David Schembri
Pharmacists defend medicine prescription but doctors oppose
It is inconceivable that doctors should lambast the Health Minister's proposals for pharmacists to prescribe medicine, according to the chamber of pharmacists.
Martin Balzan, president of the Medical Association of Malta, said the MAM was "surprised and disappointed" that the Health Ministry was "considering abandoning the ethical principles in the prescription of medicines".
On Monday, Health Minister Joe Cassar said his ministry was working to expand the role of community pharmacists by giving them the power to prescribe medicine after appropriate training. This would bring Malta in line with practices in other countries such as the UK, where this kind of scheme was implemented in May 2006.
But the MAM reacted negatively, saying "the current Medicines Act prevents medical practitioners from dispensing medicines to protect patients from a potential conflict of interest between the prescriber and the dispenser who profits from the sale of medicines".
The association made further financially-related comments, saying the reform would lead to "unsafe practice and a conflict of interest, which will further raise the price of medicines". It called for the "liberalisation of pharmacy licences" for there to be competition and subsequent decreases in the cost of medicines.
The Chamber of Pharmacists called the comments "long exhausted, feeble, non sequitur arguments," adding it took "bona fide professionals to change a mentality and move with the times".
Dr Cassar yesterday defended the proposal, saying that "if we want to ensure that our high level of health is maintained and improved, focusing on health services alone is not enough and we need to implement a series of public health strategies that will strive to bring about healthy well-being for the Maltese population now and in the future."
The Pharmacy Research Group has been studying the idea of pharmacist prescriptions for the past 10 years, following international developments and implementation strategies in other countries.
Lilian Azzopardi, speaking for the group, said it believed Dr Cassar was "bringing professional pharmacy services in Malta in line with those developed successfully in other countries more than five years ago". "Research has shown that a cooperative relationship between pharmacists and physicians should be enhanced in favour of patient safety."
Prof. Azzopardi said that, while the group understood the medical profession's reservations on pharmacist prescribing medicines, experience in the UK "has shown the reservations to be unwarranted".
"The Research Group feels, moreover, that the five-year undergraduate programme in pharmacy provides the necessary skills and competences for pharmacists to assume a prescribing role which enhances patient safety and promotes effective communication with other healthcare professionals."
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6 Comments
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Joseph Grech
Mar 27th 2010, 21:29
Dear Minister Cassar - what a hornets' nest you have stirred up!
Was it wise of you to bring this matter up NOW? Surely you would do well to stop listening to people who may have a personal (monetary) agenda in this issue. Also please concentrate on getting patient service at Mater Dei up to scratch.
For your own sake - and the government's - don't veer off this crucially important patient service issue. Please visit Mater Dei and witness for yourself the long queus at, for example, the Ophtalmology section. Old pensioners standing in never ending queus - the considerable number of chairs in the corridors being simply not enough for everybody! Quite heart-breaking really....
Any person in his right state of mind would never think of getting an IMPORTANT prescription (PLUS THE ACCOMPANYING DIAGNOSIS) through a pharmacist! Honestly now, would you?
Sadly this ill-timed matter has had the regretful effect of pitting one profession against another! The quicker it's solved, the better!
I respect both pharmacists and doctors but I believe it's folly to criss-cross their paths for convenience or monetary gain.
Hopefully you will not consider this comment as criticism - it's meant as constructive comment.
J. Debono
Mar 27th 2010, 20:56
@ J.schembri
You're making some serious allegations here - AND you are totally wrong.
If you have proof, let's see it, underwise be careful what you say.
It is the pharmacists that take commission - what they call 12 + 2 (i.e. for every 12 boxes, 2 are free), 12 + 3, etc., not doctors.
It is in their interest to push certain brands and not others, and not doctors.
J. Schembri
Mar 27th 2010, 16:40
Government is tackling the high prices of medicine,the doctors are fighting the pharmacists on who takes the commission on the sale of medicines.
Doctors don't prescribe medicine , they push brand named medicine , and there is a reason for that; it's called commission.
Paul Caruana
Mar 27th 2010, 15:54
From the general public's point of view, this interprofessional skirmish is irrevelant. What is relevant and unacceptable is the high prices of medicinals locally and the clear reluctance of the government to do anything about it!
Kirill Micallef Stafrace
Mar 27th 2010, 13:46
Come on people let us be honest. A large number of pharmacies already serve their customers prescription only medication without a medical prescription. Now either we have this illegal practice curtailed, with the law enforced, or else we change the law. personally I believe both professions have valid reasons for being in favour or against this idea. However, let us not close our eyes to the fact that the law is currently being blatently broken on a regular basis. So Minister Cassar before introducing new schemes, which if done properly will ultimately benefit the patient, ensure the current regulations are being observed. In other words, if a medication is prescription only, then it must be so and if there is abuse of this then the appropriate enforcement proceedings instigated.
C Micallef
Mar 27th 2010, 13:25
I AGREE WITH MAM's PROPOSAL TO LIBERALIZE THIS SECTOR. Does a dentist who spends thousands of Euros to open a dental clinic have any guarantee that favours monopoly? After all, in a pharmacy, we don't only find medicines!!!
On the other hand, ADDED WORK & RESPONSIBILITY ON PHARMACISTS MUST BE LINKED WITH HIGHER PAY. When the government announced the start of the POYC, both GRTU & Chamber of Pharmacists demanded a fee for every patient that will be entitled to collect his/her free medicines from the private pharmacies. Now I ask UHM to say its views because I'm convinced that although they keep a very low profile, there are a number of full-time pharmacists and part-timers working in private pharmacies and who are at the same time, members with UHM. Some of these pharmacists are also seeing their workload doubled because of the POYC.
PHARMACISTS SHOULD ALSO STOP ACCEPTING BEING THE DIRTY ASSISTANTS OF OTHER PROFESSIONALS by asking the poor patients to pay the doctors' fees and the clinic fees in order to make up for the fact that doctors (and specialists) usually don't pay any clinic rents!