such as mentoring, consoling, coaching and training to change the Organisational Kinematics; and
· Outcomes - measuring what has been achieved to provide clear feedback and recording changes in profitability and output as well as staff satisfaction and perceptions.If you take these steps, ET goes home and people get on with the job feeling fulfilled and rewarded by a sense of well-being as well as the pay packet.
..ends
The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles, and can be contacted directly by e-mail at kinematic@bigpond.com. Alternatively, the editor would be pleased to publish any responses directed to neilj@computachem.com.au .CORPORATE PHARMACY
NEIL JOHNSTON
FUTURE MODELS
Corporate Pharmacy is to become a reality in Australia.
At least, this is what is supposed to happen following the CoAG review of pharmacy.
The model initially proposed was to allow non-pharmacist ownership to a level of 49 percent of shareholding, but this was revised to pharmacist ownership only, with a couple of exceptions.
Those exceptions included allowing existing "grandfathered" corporate pharmacies and Friendly Society pharmacies to remain in non-pharmacist hands.
All other corporate pharmacies are to be controlled by pharmacists, but allow a minority shareholding be held by "prescribed relatives".
A statement was also made that minority shareholdings held by non-pharmacists (not being prescribed relatives), may compromise pharmacist control, and are not considered to be appropriate ownership structures for a pharmacy business
A working group of senior officials charged with reviewing and coordinating the final report on behalf of the states and territories, has admitted to certain reservations about pharmacist only ownership of pharmacies.The original review concluded that 'on-balance' pharmacist ownership of pharmacies provided a net public benefit to the community through improved professional conduct of pharmacy practice. The Review suggested that ongoing ownership privileges were dependent on continued industry participation in recent self-regulation activity, and the further development and adherence to professional standards and industry quality assurance benchmarks.
The working group have commented that the recommended ownership rules impose restrictions on competition and do not conclusively show that such restrictions are of net public benefit.
They also noted that the location rules have such a significant effect on the fabric of pharmacy, that it is difficult to remove ownership restrictions in isolation.
It was also noted that the CoAG recommendation on location rules was virtually ignored in the current Guild/Government agreement.
Despite this view, the working group voted to uphold the original recommendations on ownership, with the suggestion that this aspect be looked at again, once the remainder of reforms have been implemented.
It is also to be looked at in conjunction with the planned review of pharmacy location rules and places no obligation on the Australian Capital Territory and Northern Territory to amend their legislation.Interestingly, the working group considered that the introduction of a corporate model was a positive, but "relatively minor" step towards allowing more commercially realistic models to emerge. However, it wants CoAG to review the issue of non-pharmacist shareholdings, once other reforms are in place, and that this issue also be considered in conjunction with location rules.
A worrying aspect for pharmacy as a whole is that when ownership provisions come up for review, Friendly Societies may emerge as a major force. The working group has found no reasons to hold back expansion of Friendly Societies, based on their ability to provide a professional and competent pharmacy service.
This means that unless additional legislation occurs, this group of pharmacies will emerge without pharmacists being on the board of directors, or being able to exercise any degree of control.
Further, the tax advantages of Friendly Societies and the large cash flows derived from other non-pharmacy activities, is such that market domination may become a real threat.
If, after reaching a dominant market share, a Friendly Society may then choose to demutualise. Public companies with shares traded on the stock exchange could then emerge.
Against these resources, existing pharmacists may find it difficult to compete.In the field of medical practice corporations which have already gone down the road with non-doctor control and publicly floated shares, trouble is already emerging in paradise.
Some practice companies are pressuring doctors to provide excessive and unnecessary medical services, which would eventually cause a drain on Medicare resources.
In NSW, this has prompted legislation to be enacted under the Medical Practices Act, which will prohibit certain actions by non-doctor executives, that results in excessive treatment or costs.
Breaches will incur fines for a first offence of up to $44,000 and $88,000 for subsequent offences. Life bans will be imposed on those executives who re-offend within ten years.
Examples of overservicing and unprofessional conduct uncovered to date include the monitoring of sales to patients and taking doctors to task for failure to prescribe injectable medication to a set percentage of patients; failure to service a given number of patients within a set timeframe; hard-sell tactics in the area of cosmetic surgery, with bonuses paid to staff for securing patients.Considering the mindset of the people making recommendations to CoAG on the future directions for pharmacy, plus the behaviour of executives in corporate medical practices, pharmacists need to plan strategies now, to cope with what may occur post 2004, when the next review takes place.
There is little doubt in my mind that the following possibilities will occur:
* Location rules for pharmacies will disappear, as they are certainly a restraint on competition and there is little to support a process that is never in step with market forces. It is also one of the artificial activities that has contributed to the capital cost of purchasing a pharmacy.
* Friendly Society Pharmacies will be allowed unfettered growth, leading to the establishment of public company pharmacy.
What can pharmacists do to lobby more acceptable outcomes?
* Ensure any proposed legislation includes the provision for all corporate pharmacies to be "exempt" proprietary companies. This means that public companies, directly or indirectly, cannot have any ownership or control, even to the extent that a pharmacist director of a public company cannot retain a directorship in a corporate pharmacy structure.
* Ensure ownership provisions remain under pharmacist control. Although there is provision for "near-relatives" to own pharmacy shares, consideration should also be given for permanent non-pharmacy staff to own shares, as part of their remuneration package. This would represent incentive for staff to develop long term relationships. The shares would be sold back to the company on termination of employment.
* Although it is not clear under the CoAG recommendation "that ownership and control of community pharmacies continues to be confined to registered pharmacists", does this mean that the board of a community pharmacy corporate entity must be totally pharmacist, or can there be some non-pharmacist appointed directors, with pharmacists having the majority of voting power.
It may be considered advantageous if a non-pharmacist director could be appointed to a board, by virtue of having skills in the legal, accounting, investment, managerial, medical or allied health, or any other skill areas that could benefit the pharmacy company.
Recruitment of such directors would have to be from non-public company sources, if the company were to be "exempt".
* Ensure that Friendly Society pharmacies are created as wholly owned subsidiaries of their Societies, and that pharmacist directors be appointed to the board in a majority. This would overcome some of the problems that Friendly Societies have perceived, in that membership must vote all directors to their parent boards.
Wholly owned subsidiaries with all appointed directors would overcome this issue.
* Ensure that all non-pharmacist directors are bound under the respective Pharmacy Acts as for medical practice companies i.e. heavy fines and disbarment for life for any incitement to unprofessional conduct, or undue pressure placed on executive or practicing pharmacists.
* At all costs, pharmacists must resist any future attempts by CoAG to bestow ownership or control to any non-pharmacist area not in line with the above.
There is sentiment within CoAG to allow this to occur.
It is not right and should be fought vigorously.With acceptance of the above, it would be possible for a vital private corporate sector to emerge in pharmacy, which would offer job and investment opportunities for pharmacists at all levels of their career, being newly registered, newly retired, or somewhere in between.
It would reduce reliance on capital recruitment from industry areas, such as wholesalers, and would allow for the rapid and positive amalgamation of community pharmacy entities into viable and new practice models.There is a degree of urgency for the above to occur now.
We have warned of the possibility for major structural changes that may occur in wholesaling and the fact that Fauldings may be the focus of a takeover by global pharmacy manufacturer interests. We stress again that we believe this to be true but we are unable to confirm or validate any of the details.
We have also heard a rumour that Woolworths has had a look at Sigma.
For a long time, Woolworths has coveted pharmacy ownership and it would be a logical fit for Woolworths to have a pharmacy division, as do most of its global competitors, currently looking for entry into the Australian market.
And the global operators may have found it!
Franklins, Australia's third largest supermarket chain, has decided to sell out, after sustaining massive losses.
Known buyers lining up include Aldi, Wal-Mart, Bi-Lo, Woolworths, Tesco and the Dutch group Ahold.
They are all picking up valuable sites, which have been in extremely short supply, either to introduce their own brand, or to create an alliance with an Australian entity.
One of the main reasons that global food operators have not penetrated the Australian market has been the shortage of prime sites...and now they have them!
We believe some dramatic changes will now roll out into Australian retailing, and pharmacy will be caught up in the flow. E-Newsletter has been the only pharmacy news organisation reporting on these events, with all others seemingly oblivious to what is going on around them.
Eventually, one of the casualties of a pharmacy wholesaler takeover, could be the privileged method of funding new or expanding pharmacies.
To retain market share, pharmacy wholesalers have continuously funded community pharmacy via bank guarantees, and new, more aggressive corporate owners may see this contingent liability on a balance sheet as an unnecessary charge against their business.
This capital recruitment process is really due for review, because the virtual flow of unlimited funds, combined with NHS approval number restrictions, has created an artificially high value to be placed on community pharmacy practices.
This makes ownership, even for the well-endowed, more difficult to attain.
It also foreshadows that the bubble may burst immediately stress is placed on pharmacy ownership concurrently with the relaxation of location rules.
Anybody operating under a Trader's Bill of Sale coupled to a bank guarantee, may well be advised to have Plan B operational as soon as practicable.
Remember that if ownership provisions are relaxed, Australia could be flooded with overseas global interests, who would see the combined food and drug market as a very attractive entry proposition.
Australian politicians have already decided that we live in a global economy and that we should not prevent global domination of our markets.
Dick Smith, the well known Australian entrepreneur and the lone voice against this attitude, believes that globalisation is good if it is a 50 percent proposition i.e. only if Australia can own markets globally to the same extent that they are owned within our country.
This is the reason for his stand in the food industry, and because he is virtually alone, he could be wiped out if his global competitors decided to cut prices below cost, for an indefinite period.
We believe, like Dick Smith, that global domination of Australian markets is not a good thing for Australians.
The reality is that in a few years the Australian Pharmaceutical Industry ownership may be represented by a handful of pharmacists owning their own pharmacies in niche areas.
If you are in doubt, work out what percentage of drug manufacture is Australian owned, what percentage of drug wholesaling has the potential to remain in Australian hands, and what percentage of community pharmacy would remain Australian, if ownership provisions were to be relaxed.
For over 200 years, since the landing of the First Fleet, pharmacy has been in the hands of its qualified practitioners, and pharmacists can be justifiably proud of their achievements up to this new millennium.
There is no valid reason not to presume that pharmacy performance over this period has been nothing but excellent.
Politicians are assisting global enterprises to simply acquire the "farm" saying that globalisation is a good thing. This is not "evidence-based".
We, along with Dick Smith, disagree, and we promise that we will fight with whatever weapons we have, to keep Australian pharmacy in the hands of Australians.
..ends
The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles.RURAL AND REMOTE
A regular column devoted to Rural and Isolated Health Issues Roundup
(N.B.The photograph is taken from the Pinnacles, just outside of Broken Hill)
Define "remoteness"?
Have a look at the towns and the category they fall in the new remote classification for pharmacies.
It is at the following website:
http://www.gisca.adelaide.edu.au/pharm/PhARIA.htmlThis appears to have been devised for the new "rural allowances".
It differs a bit from the RRMA used for the Section 100 funding of Pharmaceutical Benefits Scheme for remote places.
For example, looking through the "A"s, Alice Springs, is a Category 3. Adaminaby is Category 5, way up in the mountains from Cooma and Tumut.
Ali-Curang is Category 6, but is a remote community out of Tennant Creek.
But Tennant Creek is not there.
A bit confusing….sounds okay to begin with, but the other confusions come when looking at the RRMA and access to free PBS through Section 100.
Alice Springs is after all a town of 30,000 people with five pharmacies and twice as many General Practitioners.
The Aboriginal health clinics in Alice Springs can get their Pharmaceutical Benefits Scheme free under Section 100 arrangements.
Will this be reviewed?
Where is the consistency?
Where is Tennant Creek?
Don't expect a quick answer though….still waiting for news on the use of Third Agreement money for Quality Use of Medicines in remote places!!
..ends
The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles. The editor would be pleased to publish any responses.THE NATIONAL RURAL HEALTH ALLIANCE
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