EDITORIAL for Monday 13 November 2017

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine, dated Monday 13 November 2017.
The Productivity Commission’s recent report, Shifting the Dial, highlights community-based pharmacy as a “significant unnecessary cost to the nation” and asks whether automated dispensing machines could replace pharmacists.
The question asked is nasty in tone and implies the complete destruction of the pharmacy profession, which has been under attack through various investigating agencies for well over 25 years of intense scrutiny – more than any other health profession.
The intensity began to increase around year 2000 with the Wilkinson National Competition Policy Review of Pharmacy
It has also been examined previously by the Productivity Commission and, most recently, by the National Commission of Audit, which recommended ‘opening up the pharmacy sector to competition, including through the deregulation of ownership and location rules’.
The effectiveness and efficiency of the pharmacy location rules was also reviewed in 2010 by Urbis Consultancy in its Review of the Pharmacy Location Rules under the Fourth Community Pharmacy Agreement.
The Draft Report recommended, “the pharmacy ownership and location rules should be removed in the long-term interests of consumers.
They should be replaced with regulations to ensure access and quality of advice on pharmaceuticals that do not unduly restrict competition”.

The latest Shifting the Dial report is the first of a new type of report that is intended to be updated every five years.
So we can look forward to a stressful future for our segment of the pharmaceutical industry, and we are collectively involved in a fight for our very existence given the tone of this new report, which on the surface shows a complete ignorance of the profession of pharmacy prepared by a group of people who have little experience in health.
So who is driving the current agenda?

Meet the chairman of the Australian Productivity Commission, Mr Peter Harris AOPeter Harris AO
He has previously served as Secretary of the Commonwealth Department of Broadband, Communications and the Digital Economy, and the Victorian Government agencies responsible for Sustainability and the Environment; Primary Industries and Public Transport.

He has worked for the Ansett-Air New Zealand aviation group and as a consultant on transport policy.
He has also worked in Canada on exchange with the Privy Council Office (1993-1994). His career with the government started in 1976 with the Department of Overseas Trade and included periods with the Treasury; Finance; the Prime Minister’s Department and Transport; and he worked for two years in the Prime Minister’s Office on secondment from the Prime Minister’s Department as a member of then Prime Minister Bob Hawke’s personal staff.

In 2013, he was made an Officer of the Order of Australia ‘for distinguished service to public administration through leadership and policy reform roles in the areas of telecommunications, the environment, primary industry and transport’.

He is a career bureaucrat and has a degree in Economics from the University of Queensland (1975) and is married with two children.
On assuming his role as chairman of the Productivity Commission he stated that he was concerned that the recommendations of the earlier Harper Review had not been implemented quickly enough and that anti-competitive regulations remained in place despite significant progress made under National Competition Policy.
The panel recommended removing regulations governing retail trading hours, parallel imports and removing pharmacy location and ownership rules.
Peter Harris thus has a background that shows no experience of health, and being a career bureaucrat has had little experience of the real world.
Two segments of his career are associated with failure – the Ansett-Air New Zealand segment ended in liquidation of the group and the NBN project is less than spectacular in its roll-out and service quality.

Government is not obliged to implement all or any recommendation from any reporting agency and this is seen in the current treatment of the Location Rules that are being legislated to ensure permanency.
This is a logical process if pharmacy is valued by government and is given the opportunity to work at an appropriate level of skill.
Location Rules are sensible when they guarantee a uniform access to health services and community pharmacy has always performed in this role and rated highly by the Australian population for its performance.

That Peter Harris produced his Shifting Sands report without any discussion with the stakeholders affected is illustrative of the quality of his work and it is obvious that he is deliberately “stirring the pot” and setting himself up for another failure.
Unfortunately, this places unnecessary stress on every person working in pharmacies around Australia and reduces their productivity because they have to devote time and energy into defending themselves from potentially poor government policy based on flawed recommendations.

i2P has published articles on the Scottish vision of pharmacy which Peter Harris seems to have simply copied.
But unlike the Scottish model which places pharmacists at the centre of productivity changes, Peter Harris’ proposal is to eliminate pharmacists altogether.
He certainly does not appear to have much originality in his thought processes given the power inherent in his career position to destroy the aspirations of many dedicated and hard-working individuals.
It is past time for pharmacy leaders to step up their activities to selectively attack disruptors (like Peter Harris) on a planned,regular and ongoing basis.
Become proactive rather than reactive.
The lead article for this edition concerns an innovative method of delivering goods using drone technology, and how the resources of a new global retailer to Australia are being directed to perfect this system.
Amazon Australia has opened its first fulfilment centre and is busily stocking its warehouse (based in Dandenong, Victoria). Price, speed of fulfilment and the ability to provide a broader range of consumer needs than any other retailer are the solid platforms underpinning their success.
The fostering of innovation and the nurturing of ideas and their conversion to unique offerings are a force to be dealt with. They will eventually dominate the pharmacy market and they will integrate their pharmacies within a wider health offering. But there is always opportunity for those who are imaginative and quick on their feet.
Meanwhile, everybody currently needs to learn how to pilot a drone to understand the reach of this type of technology solution.
Read: Prime Air – The Amazon Solution for Internet-ordered products is not quite ready for take-off

Change imposed by government on pharmacy is not a new process as this article, written by Peter Sayers illustrates.
In a past conversation with Dr Gregory Haines (author of “The Grains and Three Penn’orth of Pharmacy”) he commented that Australian Pharmacy culture never evolved from within – movement only occurred through stimulus applied by the medical profession or by government. This article illustrates a classic example of a government, advised by the Productivity Commission, simply looking around the globe for a more productive version of pharmacy and altering the model to actually destroy pharmacy.
It is also illustrative of how Australian pharmacy leadership has failed to evolve pharmacy culture to a point of relative immunity, leaving pharmacy open to imposed change.
Read: The Productivity Commission Recommendation to decouple pharmacists from dispensing mirrors a progressive Scottish community pharmacy culture

Mark Coleman is back with an article on the recent release of tax haven files of many high profile people using this type of service.
Because global pharma’s are involved, the system does eventually impact on pharmacy.
Mark Coleman describes some of these impacts in his new article.
Tax havens have become more than just a method of evading or avoiding tax.
They have become a secret meeting place for the global elite who are seeking to control all the natural resources of the world for conversion to wealth that only they control.
A corporate form of a one-world government is envisaged.
Because the system is based on greed and secret controls and mostly now illegal, it has begun to affect economies and lifestyles on a global basis, creating a system of “haves” and “have nots”.
The immorality and illegality of the participants is slowly being exposed through the leaking of confidential documents that would not normally be available for public scrutiny.
The “whistle blowers” involved in these exposures are to be commended.
Read: The Paradise Papers – Tax Evasion by The World’s “Elite” and a Payments System that buys “Decisions”

Gerald Quigley is back with an article on opioids and alternatives to their use.
Prescribed opioids have become the world’s gateway to addiction.
And once addicted a patient will often turn to illegal drugs (like heroin) to sustain their habit because they avoid supply regulations and are now cheaper per dose.
Pain management underlies the problem and there are solutions in the natural world as well with non-narcotic mainstream drugs.
These options need to be promoted and patients prescribed non-opioids as the first option for their pain management.
Read: Opioids & Non-opioids

Hospitals routinely treat cardiac patients with magnesium sulphate injections during their stay in the emergency department or acute care departments. But they are never discharged with a magnesium supplement. Why? Magnesium deficiency is fairly widespread in most population groups, yet it is often overlooked as a valid support for a range of health issues. This article discusses how magnesium may provide support for a wide range of conditions, and in an appropriate format.
The Orthomolecular Medicine News Service has provided a well researched and detailed article on the use of magnesium as a condition support nutrient.
Read: Orthomolecular Medicine News Service – MAGNESIUM

WHO has made a statement saying that cannabis should be decriminalised world-wide because existing laws cause health discrimination.
In Australia, patients are being actively discriminated against as police are instructed to enforce existing laws and close down “illegal” supplies, leaving critically ill people with no workable solutions for their health problems.
Flawed health policy generates bad laws and lowered community respect for policy and laws.
Yet again, Pharmacy is in a position to provide solutions very simply and simultaneously create opportunity for the profession to treat chronically ill patients efficiently and economically.
Pharmacy leaders need to be proactive in the regulatory area because other health professionals are actively competing to lock pharmacy out of any opportunity whatsoever.
Potential for pharmacists is found in the compounding of THC and CBD in specific ratios to match the best result for patients with chronic illness.
Further pharmacist potential also lies in using cannabinoids in harm minimisation programs involving opioid dependencies and as an adjunct for the management of pain.
Pharmacists also need to be active and have a voice in the regulation of these substances ensuring that maximum patient access can be obtained through the application of Schedule 3 of the Poison’s Act.
Read: Understanding Medical Cannabis – 1. The Hemp Chronicle: DECARBOXYLATION OF TETRAHYDROCANNABINOLIC ACID 2. The Hemp Chronicle: HUMAN BREAST MILK 3. The Medical Cannabis Council : A New Organisation established to support Australian Medical Cannabis

“The science is settled”.
So say the people who promote vaccination as some form of extreme medical ideology.
“Scientism is settled” is a more accurate description of the manipulation of the science surrounding vaccines – and it is certainly “unsettling” to hear the dishonest claims that blare out in all forms of media.
“First do no harm” is the concept that underwrites all medical practice.
Australian vaccination policy is so poor and damaging, that it beggars belief that legislators can be so close to manufacturer sales objectives as to guarantee them a market through coercive legislation that involves simultaneous removal of patient choice.
The evidence supporting vaccine policy failure and its lack of safety is becoming so voluminous that it will eventually destroy the unnatural power alliance that desperately tries to hold it all together.
Read: The Safe Vaccine Debate – 1. OMNS: VACCINE ADJUVANTS AND EXCIPIENTS  2. Jon Rappoport – The great flu vaccine hoax: new evidence 3. The Dr Judy Wileyman Report – Newsletter #180 and Newsletter #181 & Letter to Illawarra Mercury

And we conclude this edition with media releases from two leadership organisations:

PSA- http://i2p.com.au/psa-media-releases-1-patient-focused-clinical-overview-of-pain-module-released-2-new-partnership-supports-my-health-record-rollout-in-community-pharmacies-3-ceo-resigns-from-peak-national-body-fo/

ASMI – http://i2p.com.au/asmi-media-release-otc-proton-pump-inhibitors-and-links-to-stomach-cancer/

We hope you enjoy our content and we invite you to participate by adding comment in the panel provided at the foot of each article.

Neil Johnston
Editor, i2P E-Magazine
Monday November 13, 2017






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