THE Remote and Isolated Pharmacist Association Australia (RIPAA) is urging a restructure of the Community Service Obligation (CSO), to provide direct payments to pharmacies in MM4-7 areas (PD 23 Apr).
The RIPAA argues that an average of $150,000 per year for an isolated pharmacy is necessary to enhance primary healthcare services in the 600 disadvantaged communities they serve.
"Pharmacists in these regions are losing confidence in the current CSO system and its negotiators, as they seek genuinely equitable outcomes," explained a spokesperson for the RIPAA.
While rural allowances help keep pharmacies open, the RIPAA says they fall short in enabling non-dispensing primary healthcare services in truly rural locations.
The RIPAA claims the CSO system, as it stands today, is outdated and needs revamping to ensure equitable access.
It is calling on the government to address primary healthcare inequities in small and remote communities, which are driving population loss.
Currently, CSO funds are paid exclusively to wholesalers, who allegedly favour larger pharmacies in MM1-3 locations, undermining the CSO's purpose.
The RIPAA believes that some CSO funds should be redirected to the intended beneficiary pharmacies.
They propose a primary healthcare package for remote areas, funded by a redesigned CSO, to restore the community service aspect of the system.
"The CSO was established to ensure equitable access to PBS medicines across Australia but instead is allegedly underwriting incentives and inducements to larger pharmacies, franchises, groups, and chains to trade with them," said the spokesperson.
"This is fuelling the growth of corporate pharmacy, which was never intended to be a beneficiary of the CSO."
Smaller pharmacies face double penalties: they can't access favourable CSO-supported trading terms and suffer from an underfunded rural supply network, making freight operations uneconomical, he added.
The RIPAA argues there is no public health justification for penalising pharmacies based on geography and demographics.
It stresses the need for the government to use the 8CPA to ensure equitable access to pharmacy care, allowing for the sustainability of healthcare services in rural communities. JG
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