Good morning, to Kos Sclavos (APP chairman), George Tambassis (National President, Pharmacy Guild of Australia), Pharmacists, Pharmacy professionals, ladies and gentlemen.
This is my first Australian Pharmacy Professional Conference and I am very pleased to be here, and very impressed.
It’s a huge event and it reflects the importance of pharmacy in today’s health sector – spanning both the business and clinical aspects of pharmacy.
People outside the pharmacy sector probably don’t understand how much pharmacists do to help people with their health and the depth of health knowledge that you acquire.
Just a glance at the agenda for this conference is illuminating – from the special needs of organ transplant recipients to the use of micronutrients to improve mood and cognitive functions.
I do feel a strong connection to your profession.
My grandmother was a pharmacist – and one of the first women to take up pharmacy in Victoria when it was becoming established as a discipline in the 1930s.
In addition, my mother was a nurse – at what is still my local hospital in Frankston in Melbourne’s south. And my wife is a surgical nurse.
So I have a deep appreciation for health care workers and pharmacists.
Community pharmacy is the very origin and heritage of where I came from.
I know from those connections, and also as a Dad and as a patient myself, that pharmacists are often the first port of call for people with health concerns.
You are tremendously accessible and I know that there are many circumstances where pharmacists provide vital advice.
It doesn’t matter how old or young you are, chances are you will regularly need something from one of the 30,000 pharmacists across Australia.
1. Broad vision for Health
1.1 Creating the world’s best health system
I was honoured to be appointed as Minister for Health in January.
I want every Australian to know that they and their families have access to the best quality health care when they need it.
Because after all, our health is our greatest and most important asset.
I said at my first press conference in this role, and I say it again today, that my vision and the Government’s vision is to ensure that Australia has the best health care system in the world.
We are already have an outstanding health system. But it can be even better.
That vision involves an expanded health care role for pharmacists – to use your skills, your knowledge and your essential place in every community.
To work even more closely with the other health and medical professions – doctors, nurses and other allied health professionals – as the focus shifts to the patient and what they need from their health care team.
Pharmacists are essentially experts in medicines.
But pharmacists working in our 5,500 community pharmacies across Australia work well outside that mould.
You’re not just the source of prescription medicines, complementary medicines and other health products.
Your role in our health system is more significant than it has ever been, and it is set to expand further.
Since the first Community Pharmacy Agreement was made 27 years ago, the Commonwealth and the Pharmacy Guild have worked together to steadily expand the range, scope and locations of the services that the Government pays pharmacists to provide.
Successive Community Pharmacy Agreements have provided payment for medication reviews and patient education about medications.
1.2 Pharmacists in primary health care
Pharmacists are also moving beyond the dispensary, taking services like medication reviews into patients’ homes and aged care facilities.
Now we’re confirming this trend – and establishing the pharmacist as part of the health care team, together with GPs, Aboriginal health workers, nurses, dietitians, physiotherapists and others.
Chronic disease is a huge issue for 21st century health, here and overseas.
One in two Australians now has a chronic health condition and one in five has two or more.
They have multiple care needs that are not well served by the traditional fee for service GP model.
This is why the Government is introducing new structures. Primary Health Networks and Health Care Homes will create a coordinated, team based approach for these patients.
Pharmacists can play a central role in these new care models, providing services in health promotion, chronic disease prevention, risk assessment and early intervention, ongoing treatment and broader patient management.
It is about providing the right care in the right place at the right time.
In this way, you can help people to delay or avoid complications from their chronic disease. That helps them to avoid a hospital admission, and that has the added benefit of reducing the cost to the health system.
This role for the pharmacist in health care can be especially important in areas outside the major cities, where communities may not have easy access to medical services.
These options are being explored right now through the Pharmacy Trial Program which is trialling services proposed by pharmacists, for delivery through community pharmacies.
That’s exciting for you as pharmacy professionals.
It’s exciting for all of us, as a way to provide better health care and better health outcomes, through simple interventions instead of high-tech and high cost medicine.
2. Long Term National Health Plan
Let me look now at the big picture.
From a Government perspective, helping Australians to better health is at the absolute core of my responsibilities.
I’ve been in the role for less than two months, but I signalled early on that I want to develop a Long Term National Health Plan.
It is made up of four key pillars:
One – a rock solid commitment to Medicare and the Pharmaceutical Benefits Scheme – an absolutely rock solid support.
Two – support for the long-term hospital system, we believe in the public hospital system deeply, we believe in the balance with the private hospital and private health insurance system as well.
Three – for the first time ever mental health and preventive health will be one of the pillars of our long-term national health plan.
And four – medical research to give us the treatment, not just in the physical health space, but also the mental health space that will allow us to go forward.
2.1 Strengthening Medicare and universal healthcare
First off, in this portfolio I’ve made it absolutely clear from the outset that the Turnbull Government has a rock solid commitment to Medicare and the Pharmaceutical Benefits Scheme.
Timely and affordable access to health care is a fundamental right for all Australians.
Funding for Medicare is increasing by around $1 billion every year and in fact, new figures released last month show Medicare is stronger than ever.
Australian patients are getting more benefit from Medicare than ever before with GP bulk billing rates jumping to 85.4 per cent during the second half of 2016 – up from 84.7 per cent for the same period in 2015.
This means that more Australians are visiting the doctor without having to reach for the wallet.
And funding for the PBS is growing significantly. Since coming to Government we’ve added $4.9 billion of new PBS listings.
You know as well as anyone, that universal access to medical services and medicines through Medicare and the Pharmaceutical Benefits Scheme is something that Australians hold dear.
2.2 Supporting our hospitals
Like Medicare, Commonwealth funding for hospitals is increasing every year.
The Turnbull Government is providing an additional $2.9 billion to public hospitals over the next three years (2017-18 to 2019-20) under a new funding agreement signed onto by all State and Territories (COAG National Health Reform Funding Agreement, April 2016).
Over 6 years our support for public hospital funding is forecast to grow from $13.8 billion in 2013-14 to $21.2 billion in 2019-20 (7.43% per annum).
This represents an increase of $7.4 billion by the Commonwealth Government since coming to government – or more than 50 per cent.
This means more doctors and nurses, more hospital treatments for Australians and greater patient quality and safety, particularly those with chronic conditions.
2.3 Prioritising mental health and preventative health
The third pillar is prioritising mental health and preventive health.
Mental health is a deep personal passion.
Almost four million people in Australia will experience a mental illness in any one year – the emotional toll on suffers and their families is immense.
Last year the Australian Government’s spent over $4.2 billion on mental health from the health portfolio alone – my task is to ensure that this spending actually delivers what people need, when and where they need it.
Over the next two years I will work to develop more unified partnerships and system and more frontline youth and mental health workers.
And I want to get Australians active. We know that increasing participation in sport and recreation for all ages has significant health benefits – both mental and physical.
2.4 Medical research
And finally, the fourth key pillar is medical research.
I don’t need to tell you about the importance of ongoing research. In many ways you deal with the dividends of medical research every day – whether it be new drugs for ovarian cancer, new drugs for lung cancer or new drugs for cystic fibrosis.
Last month we announced $125 million in new grants to help Australia’s world-leading medical researchers and scientists with their work towards making the next major medical breakthrough.
I want Australia to be a world leader in medical research and precision medicine – with a thriving biotech sector. Supporting this we have the $20 billion Medical Research Future Fund, the $500 million Biomedical Translation Fund and $800 million each year through the National Health and Medical Research Council grants.
Hopefully you’ll be dispensing some of their medical breakthroughs in the not too distant future.
3. Pharmacy plan
3.1 Ongoing funding for pharmacy programs
I’ll turn now to your industry – and the issues that matter most to your profession.
I am very pleased to announce today that the Government is negotiating with the Pharmacy Guild to reach agreement on the development of new and expanded community pharmacy programs.
The 6CPA included a total of $1.26 billion for evidenced based, patient focussed professional pharmacy programs and services.
$600 million of that was allocated for funding of new and expanded programs as per clause 6 of the 6th Community Pharmacy Agreement.
I am confident that the $600 million will be made available in the near future, subject to the successful completion of these negotiations.
New and expanded programs will build on the positive aspects of current programs, be better targeted and better meet the health needs of the community. Programs would also include collection of robust data and evidence so that their benefits can be properly measured.
These programs will offer new opportunities for community pharmacies to deliver patient focussed health care services and enable community pharmacists to be integrated into the Health Care Home model by providing access to quality personalised medication support for patients with chronic and complex care needs.
This is a trend which is good for Australians’ health, and good for the pharmacy profession.
Pharmacists’ role in advising consumers about evidence based medicines information also gives you an important role in supporting a sustainable PBS.
We all have a shared responsibility for the stewardship of the Scheme.
As you know, biosimilar drugs are part of the next generation of precision medicines.
Biosimilar listings on the PBS are expected to deliver significant savings – freeing up money for use in other areas of the Australian health system.
They can also expand treatment options by offering more affordable medicines, and reduce the risk of shortages.
But uptake of biosimilar medicines depends on education to increase consumers’ awareness and confidence in them.
The Government’s Biosimilar Awareness Initiative is an example of positive collaboration with key pharmacy stakeholders – including the Guild, the Pharmaceutical Society of Australia and Society of Hospital Pharmacists of Australia.
As part of this Initiative, the Department of Health has developed tailored brochures and FAQs following an extensive review process with the stakeholder reference group and independent focus groups.
Launch of these materials will occur shortly.
In addition, the Pharmaceutical Society of Australia has agreed to incorporate accredited biosimilar medicines education as part of rolling out the revised Professional Practice Standards and Code of Ethics, which can be accessed by all pharmacists and go towards their continuing professional development requirements.
Pharmacists have an important role to play here.
I will soon be formally announcing the first biosimilar brand available on the PBS through community pharmacies, rather than hospital use.
Due to the level of trust pharmacists have in their communities, pharmacists are ideally placed to support the appropriate uptake of biosimilars in Australia.
3.3 Diabetes and other pharmacy trials
The first trial is on screening for diabetes in pharmacies.
Type 2 diabetes has become a very common disease for Australians, even though it is almost entirely preventable.
It currently affects around 1 million Australians and that number could soar as we struggle with obesity and an ageing population.
And of course it’s a particular worry for Indigenous Australians.
The pharmacy diabetes screening and referral trial, managed by the Pharmacy Guild, involves more than 350 pharmacies across the country.
The screening process includes a risk assessment questionnaire, to determine if someone could develop diabetes within the next five years. It may also include testing a drop of a person’s blood for diabetes-related health indicators.
Based on the outcome of these checks, the person will then be referred to their doctor for follow-up.
This screening has already started and I have been advised that the first patient to be identified as at risk of diabetes has been referred to a GP and had that diagnosis confirmed.
This is a significant achievement and represents an excellent example of how pharmacists can apply new and innovative care models to contribute to a stronger primary care system.
In total, around 30,000 participants will be screened as part of this trial.
From this trial we are likely to see a large number of patients receiving earlier treatment for their Type II diabetes than would otherwise be the case – all due to the expertise and intervention of their pharmacist.
The next stage of the Pharmacy Trial Program is examining trials in the following areas:
• community pharmacist outreach to residential aged care facilities;
• medicines management and reconciliation, especially looking at patients moving between care sectors;
• pharmacy as part of shared, collaborative primary health care management of appropriate conditions;
• and, screening and referral by pharmacists for cardiovascular risk.
The direction is clear. It’s about pharmacists using their training and skills to bring preventive health services closer to communities.
Making it easier for people to get early diagnosis and early intervention to reduce the severity of illness.
It’s about encouraging and assisting people to manage their own health, people who would not otherwise be able to do this.
There is a lot of scope for pharmacists to pick up preventive health services in areas where doctors are in short supply, and help these Australians to better health.
A prime example is the support pharmacists provide in remote communities through the Remote Area Aboriginal Health Service (RAAHS) arrangements to help chronic patient’s access medicines.
The Prime Minister announced at the Pharmacy Guild dinner that from 1 January 2017 these scripts will now receive the full dispensing fee to recognise the expertise and value that pharmacists provide in these communities.
I am pleased to advise that the interim arrangement for these payments commenced on 1 January 2017 and are working well while longer term arrangements are being finalised.
As the Prime Minster said, this is an important step that will help our dedicated pharmacists working in remote areas to address the barriers that Aboriginal and Torres Strait Islander people face in accessing medicines.
3.4 Pharmacy Remuneration and risk share
Another issue that has also been raised rigorously and effectively by George Tambassis and David Quilty is overall pharmacy remuneration and the risk share.
Let me say very clearly – I hear the points. I hear every point and understand the importance.
There is more work to be done, but along with the importance of location rules, I understand the absolute importance of both these issues.
You could not have more effective advocates in George and David, nor a more engaged partner with myself.
We will continue to work on steps forward – and I am confident of finding a positive outcome on location rules and risk share which will strengthen community pharmacy.
One issue of which I am particularly aware is the perverse outcome of rent hostage and its impact on the viability of pharmacies.
The Government is committed to ensuring that the community pharmacy sector remains viable and able to meet consumers’ needs.
The review has allowed a very valuable and open public discussion about the role of pharmacies in Australia’s health system.
I intend to continue this consultative approach to change and improvement in all areas of health.
I greatly admire the health professionals who are the backbone of Australia’s health system – doctors, nurses and pharmacists.
I believe the route to good policy is to listen to the real experiences of you and your customers.
My vision for our health system is one where all sections of health work together to get the best results.
Not just in the cities – but rather in all communities and all regions.
This is a time of historic change in the role of the pharmacy professional.
Your future is very much part of the future of Australia’s health care system and I really look forward to working with you as we turn the vision into reality.