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21 Aug 2019

Transcript: AMA President, Dr Tony Bartone, Sky News, The Bolt Report with Chris Smith, Friday 16 August 2019

Subject: Pharmacy Guild proposals


CHRIS SMITH: Well, there's a classic demarcation dispute going on in this country at the moment between pharmacists and doctors. The pharmacists are pushing the Federal Government to make changes that would allow us to visit our local chemist instead of our GP for various medical issues. Pharmacy Guild Vice President, Anthony Tassone, said pharmacists should be allowed to give travel vaccinations and prescribe some medications and that it would help alleviate pressures on the rest of the medical system.

Now, the Australian Medical Association though is fiercely opposed to this idea. It says it's irresponsible and dangerous and it would actually put patients' lives at risk. I spoke to the President of the AMA, Dr Tony Bartone, earlier today.

Dr Bartone, to a lot of Australians, this sounds like a really convenient [audio skip] to get in and out with less cost. You don't have to book an appointment with a GP. It takes pressure off the system overall. But your GPs don't want a bar of it - why?

TONY BARTONE: So look, let's be very clear about what we're talking about here. We're talking about clinical care and clinical outcomes, and we know from all the research and all the studies that you get the best outcomes when you work in a collaborative team-based model with doctors and pharmacists working to their scope of training and of experience. So, clinical care from doctors - the history, diagnosis, examination and investigations and formulating a management plan and then, if that so requires, dispensing a script or authorising a script which then gets dispensed at the pharmacist with all the various skill in medication management and their expertise that they bring to [audio skip]. That's about clinical outcomes and ensuring quality care for our patients, which obviously is the number one priority.

Now, it's a bit of a furphy to say that access is an issue, they're time stressed and time poor and opportunities and lack of access to doctors. We know every day, 75 per cent of the Australian public can get in to see their GP within a day of seeking to make an appointment. We also know that each day, tens of thousands of appointments go unfilled at all doctors’ practices across the country. So, access- convenience is perhaps more- it shouldn't be equated with access and the convenience model is talking about - and let's be clear about this as well - that if we're looking for convenience as a substitute for access and quality, well then, it's patient [audio skip] …

CHRIS SMITH: [Talks over] Okay.

TONY BARTONE: …We need to be ensuring that their patient outcomes and quality care is number one in the job.

CHRIS SMITH: [Talks over] Okay. Correct me if I'm wrong, but in places like New Zealand and Canada, this system and a model based on the system that pharmacists are trying to get through here operates already. Am I right, firstly? And secondly, how has that worked?

TONY BARTONE: So, various places overseas have gone to this model, of course…

CHRIS SMITH: [Talks over] Yeah.

TONY BARTONE: …But they have been looking at solutions based on a lack of resources and a lack of opportunity. Now, what we really want to be so sure is why do we have to look at an alternative model if the system isn't broken and if the system is not about trying to replace quality care. [Indistinct]-

CHRIS SMITH: [Interrupts] Well, Tony, the system is broken in regional Australia. The system is broken because you don't have as many as bulk billed doctors in particular, and some of those regional areas could do with a backup system that they can use conveniently.

TONY BARTONE: So, at the end of the day, we've got to look at solutions to try and bridge that equation in rural and regional Australia where there may not [sic] be that access issue, but simply installing a pharmacist that is able to prescribe and dispense removes that overriding opportunity for access to care. Now, there are many other ways of trying to have still good clinical care by a medical professional without that immediacy, and we'd look at options like Telehealth and other things that really still allow the access to the continuity of care with a recognised doctor and the longevity that that brings to the equation. We can't throw out [audio skip] just purely because we're looking at a model of trying to increase convenience or trying to solve a problem by the making of other parts of the system not working.

CHRIS SMITH: So, this is not purely a case of self-interest from doctors?

TONY BARTONE: I [indistinct] be stronger in my opposition to such a claim. This is about ensuring that the Australian public still get access to the best clinical care available and that clinical care has to come from a trained medical professional that has at least as much as a dozen years or more in training both in examining patients, taking a history, formulating a diagnosis and instituting a management plan. That's not just something that was developed yesterday. This is based on many, many decades of research, of clinical studies and of long-held [audio skip] in our craft, in our profession. Looking at what is clearly a solution to competitive presses and competitive tensions in the pharmacy space as a reason to offer a second level of care to the Australian public is just not what it's about.

CHRIS SMITH: What do you mean by competitive tensions?

TONY BARTONE: Well, we know the retailing space in the pharmacy sector is under competitive tensions. There are many, many players and there are many other forces looking at everything from location rules as well as the decreasing margins that are [indistinct].

CHRIS SMITH: [Talks over] So you're suggesting this is a money making plan by the pharmacists to try and increase their margins.

TONY BARTONE: What I'm saying is this is clearly an attempt by a sector that is really under competitive threat from forces both within it and from without.

CHRIS SMITH: Okay. What about a partial system where someone's repeat scripts could be written by a pharmacist or you don't contend at all and wouldn't put up with the pharmacist writing a script at all?

TONY BARTONE: So we've got really good strong policy about the collaborative approach working with pharmacists in our practices as we speak. We know that when we're working together, we will deliver the best outcomes from our [indistinct]…

CHRIS SMITH: [Talks over] Okay. But that's a no, is it?

TONY BARTONE: …really, there are opportunities where we can work under, say, a model which allows increased access and increased availability under the supervision of a GP but with a pharmacist working in that practice as part of what we call a general practice pharmacist, which is clearly part of our position and clinically proven to work in all those places that you've mentioned, including many parts of [audio skip] and that's what the research has shown.

CHRIS SMITH: Okay. Tony Bartone, thank you so much for your time.

TONY BARTONE: My pleasure. Have a good night.


19 August 2019

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Published: 21 Aug 2019