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Implementation of Commonwealth Pharmaceutical Restructuring Measures

May 1992

ISBN 0 642 17524 1

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View the report as a single document - (PDF format) - 4 579 KB

View the report as separate downloadable parts:

TABLE OF CONTENTS - (PDF format)

Chapter 1: The Protagonists in the Development of a Restructuring Strategy - (PDF format)
Objectives of the restructuring
The Pharmaceutical Benefits Scheme
- pharmacists remuneration
Escalation of costs
- increase in the number of pharmacies
- economies of scale
Containment of costs
- the community
- the retail pharmacy industry
The Pharmacy Guild and the Government: from cooperation to confrontation - the 1988-89 dispute
- the role of the Pharmacy Guild
Rationalisation of the pharmacy retail industry

Chapter 2: The Implementation of the Pharmaceutical Restructuring Measures - Administrative and Legislative Framework - (PDF format)
Introduction
The time frame
Consequences of the time frame
Ministerial media releases
- existing legislation on the approval of pharmacists at 8 August 1990
1. The National Health Act 1953
2. State requirements
3. Procedure manual
- granting of approvals in line with the Minister's announcement
1. Applications lodged before 9 August 1990
2. Applications lodged after 8 August 1990 claiming prior commitment
3. Applications lodged after 9 August 1990 to be decided on criteria 'being established'
Guild/government agreement
- loose terminology: 'guidelines', 'freeze period' / freezing of approval numbers
- lack of definitions: closure and amalgamation payments, 'prior commitment', 'unmet public need'
- inflexibility: Essential Pharmacy Allowance (EPA), The National Health Act 1953
Ministerial Determination no. PB1 of 1991
The key players
- the Department of Health, Housing and Community Services (DHH&CS)
- the Health Insurance Commission
- the Pharmacy Restructuring Authority (PRA)

Chapter 3: The Implementation of the Pharmaceutical Restructuring Measures - Administration - (PDF format)
The Health Insurance Commission (HIC)
- procedural laxity: (a) accommodating the pharmacists
- procedural laxity: (b) tentative approvals
- procedural laxity: (c) careless communication style
- lack of training
- lack of briefing
- conflicting or inadequate advice
- relocation of premises and unauthorised dispensing
- absence of remedial action

The Pharmacy Restructuring Authority (PRA)
- the membership and mode of operations of the PRA
- misreading of guidelines
- disregard of legislation
- guidelines
- changed definition of criteria: prior commitment
- inadequate decision-making and administrative delays
- procedural complexities
- closure/amalgamation payments
- approval to supply
- lack of monitoring
- lack of evaluation

The Department of Health, Housing and Community Services (DHH&CS)

Chapter 4: Conclusions and Recommendations - (PDF format)
Part 1
Part 2
- appeal mechanism
- Essential Pharmacy Allowance (EPA)
- unmet public need
Part 3

LIST OF APPENDICES - (PDF format)

Appendix 1: Organisations and Individuals Who Presented Written Submissions to the Inquiry - (PDF format)

Appendix 2: Witnesses Who Appeared at Public Hearings - (PDF format)

Appendix 3: The Port Macquarie and Other Cases - (PDF format)

Appendix 4: Minister for Aged, Family and Health Services: Media Releases of 24 July and 8 August 1990 - (PDF format)

Appendix 5: Relevant Legislation - (PDF format)

Appendix 6: Agreement Dated 6 December 1990 Between the Minister of State for Aged, Family and Health Services and the Pharmacy Guild of Australia - (PDF format)

Appendix 7: Summary of the Legal Aspects Affecting the Process of Approving Pharmacists' Application to Supply Pharmaceutical Benefits in the Period from August 1990 to January 1991 - (PDF format)