Let The Games Begin – Sussan Ley to centre-stage please

Often, in the turmoil of disinformation that screams from the various mastheads of mainstream media and the “butt” covering by those targeted, it is little wonder that we pharmacists get confused.
While we recognise each other as being part of a “family” we are definitely not united because of the power politics of the day within our professional ranks.
Recently, I received an email from a GP contact who has extensive experience in health, and health informatics. 

He shared this thought:

“When reading about the 5CPA Audit I thought of you and i2p. I have observed our new Health Minister Sussan Ley very closely since she was appointed. Given her background, bearing, presentation and communication style, and her clear no nonsense approach to some extremely thorny problems so early on in her Ministerial role, I quickly reached the conclusion that if her testosterone laden colleagues get in behind her and don’t undermine her (that includes Abbott, Hockey, Morrison,) and if the AMA would stop carping about her not doing enough quickly enough then the Guild will have finally met its match.”

Initially, I did not reflect too deeply on those comments because of all the “noise” surrounding the ANAO report, but this week I got to thinking : who is Sussan Ley?

Sussan Ley

The last time i2P researched the profile of the minister in charge of health was when Nicola Roxon held this role through the Rudd-Gillard years of government, commencing in 2007.

My research at that time illustrated that Nicola Roxon was a highly intelligent person with a law background (and had Justice Mary Gaudron as a mentor).
She also had a social conscience and a no-nonsense approach.
On the surface, she had little experience of health until you learned that her mother was a community pharmacist and her father trained as a pharmacologist.
Her father also died early in life from lung cancer (he was a heavy smoker).
It was Nicola Roxon that had the “guts” to challenge the tobacco companies and introduce plain packaging for tobacco products.
In the public health arena, I believe she triumphed because of this single issue and its long term implication for the health of all Australians.

Sussan Ley is the first female Minister for Health to hold the portfolio since the resignation of Nicola Roxon.
She shares a similar range of qualities with Nicola, but is a more outgoing personality.

Born in Nigeria to British parents, Sussan Ley spent her early childhood in the United Arab Emirates, before migrating to Australia at the age of 13 with her parents and older brother.
Schooled in the U.K., QLD and ACT, later tertiary study led to a Bachelor of Economics, Master of Taxation Law and a Master of Accounting.

Before entering Federal Parliament, her career path was a diverse one, providing a range of ‘real life’ experiences.
Developing an early fascination with the skies and flying, a young Sussan worked a variety of odd jobs and hours to finance this passion, obtaining a Commercial Pilot’s License which she still holds.
This interest also led to work as an air traffic controller with Sydney and Melbourne Airports, aerial stock-mustering in outback New South Wales and Queensland before life on the land as a shed hand / shearers’ cook through a large chunk of rural Australia.

It is probably at this period in time that she learned to “mix it” in a rough and tumble male-dominated environment.
Good training for dealing with the tough negotiators found in the health professions.

During a livestock and dairy farming partnership (near Tallangatta in North East Victoria) of seventeen years, Sussan experienced the highs and lows that routinely test the resolve of farming families.
In this may be found some sympathy with the similar situations that have routinely occurred with pharmacy proprietors.
At least the analogy of farming to pharmacy can be used to illustrate the problems of pharmacy, often let down by a bureaucratic department that has never experienced the chill winds of business pressures, and often induced by government ignorance of small business financial management issues.

Starting university when her first child turned one, would lead to ten years of part time study on the way to three children and three finance degrees. During this period Sussan certainly gained a deep appreciation of and continued support for rural-based educational institutions.
This is indicative of a strong person able to create the mental discipline of gaining academic qualifications, and hopefully, this may translate into an understanding of pharmacy business finances (as distinct from PBS reimbursements).
Still helping manage the farm Sussan took up a position with the Australian Taxation Office at Albury, graduating to the role of Director, Technical Training before seeking Liberal Party pre-selection for the Federal seat of Farrer in 2001.

The local election result was undecided for ten days with the new MP eventually installed by just 206 votes, a friend sending a congratulatory reminder that the ‘Cessna 206’ – a popular bush utility plane – was also her favourite aircraft.
Re-elected in 2004, Sussan was offered the added responsibility of Parliamentary Secretary for Children and Youth Affairs, then Agriculture, Fisheries & Forestry in 2006.

In 2007 Kevin Rudd was elected and Nicola Roxon took on the job of Minister for Health.
Thus they would have known about each other because of these events.

Sussan was appointed Shadow portfolios for Housing and Women in 2007, Justice and Customs /Assistant Treasurer (2008 -2009) then Childcare, Early Childhood Learning & Employment Participation (2010-2013).
On the election of the Abbott Government in September 2013, Sussan took on the role of Assistant Minister for Education before being appointed Minister for Health and Minister for Sport in December 2014.

One gets the feeling that she was being “fast-tracked” by being given the opportunity to perform with a range of appointments prior to becoming Minister for Health.

Sussan is a strong advocate for many rural and regional issues especially those which assist in bridging the ‘city v country divide’. She is particularly passionate about fostering decentralization, supporting our farmers, home grown food security, balancing water for agriculture and the environment as well as improving services for rural health.
Other interests and pursuits include an abiding interest in Middle Eastern politics, fitness and cycling and relaxing back with a ripping yarn, usually a true crime thriller.

Residing in Albury, Sussan maintains her enthusiasm for all things aeronautical, handy when getting around an electorate of nearly 250,000 square kilometers, roughly the same size as New Zealand.
No wonder she was dubbed early in her political career the “Farrer Flier”.

So you get the feeling that Sussan, at least for the moment, has the confidence of her fellow ministers and will be supported in her vision for the health portfolio.
One of her recent press releases targets pharmacy and makes comment on the 6CPA and the recent release of the ANAO report:

“Labor must answer serious questions about a lack of transparency, as well as maladministration, relating to the $15 billion Fifth Community Pharmacy Agreement they signed and managed in Government.
Minister for Health Sussan Ley said she was deeply concerned by the findings of the Australian National Audit Office report about the five-year pharmacy agreement – signed on 3 May 2010 by the then-Labor Health Minister.
Ms Ley said she would consider the report closely as part of upcoming negotiations for the Sixth Pharmacy Agreement and would continue consulting a range of stakeholders, including consumers.
However, Ms Ley said ANAO reports only tended to look at Department administration and there were clear information gaps and problems that Labor, as the Government at the time, needed to explain.
“These serious allegations seem to be just another example of Labor’s culture of secret handshakes, winks and nods and general incompetence in Government,” Ms Ley said.
“However, they cannot be allowed to wash their hands of this or hand-ball it all to the Department.
“Labor had ultimate responsibility for the creation, implementation and administration of this $15 billion pharmacy agreement. The findings of this report don’t relate to one or two minor issues – they go to the core of the agreement and its management.
“Therefore, Labor was either complicit or incompetent in their oversight of these alleged failures in proper process and ministerial accountability and they must answer these serious questions.
“And we’re not just talking Health Ministers – such as the current Deputy Opposition Leader – what about the then Treasurer and Finance Ministers, both of whom are still in the Parliament
“The report’s findings further support the Abbott Government’s decision to consult with all members of the pharmacy supply chain – including consumers – before the next agreement is finalised.
“That’s because I want to hear from a range of voices about the best ways patients can continue to access medicines when and where they need them at a price both they and taxpayers can afford.”
Ms Ley said that while she would consider the report closely, Labor could avoid the need to rush into any form of inquiry by putting forward a full and detailed account of its handling of the agreement and how they allowed these alleged serious issues and irregularities to occur.”

Stripping away all the political in-fighting and point scoring and the fact that the ANAO had the Department of Health solely in its sights, you still can’t avoid the fact that the 5CPA was an agreement between two parties, the other being the Pharmacy Guild of Australia (PGA).
So by implication, how close was the PGA to the Dept of Health mismanagement?
Senator Richard de Natale has asked that very question and is calling for a separate enquiry into PGA management of the 5CPA contract. The PGA is mounting a very strenuous rearguard action to avoid this possibility.

Sussan Ley has indicated that she will be talking to all members of the pharmacy supply chain, including consumers and that she wants to hear a range of voices on better patient access to medicines.

Clinical service pharmacists have the greatest need for a voice in the 6CPA because they will otherwise be drowned out by the PGA communications system.
They are already hampered in getting their message out because their representative bodies are not organised for best effect.

So the only alternative is to write letters to Sussan Ley that unfortunately have to be screened by her “minders” and may not make it to her desk.
Nonetheless, the effort should be made.

Meanwhile, we believe that Sussan Ley will make a good Minister for Health in a similar mould as for Nicola Roxon. She is young, energetic and has a keen interest in sport and its effect on health. Her background in legal/finance is an asset for her.

I suspect that if approaches are made in respect of rural and regional health, they will get a better hearing than approaches for a city-centric health solution.
She would also be amenable to promotion of preventive medicine.

The big question is how she will evolve future community pharmacy agreements.
The big issue on the pharmacy side is that there is a lack of confidence in the PGA by some sectors of pharmacy that want negotiations to reflect a whole of pharmacy approach.
This will never happen because of bias that occurs when the PGA on the one hand, unashamedly claims to only represent its members while on the other hand misleadingly claiming to be able to negotiate for all of pharmacy.

This is such a contradiction. The conflict of interest is obvious; the PGA must give priority to its member pharmacy owners at the expense of the rest of pharmacy. This conflict of interest has been proven to lead to forever festering argument creating long standing bitter division within the pharmacy profession. Only by involving others at the negotiating table will it be possible to negotiate for all of pharmacy to the benefit of all Australians.

So, Sussan Ley, you must use your political position to help create a leadership organisation that can represent the whole of pharmacy.
This does not mean that the PGA should not pursue its PBS interests – only understand and recognise that PBS has run its course and that an urgent professional invigoration is required to sustain the viability of the profession – particularly its ability to attract new members and to reward them comparable to other professions.

I’ll give my doctor correspondent the last word (and I agree with him totally).
He says:

“I believe Sussan Ley has the courage and insight to take on the Guild and totally disrupt the status quo. Her first steps in bringing others to the 6CPA table albeit tentative have the potential to achieve just that. Let us hope she prevails.
John Menadue said in his health reform articles recently that in order to implement real and meaningful reforms in health we must bypass the vested interests (the rent-seekers). That is almost impossible.
The corollary therefore is that if you can’t bypass them the only other option is to totally disrupt their power – management by chaos. Sussan Ley is on the right track and hopefully will be able to do just that.”

Meanwhile, write to Sussan Ley (preferably snail mail) and deliver your point of view for pharmacy.


Suite M1 41 , Parliament House Canberra  ACT 2600

Phone – (02) 6277 7220

Facsimile – (02) 6273 4146

Email – correspondence: Minister.Ley@health.gov.au


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