Remote Pharmacist WA – A conversation between myself and the Pharmacy Guild President

In January 2015 the president of the Pharmacy Guild George Tambassis and his PR man Greg Turnbull came onto the lands to spend 5 days with me on the lands. George and I have known each other since uni (in the same prac. group) but had not seen each other since we graduated. We caught up for the first time in nearly 30 years at an international pharmacy conference in September 2014.

The first few hours were spent in Alice Springs where the now previous CEO tried to tell him I was acting out of scope of practice for reviewing medications on the discharge summary of our patients from hospital and advising the doctor of any problems (actually best practice). This set the tone for 2015.

George and Greg travelled out the hard way in a troopie with me for 924km from Alice Springs in the January heat and spent nearly a week with me.

On their last day on the lands Greg filmed George and I having a conversation. Yes, it is a year old but the discussion is still relevant.

Kungkaku Yungupalaku Healthy Relationships Project – a Improving Sexual Health in Aboriginal and Torres Strait Islander Youth Demonstration Project

These stories were developed and mostly filmed, animated by young people in Warburton and Warakurna. They have identified ways of health seeking, appropriate services, supporting each other, problem solving and identity through these stories. Young people really engaged and enjoyed the workshops and processes involved in the development and provided fantastic learning opportunities around problem solving.

Lost Zac from Ngaanyatjarra Health on Vimeo.

Kungkaku Yangapalaku from Ngaanyatjarra Health on Vimeo.

Carlston’s Love Song from Ngaanyatjarra Health on Vimeo.

Kulila Kangyima from Ngaanyatjarra Health on Vimeo.

Medicines Australia and the Western Desert Dialysis Truck

The Purple House’s (Western Desert Nganampa Walytja Palyantjaku Tjutaku) dialysis truck has been a long time coming. But the wait is worth it.

Cross border issues with funding and the locations to where patients in the tri-state (WA/SA/NT) area have to move for dialysis means members of remote communities can be a long way from home.

This dialysis truck can move to any central Australian Aboriginal community to allow some dialysis patients from the Northern Territory, Western Australia and South Australia to return home to country and spend time with family.

Despite the benefits this truck will bring I am a little annoyed by how the funding for this truck is portrayed.

There was no government money involved but that didn’t stop the politicians coming out for the handover of the vehicle to this Indigenous owned and controlled dialysis service.

But that isn’t what annoys me.

The money came from the pharmaceutical industry group Medicines Australia. And here is where it starts to annoy me.

Western desert dialysis truck

In all the reports including ABC TV news, Medicines Australia press release and even this article by the head of the WDNWPT applaud the generosity of the industry in donating the money for this $340,000 dialysis truck.

The reality is that it isn’t a donation where members have said “oh this is a good idea – lets chip in to help”. It is funded by the collection of fines from when Medicines Australia members (drug companies) break their own guidelines when spruiking their drugs.

If drug companies are thought to have breached the Code of Conduct they are asked to front the monitoring committee where if found guilty are fined what I consider to be peanuts for a large multinational company. The fines in 2010-2011 (see pages 11-12), totalled $160,000.

So drug companies continually breach their code of conduct, pay a fine which their industry body collects and then “donates” making the industry appear wonderful.

As Jarrad Hall commented on Twitter

I wonder if we little people can do that. I feel like donating to charity, I might go speeding later

I’d prefer some openness and honesty in saying where the money comes from.

But should Medicines Australia be allowed to hang on to these fines at all?

Two Meetings Highlight Disparity in eHealth in Remote Australia

Meeting 1. E-Health Conference, Revolutionising Australia’s Health Care

An invitation only two day seminar on e-Health was held in Melbourne on November 30 and December 1st. Apparently a “draft concept” of the shared e-health record concept was shown. It seems like there is $55 million splashing about for projects based on the personally controlled e-health record (more about money later on).

The Minister for Health and Ageing, Nicola Roxon gave the opening address. Here is part of what she had to say.

Part of our job in embracing this change and exploring further opportunities is to explain to the wider public the benefits of this big step into the future.
Let’s consider some of the situations that face clinicians and patients today.

Take the case of a young mother whose two children suffer from asthma.

The children might have tried many asthma drugs on and off, and keeping track of what each child has tried is challenging – for parents, for doctors, for hospitals.
Or consider the case of a Melbournian retiree escaping to Darwin for a holiday, becoming sick and being raced to hospital by ambulance.

He arrives without his current tablets and is not in a condition to talk about his medical history. What does the ED team need to know to make the treatment effective?

Or let’s think about a carer’s perspective for a moment. Hundreds of thousands of Australians care for a loved one, many of whom can’t participate in their own care which might involve a GP, then local pharmacist, the district nurse, specialists and the local hospital.

There’s a constant worry that the wrong medication might be taken at the wrong time. These fears are well grounded – medication errors currently account for 190,000 admissions to hospitals each year (my italics).

And take the case of the hundreds of thousands of Australians with chronic disease. Many of whom want to better manage their diseases, but lack the connection over their information that can make this happen.

These scenarios reflect the kinds of real-life situations that occur all around Australia every day.

national electgronic health transition authority

Let me digress a bit here. It does have something to do with the second meeting.

Pharmacists reviewing medication histories and more pharmacists in wards in hospitals reduce error rates. And an electronic patient record should reduce them even further.

Aboriginal Community Controlled Health Organisations (ACCHO) are where Aboriginal Australians wish to receive their healthcare. There are five pharmacists I know of that work full time for an ACCHO.

Meeting 2. 28th June 2010 No title, attended by stake holders in remote Indigenous Health

This meeting was called after a presentation and some networking at the National Medicines Symposium. It was to discuss the lack of dispensing software, tools and training for remote area S100 ACCHOs and other Aboriginal Health Services.

  • Dispensing is usually done by Aboriginal Health Workers, Doctors and Remote Area Nurses who in the main have have no specific training for this task and may under-appreciate its importance in Quality Use of Medicines. In some states this may be illegal
  • Dispensing systems either stand alone or incorporated into electronic patient management systems for tasks such as labelling, recording of supplied medication and stock control are for the most part primitive or non-existent. Indeed in many cases medicines are dispensed with handwritten, incomplete, or no labels at all.
  • Yes, that’s right. We are spending millions on eHealth but in remote Australia we still can’t print a legible label for a patient’s medication. Does it surprise anyone that there seems to be no money to rectify this lack of not only dispensing, but no pharmacist involvement?

    Is it too far a stretch to think we are building a whizz bang house, but out bush it is on very poor foundations?

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