When every Australian can get a Pharmaceutical Benefit prescription dispensed and have access to the advice of a pharmacist it is taken for granted. Yes every one of the 22 million people in this country has access to a pharmacist in one of the 5,000 Approved Pharmacies around the Nation every time they have a script filled. In fact the PBS pays for that pharmacist to be there through the dispensing fee of $6.42 paid on each and every prescription dispensed..
But what of the 150,000 Aboriginal and Torres Strait Islander people who live in remote places in Western Australia, Rural Queensland, the top and west of South Australia and the Northern Territory scattered across the 70 odd communities there?
Ask any of them what a pharmacist is does or hangs out and they wouldn’t have a clue. They will never have seen one. They may remember the glossy looking shop in town when they had to go there for a medical purpose but chances are they wouldn’t have noticed because they were so intent on knowing whether they were going to get back home alive.
Pharmacists do not exist in the remote Aboriginal health workforce, with a very few exceptions. The Government provides through the Section 100 Support Allowance a possible six monthly visit by a pharmacist with the grand sum of $4 million spent on this annually across 166 health services serviced by 34 community pharmacies.
We have to get real and understand that these people not only deserve an equal deal to mainstream but probably require the help 10 times more because of their poor state of health.
The PBS has to find some money to support the appointment of pharmacists located strategically around remote Australia where they can at least direct and train others towards a quality improvement process. Go to any of the 166 health services and you will find a pharmacy supply system that simply does not match current day practice standards. This is an indictment on the profession and requires urgent attention before someone goes to the UN claiming institutionalised racism.
And okay – there cannot be pharmacists everywhere of course we know that – but then it is a matter of training persons to take the pharmaceutical care message out to people in their own language and using the basis of knowledge the person is coming from in their own cultural way. This is done in Africa (Zambia) through what is called Adherence Support Workers and a similar trial in Australia is hoped to be struck in Katherine (NT) this year to test the concept. If we cannot have pharmacists everywhere we can at least try to have their agents as ASWs trained in the need for compliance and the actions and interactions of popular medicines for the chronic diseases that are killing these people at a rate unknown in the developed world.
It is all a matter of equity – and at the moment that does not exist.
Unfortunately as in many areas of endeavour towards alleviating Indigenous disadvantage we tend to rest on our laurels with the 10% of good effort and put aside the 90% that are not benefiting.
As Noël Pearson put it recently:
“I’m sorry I can’t take my focus off the glass 90 per cent empty, rather than being thankful for the glass 10 per cent full. Because I know what that 90 per cent translates into when those beautiful children who miss out on the social justice ticket become adults. Jail. Ill health. Early death.” (The Weekend Australian 28th November 2009).
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