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New Zealand Pharmacy Forum Panel Discussion Speech

Hon Annette King
22 April 2001 Speech Notes

Noon, Sunday, April 22
New Zealand Pharmacy Forum panel discussion

Noon, Sunday, April 22

Thank you Bernie for your invitation to speak today and thank you Kim for chairing the discussion today

I would like to welcome you all here as I know many of you have taken time out of your busy schedules to participate in this event. Linda, thank you for your presentation on the initial findings of National Pharmacy Intervention Day and I am looking forward to joining Joan, Graeme and Ben as part of the panel discussion.

This is my second visit to Dunedin this week, so I can nearly claim to be a local. To start I would like to acknowledge the daily effort and contribution you make to the health sector. Pharmacy and pharmaceutical services are a critical part of our health service.

I know many of you are asking yourselves why you have given up lying in bed this Sunday morning. I know I was questioning this as the alarm went off at 6am.

The reason I am here is because I wanted to take up this chance to say I need your help. The Government wants to reduce inequalities between groups, and to deliver improved health services.

We can not do that by lying in bed, of course. In fact, given that Kim is chairing this discussion, I should put it on record that you cannot achieve anything by lying at all, even tiny little white lies.

Seriously, however, I cannot do my bit to provide better health services without the help of health professionals like you.

As you know, we have made changes to the health structures. We needed to change from a commercially driven health sector, to one with a strategic focus. That focus is clearly outlined in the New Zealand Health Strategy.

The NZHS provides the umbrella under which other strategies will operate. One of the most critical of these is the Primary Health Care Strategy, which I released in February this year. This strategy will directly impact on your work and the services you provide.

The Primary Health Care Strategy involves a new direction for primary care, with a greater emphasis on prevention, focus on population health, health education and promotion, and community partnership. This government believes that improved primary care services are integral to driving future health gain.

I believe there are some very positive opportunities presented by the Primary Health Care Strategy for pharmacy. We want primary care to move from a GP dominated sector, to one based on teamwork and a population focus – the right professional at the right time is the goal.

The key organisations through which primary care services will be delivered will be Primary Health Organisations (PHOs). PHOs will be formed as non-for-profit bodies to look after primary health care needs of a defined population. PHOs will involve different health practitioners and local communities will have a say in their governance, to ensure local views and priorities are taken into account.

So who will be involved in PHOs?

I need to make it absolutely clear that Primary Health Organisations are not IPAs with new letterhead. They will include general practitioners, nurses and others who will network together in PHOs covering a population of people who have enrolled with them.

PHOs will have service agreements with DHBs under which they will be funded for the provision of an essential set of primary health care services to that population. This is likely to include budgets for pharmacy services. There are no plans for them to hold budgets for secondary services.

In addition, in the medium term, District Health Boards are likely to contract for packages of services for particular patient groups. Many of these packages of services are likely to include a pharmacy component; for example, management of the health needs of diabetics is likely to include pharmacy services.

Like every other aspect of health, pharmacy is changing and we want to help in developing the new face of the profession.

The profession of pharmacy has the potential to contribute to improved medicines use through a range of new pharmacy services, such as pharmaceutical review. The Government wishes to ensure that pharmacy contracts and the regulatory framework around pharmacy practice facilitate the development of these new services.

Moving into this new era the Government has been keen to work with pharmacy to discuss, examine and find solutions to problems. The Ministry of Health’s Pharmacy Forums are designed to bring all the interested parties together to discuss how best to move the sector forward.

I realise that some issues are heated, and I know that there will not always be agreement, but I believe that by working together we are more likely to reach workable solutions to our problems and challenges. What I want to hear from is pharmacy as a whole, and the forum is the best place for that to start.

It is this same philosophy of working in cooperation that underpins the changes in primary care. As Primary Health Organisations will be required to offer a range of services, it is expected that they will be multi-disciplinary organisations.

In relation to pharmacy, there is a range of options that PHOs can take up, including having pharmacists as members, sub-contracting pharmacy, and employing pharmacists for services like pharmaceutical review and medicines management for patients with chronic conditions.

The Government is not dictating what happens. The Primary Health Care Strategy does not specify just one model, as one size does not fit all. Instead the is emphasis on developing workable models of teamwork and recognising the complementary skills of others, as well as a willingness to share power in order to achieve group goals.

In other words, it is up to health professionals to develop the working relationships. The Government and DHBs want to work with people who are working together.

To achieve this we need to be clear about each other’s roles and responsibilities. We will strengthen professional regulations, as they are there to protect the public and professional integrity

Recently you will have all witnessed the Gisborne Inquiry, the Cull report, and mounting public and media interest in professional accountability. The public rightly expects Government and health professionals to be accountable for their actions. Their confidence in the systems has been eroded, and it is in all our interests to restore that confidence.

The Health Professionals Competency Assurance Bill will update Acts such as your own Pharmacy Act dating back to 1947, and will reform all health occupational regulation statutes. The current regulation statutes are considered to be inflexible and prescriptive.

New Zealand is not alone here; every country is tackling the issues of safety and quality in health. We must move away from a name, blame and shame culture, and instead focus on developing systems which encourage sharing of information, and learning from best practice.

Finally, we can only talk about quality and safety if we have a trained workforce to deliver the service. The health sector’s ability to recruit and train competent staff is very important to the government. I have established the Health Workforce Advisory Committee which will be the body responsible for recommending strategies for the future development of a health workforce.

The Government is determined to provide the leadership that is needed in health. This Government wants to work with pharmacy and I want to use this panel discussion today to share ideas on how we can do things better.

I wish you well for the rest of your time here in Dunedin and thank you again for inviting me to be part of this panel discussion.


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