Draft pharmacy ownership laws bad for consumers

AMA Queensland has urged a parliamentary inquiry to recommend against proposed pharmacy business ownership laws that would make it harder for new owners to enter the market and establish a new regulatory body made up of pharmacists.

The Productivity Commission, the Queensland Aboriginal and Islander Health Council (QAIHC) and the RACGP have also expressed serious concerns about the Pharmacy Business Ownership Bill 2023, which was negotiated secretly from October 2022 to March 2023.

The bill would entrench existing ownership protections, create a taxpayer-funded regulatory body to oversee the protections, and restrict opportunities to develop Aboriginal community-controlled pharmacy arrangements.

AMA Queensland CEO Dr Brett Dale warned of the potential impacts on First Nations communities if Aboriginal community-controlled health organisations (ACCHOs) were banned from running pharmacies.

“To be frank, it is outrageous that the bill shows disregard for the National Agreement on Closing the Gap and potentially will undermine the provisions for culturally safe services for First Nations communities,” Dr Dale said.

Allowing ACCHOs to own on-site pharmacies would provide culturally safe and appropriate care, improve compliance with medication and accessibility and lead to better health outcomes, he said.

“If you give a patient a script and they need to go elsewhere, the risk of commencement of that treatment is quite large. It is really important that it is available at the point of care. It is most culturally appropriate that it is owned by the community-controlled sector that will not be driven by profit. They will be driven by a team-based approach,” Dr Dale said.

QAIHC deputy chief executive David Harmer called for the bill to be amended to expressly exempt Aboriginal and Torres Strait Islander community-controlled services from the ownership requirements.

Without culturally safe service provision, Indigenous people tend not to comply with the instructions related to the use of medicines and, as a consequence, do not use medicines appropriately or at all, he said.

“This results in a significant underspend on the use of safe medicines for Aboriginal and Islander people. In fact, it is estimated that for every $1 spent on other Australians. just 30 cents is spent on Aboriginal and Islander people,” Mr Harmer said.

“Aboriginal and Islander people in Queensland are not getting access to medicines that they would have if they were supported to do so through appropriate arrangements in pharmacy legislation.

“Existing pharmacy arrangements in Queensland restrict these options and need to be changed.”

The Productivity Commission savaged the bill. Commissioner Dr Steven King said there was no evidence the changes were needed, and the new regulatory body would inevitably lead to higher prices for patients.

“There is both no evidence of a problem, and no evidence that if there were a problem, the solution proposed by the bill would fix it,” Dr King told the inquiry.

Establishing the Queensland Pharmacy Business Ownership Council would cost approximately $9.8 million, with ongoing operations to be funded through fees imposed on Queensland pharmacies.

“These fees will inevitably increase the cost of operating a community pharmacy in Queensland and will inevitably be, partially at least, passed through to consumers,” Dr King said.

Lawmakers would be better off implementing recommendations of many previous reviews to regulate product placement in pharmacies and ban the sale of homeopathic products by community pharmacies, he said.

“I think the problem with ownership rules in pharmacy is best characterised by saying that they create a necessary paradox for our allied health system,” Dr King said.

“Either pharmacists are fundamentally different to GPs, psychologists, physiotherapists and so on in that they are so untrustworthy that they must have these ownership rules to ensure their professional integrity, or the situation is that the pharmacy ownership rules create professional conduct in pharmacy that is lacking in other allied health professions around Australia.

“I have seen no evidence whatsoever that other parts of the Australian allied health professions — including GPs, psychologists, physiotherapists and others — act in anything other than the most professional way in the interests of their clients, regardless of the fact that they do not have those ownership rules.

“So I have to ask myself: what is it that is unique about pharmacy or pharmacists that means there is a view that they have to have this additional control?”

But the chair of the Interim Pharmacy Roundtable, an advisory body of pharmacists set up to assist the development of the new laws, defended the need for continued regulation of the pharmacy sector and accused AMA Queensland and the RACGP of “an hysterical argument”.

“It seems sour grapes to say that the last-standing regulated profession should ‘join the rest of us’,” pharmacist Fiona Watson said.

The committee is due to report on 8 March.