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Speech to the 2015 Green Cross Health Conference

Hon Peter Dunne
Associate Minister of Health

Speech to the 2015 Green Cross Health Conference, Melbourne

Good afternoon, it is a pleasure for me to join you this afternoon for this year’s Green Cross Health 2015 Conference.

I would like to thank Green Cross Health for the opportunity to be here today.

It is a real pleasure to see so many pharmacists coming together with a genuine focus on the future.

I would like to take this opportunity to formally thank you and acknowledge you for your commitment and dedication to providing important health services in our communities.

Also, I would like to reiterate my commitment to supporting pharmacists to work more broadly within the wider health sector.

I have been asked to speak to you today about the Medicines Strategy, Medicines New Zealand, and to talk to you about the Government’s vision for the future role of pharmacy, which aligns well with this year’s conference theme.

“The future is yours” – is the theme for this year’s conference.

I am sure you would all agree that the role of pharmacy within the primary care sector is becoming increasingly important for delivery of health services with a more integrated model. Recently, like some of you, I attended the Pharmacy Awards 2015.

The Awards were a great success and provided many excellent examples of better use of pharmacists’ skills to positively impact on the delivery of healthcare services including improving patient experience, health outcomes, and medication safety.

I encourage all of you to embrace the theme ‘the future is yours’ and to actively seek opportunities to broaden your scope of work to enable you to make a greater contribution with the wider health sector.

Implementing Medicines New Zealand 2015 to 2020
Some of you will be aware that in June this year, the Medicines Strategy Action Plan – Implementing Medicines New Zealand, was launched.

Medicines play a significant role in helping New Zealanders to live longer, healthier, more independent lives. Despite the progress made in this area, significant challenges remain ahead.

We need to buy, use and manage medicines wisely. We must meet the needs of our ageing population and the increasing numbers of people with multiple chronic conditions.

We also need to do this more efficiently, through better coordination and within constrained resources. Achieving this will require everyone in the health sector to work differently. Integrated healthcare teams will increasingly have to focus on coordinating their efforts to provide consumer-centred services.

New Zealand needs pharmacists to be empowered and challenged to work to the top of their vocational scope. This will be achieved by collaboration between Government agencies, health professionals, service providers, responsible authorities and patient groups.

As is the case with any good team or system, it is only through working collaboratively and cooperatively that we will achieve the best health outcomes for New Zealanders.

The Medicines Strategy
The Medicines Strategy, Medicines New Zealand, provides the overarching framework to govern the regulation, procurement, management and use of medicines in New Zealand.

It describes the outcomes we want to achieve. We want New Zealanders to have access to safe, high-quality, effective medicines, and we want those medicines to be used in the best possible way.

The three core outcomes set out in the Strategy are:
• access to the medicines New Zealanders need, regardless of their individual ability to pay and within government funding provided
• quality medicines that are safe and effective, and
• optimal use of medicines, resulting in optimal health outcomes.

These outcomes were relevant in 2007 when we drafted the Strategy and its first action plan and they remain relevant now.

We have achieved a great deal since the release of that first action plan in 2007 and its successor in 2009. Those plans focused on action by the Government – both legislative and policy changes – and we have made solid progress.

Actions under those plans have provided the foundation of a functioning and capable medicines system. The 25 actions under the 2009 action plan have been completed.

For example, we have established the New Zealand Formulary, enhanced pharmacovigilance activity and there have been changes to who can prescribe medicines.

Challenges ahead
Despite progress we still have challenges ahead of us.

We are not yet achieving the Medicine Strategy outcomes every day and for all New Zealanders. We need to take a broad, forward-looking view of the role of medicines in the health system. We need to ensure that every opportunity is taken so that everything we do with medicines is better coordinated, is mutually reinforcing, and leads to meaningful improvements in health outcomes.

Above all, everything we do needs to be focused around consumers. In order to drive further meaningful change for patients it is important that health professionals, especially pharmacists, are engaged and committed to this work. To ensure this, I sought the help from different parts of the health sector to develop a refreshed plan.

Collaboratively we have identified a clear pathway for achieving the most from New Zealand's use of medicines.

This has enabled us to develop the Implementing Medicines New Zealand Action Plan.

The Plan supports the Strategy by helping enable the health system to move to a more integrated model of care. It does this through its focus on harnessing collective efforts and re-orienting the health sector towards consumer-centred activity. The Plan’s seven impact areas provide an agreed framework for activity across the health sector and require activity in a range of settings.

Each impact area has explicit objectives so that we are all clear about what needs to be achieved.

However, the Plan is flexible.

It allows us to keep focus on the impact areas, while allowing activity to evolve over time. Each impact area also describes some of the actions required to achieve those objectives.

There are two types of actions:

First, work that is already underway or activities that we know are already common and regarded as good practice across the health sector. The Plan brings this work together in a coordinated way and ensures we are all clear about the objectives it contributes towards.

And then, with the help of the sector, we have also identified a second type of action.

These are new and aspirational actions that may evolve over the next five years. They are often based on developing innovative practice that already exists in pockets.

The Plan challenges organisations across the health sector to consider how they can build these actions, or others like them, into future work programmes.

Health professionals, particularly community pharmacists, are the public face of the medicines system and are crucial to implementing the Plan and achieving the outcomes of the Strategy. In particular, we have identified great opportunities for enhancing the role of pharmacists – something I have long been an advocate of and a reason why I was pleased to learn that the theme of this year’s Green Cross Health Conference is ‘the future is yours’.

Pharmacists are often the first point of contact for people seeking health care or advice.

They can work collaboratively with other health professionals to ensure the right people receive the right services at the right time. Changing the interaction a person has with a pharmacist could therefore have a large impact on the health outcomes of New Zealanders.

As an example, the sale of pharmacist-only medicines has enabled consumers to have more timely access to medicines for the treatment of a number of common conditions and I support the ongoing reclassification of appropriate medicines through to pharmacist-only category.

I therefore challenge you today, to build on the innovative practice already underway across the sector, to consider how you can help to deliver on the actions in this Plan, and to work with your colleagues across the health sector to share your vision.

The Government also has an important role to play.

While these efforts continue across the sector there are other critical projects that will help ensure that health professionals have the leadership and guidance that they need to support their work. One of the most important upcoming changes is the new regulatory regime for therapeutic products.

This new regime will replace the existing Medicines Act. It will ensure that the regulation of therapeutic products is fit for purpose not just in 2015, but for the next 30 years. It will need to be robust but also flexible enough to enable the innovation that we know will happen, and needs to happen, over time.

As well as modernising the regulatory arrangements for medicines, the new regime will also encompass all therapeutic products. For the first time it will include medical devices. Cell and tissue therapies will be included, which currently are not adequately regulated in New Zealand.

A robust regulatory regime is a prerequisite to high-quality health care services that are safe and effective.

In order to achieve a robust regulatory regime we will need input from you, our practitioners, regulators and experts. I encourage you to look to the outcomes we want to achieve, and to tell us what a true future-focused regulatory system would look like.

A key question is how can we achieve the optimal balance between the need for safe and trusted systems, and the need to ensure flexible, efficient and affordable access to the most appropriate therapeutic products?

The Pharmacy Action Plan
Also helping us to look towards the future is the work currently being led by the Pharmacy Steering Group.

They are working closely with the Ministry of Health to develop an action plan for pharmacy that is consistent with the Governments vision for pharmacy.

The Action Plan sets a vision for the sector over the next three to five years.

It articulates how the capacity and capability of the pharmacy workforce can be most effectively used to deliver quality, accessible and cost-effective healthcare services as part of an integrated health system that supports all New Zealanders to live longer, healthier, more independent lives.
The Action Plan:
• defines how the pharmacy sector can work in partnership with other health professionals

• identifies actions that will contribute to a better use of the pharmacy workforce delivering pharmacy services as part of a highly functioning, patient centred, fully integrated health team

• increases the emphasis on pharmacy services being provided more flexibly, in the context of the continuum of care, and new models of care.

The Pharmacy Action Plan is being developed concurrently with the refresh of the New Zealand Health Strategy, Implementing Medicines New Zealand and the review of the Therapeutic Products Regulatory Regime.

The Plan includes a series of draft actions that articulate how pharmacy can contribute as collaborative partners in an integrated health system and improve health outcomes for all New Zealanders. A strength of the Plan is that it will assist the pharmacy sector to take ownership for driving innovative change.

Further work is being undertaken within the Ministry on prioritising the actions, ensuring alignment with strategic priorities and scoping the requirements of the Plan. A targeted external consultation approach with key stakeholders, including consumer representatives, will take place prior to the launch of the Plan.

We have made solid progress towards utilising pharmacist skills better and we are on the right path. The Medicines New Zealand Strategy and the development of the Pharmacy Action Plan will support innovation and help the sector move towards better integrated, consumer-centred care but the Government cannot do this by itself.

New Zealand has a large number of expert and dedicated health professionals who are in the best position to deliver change. If we want to make progress, we need you to drive change.

I thank you for your commitment, your ongoing dedication to improving the health outcomes for all New Zealanders and, for inviting me to speak with you today.


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