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Many Wairarapa people are concerned with possible changes to the way medicines are dispensed and I would like to give a bit of background to this issue.
Patients have been unhappy with monthly dispensing since its introduction in 1996, as for many it is inconvenient to visit the pharmacy monthly to collect their repeats, particularly the elderly, chronically ill or those with young families.
Pharmac and MPs have received complaints from patients, including those who missed the cut off date, which meant they didn't receive their full prescription.
The Pharmacy Guild has expressed concern that the current volume of dispensing is unsustainable, stating it is the responsibility of DHBs, Pharmac and the Government to reduce the number of dispensings. This is a particular concern since the volume of funded pharmaceuticals is growing at 4-5 percent each year.
The proposed changes would affect around 70 percent of dispensing subsidised by the Government. It is not cost effective to dispense expensive medicines in one lot so these (accounting for only 30 percent of dispensings) would continue to be dispensed monthly.
Other medicines such as antidepressants and antipsychotic medicines would be restricted to monthly dispensing for safety reasons to ensure no additional risks to patients.
Monthly dispensing was introduced to reduce the cost to Regional Health Authorities but since 1996 there have been some dramatic price reductions for many drugs.
Pharmac has calculated the savings from the proposed changes outweigh the expected increase in the supply of funded medicines - the annual savings in dispensings from the proposal are estimated to be $60 million, compared to the estimated annual waste cost of approximately $25 million.
This would free up approximately $35 million to be used in other parts of the health sector. As part of this strategy DHBs propose to run 'dump campaigns' to help people dispose of unused medicines, rather than keep them in their homes.
Pharmac would continue to work with the medical profession to ensure patients get the right amount of medicines and encourage patients to take the full course of medicine prescribed.
Pharmacists are paid around $5 each time a medicine is dispensed and the average pharmacy earns $222,000 from DHBs for dispensing medicines. However, there are some large variations across the country. Dispensing is part of a pharmacist's business and doesn't include over the counter medicines or other retailing activities, Lotto outlets etc.
Total Government expenditure on dispensing costs is around $207 million each year. The Government realises that not all pharmacists will welcome this change, as it may affect the amount earned from dispensing fees.
The proposal for stat dispensing would ease pharmacists' workload and allow them more time to discuss patients' clinical concerns and focus on their role as part of the PHO and Primary Health Care Strategy.
It is important to note that rural pharmacies would be less affected by the proposed changes as people living in isolated areas, or who have to travel long distances, are already allowed to collect their prescriptions in one lot.
The DHBs would monitor pharmacies in small towns to ensure a service is provided for patients.
Legal aid eligibility is being reviewed to ensure that people with genuine need are granted it.
The review will consider several issues, with a particular emphasis on addressing concerns that the financial threshold for eligibility for legal aid is too low.
It will also look at concerns that too much legal aid money is spent on long or complex cases, and that access to legal aid creates an incentive for people to extend cases unnecessarily, particularly in the Family Court.
Reviewing the legal aid system is important because it plays a fundamental part in ensuring New Zealanders have access to legal representation in genuine cases of need.
The Justice Ministry has been consulting with government agencies and justice sector groups with a special interest in legal aid over those proposals. It has also produced a discussion document (found at http://www.justice.govt.nz).
Dairyfarmers are likely to have welcomed Canada's action in dismantling its WTO-inconsistent "Commercial Export Milk" programme, which enables this longstanding trade dispute to be brought to an end.
New Zealand has had a long-running dispute with Canada over its dairy export subsidy schemes. In December 2002, the World Trade Organisation Appellate Body issued a ruling in which they had confirmed that Canada continued to provide export subsidies to its dairy exporters, contrary to its WTO commitments.
From 1 August 2003, Canada has committed itself to fully comply with its WTO obligations.
This is a good outcome for New Zealand's dairy industry. Canada's export subsidy scheme was estimated to cost the New Zealand dairy industry around US$35 million a year in lost returns, and the losses would have been even greater if other countries had adopted similar policies.
The resolution was the culmination of almost five years of litigation by New Zealand and the United States to challenge Canadian export subsidy schemes.
My week has been another busy one, with constituent appointments in Masterton on Monday and Friday and the usual round of select committee meetings, House duties and appointments in Wellington.
Finally my sympathies to the family and friends of Wairarapa College teacher Roger Dee. His passing will leave a huge gap in the community.
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