The Intergenerational Report – One for the Nation and One for Pharmacy?


The 2015 Intergenerational Report projects a range of issues that will have interest and impact on the pharmacy profession.
It has taken a few attempts to get the Intergenerational Report to a reasonable degree of acceptance because of previous high levels of inaccuracy.
Those high-levels of inaccuracy impacted the thinking and projections of government in respect of Pharmacy funding decisions which still continue to damage pharmacy infrastructure well into 2015.

There is every reason for the leaders of all pharmacy leadership organisations to combine under a single council – not just to negotiate what will happen with PBS funding, but what will happen to pharmacy holistically, over say, a ten-year time frame.
To the best of my knowledge there has only been one national government (the Scottish Government) that has set out to achieve a sensible plan, because they realise that the solution to healthcare costs lies in the development of an effective primary health care solution – and that that relies on a sensible, respectful and balanced relationship between pharmacists and GP’s.

Scotland’s plan was initially covered in i2P on 22 September 2014 titled “A 10-year Pharmacist Service Plan-Scottish Government Style”

The full paper detailing the Scottish Government’s 10-year plan is found here:  ScotlandTenYearPlan.
i2P readers are urged to bookmark/download both items for their own desktop reference, because if Australian pharmacists do not sort themselves out internally (because they are already an endangered species) then they will become extinct.

If I had written those words a year ago, I would have been greeted with skepticism.
Today, few would disagree.

Recently, an announcement was made in Scotland as follows:

Pharmacy schools at Robert Gordon and Strathclyde Universities have been commissioned to run two independent prescribing courses each to realise the government’s 10-year vision for the sector”

“In 2013 The Scottish Government set out plans for every pharmacist to become an independent prescriber by 2023, and NHS Education for Scotland (NES) has now reported that it had commissioned Robert Gordon University in Aberdeen and the University of Strathclyde to each run two courses, to launch in either 2015 or early 2016. Now, there is only one course offered between both universities.

Professor Donald Cairns, head of pharmacy and life sciences at Robert Gordon University, said that its two courses would help deal with the “huge backlog” of pharmacists requiring prescribing training in order to reach the government’s goal.

“This is a golden opportunity for the two schools of pharmacy, that will be responsible for upskilling the workforce to become independent prescribers,” he said. 

Professor Philip Winn, head of Strathclyde University’s pharmacy and biomedical sciences institute, said he anticipated that more courses would be developed in the future.

“We will continue to work with NES to provide more independent prescribing courses and to develop the clinical skills courses,” he said.

NES assistant director of pharmacy Anne Watson stated that around a fifth of pharmacists in Scotland had completed or were taking training to become independent prescribers. 
NES was planning to increase the number of courses over the coming years, she confirmed.”

That Scotland is well on the way to working out its primary health solutions is apparent in the consultative planning that has occurred over many years.
That Australia shows up as highly deficient due to the lack of accepted development of a single pharmacist council to negotiate its affairs with government illustrates on one hand, the feeling of despair among Australian pharmacists (whether owners or career pharmacists) compared to the Scottish pharmacists on the other hand, looking forward to, and embracing positively the challenges of the decade just beginning for them 

The Australian Intergenerational Report highlighted the following points for the next 40 years:

DEMOGRAPHY

Life expectancy:

Males – 91.1 years – 95.5 years in 2055.

Females – 93.6 years today – 96.6 years in 2055.

Population in 2055 – 39.7 million.

40,000 people to be aged 100 and over in 2055 – compared with about 5000 now and 122 in 1975.

Number of people aged 15-64 for every person aged 65 and over was:

7.3 in 1975.

4.5 today.

2.7 in 2055.

Annual income to rise from $66,400 to $117,300.

ECONOMIC CHANGES

Labour force participation – 62.4% from 64.6% today.

Aged workforce participation (those 65+) to rise to 17.3% from 12.9% today.

Economic growth – will average 2.8 per cent a year for next 40 years (compared with 3.1 per cent for the past 40 years).

Productivity growth to average 1.5 per cent (average of last three decades).

SPENDING (under the government’s proposed trajectory)

Healthcare

$2830 per person in 2015 to $6460 per person in 2055 (4.2% of GDP to 5.5% of GDP).

Aged Care

$620 per person in 2015 to $2000 per person in 2055 (0.9% of GDP to 1.7% of GDP).

Age and other pensions

$2000 in 2015 to $3200 in 2055 (2.9% of GDP to 2.7% of GDP).

Other welfare (ie disability pensions and family tax benefits)

$3100 per person in 2015 to $3700 per person in 2055 (4.5% of GDP to 3.2% of GDP).

Education

$1200 per person in 2015 to $1200 in 2055 (1.7% of GDP to 1% of GDP).

National Disability Insurance Scheme

$20 per person in 2015 to $1000 per person in 2055 (0% of GDP to 0.9% of GDP).

Defence

$1200 per person in 2015 to $2300 per person in 2055 (1.8% of GDP to 2% of GDP).

Pharmacy is buried within healthcare spending somewhere, but it has not yet been translated for pharmacists generally to this point.
And how could this occur at all given that government talks to a limited cohort of pharmacists that do not necessarily represent the aims and ambitions of the majority of pharmacists?

Surely, it is a sensible proposition for both government and pharmacists to work out appropriate planning based partly on the input for the Intergenerational  Report that also includes an equally sensible approach from the medical profession so that we can all get on with the job of providing primary health care solutions in an inter-professional  and respectful manner.

And further, while the Intergenerational Report spans a period of 40 years it needs to be looking at smaller planning periods with data updated every 5 years, 10 years and 40 year projection points.

The Scots have got it right with a 10 year published pharmacy plan.
Until that happens in Australia you can forget the propaganda about Australia having the best health care in the world – move over, Scotland is streaming through!


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