Kedgley Sue: Questions for Oral Answer — Questions to Ministers 
Kedgley Sue: Questions for Oral Answer — Questions to Ministers 
[Volume:609;Page:6141] 
12.  
SUE KEDGLEY (Green) 
 to the  
Minister of Health 
: Does she stand by her statement of 7 May 2003 with regard to Pharmac’s proposal to move to 3-monthly dispensing that “The decision as to whether a medication is dispensed for 3 months 4 days or 1 month can be made by the doctor.”; if so will a doctor’s decision affect how much patients must pay for their medicine? 
Hon ANNETTE KING (Minister of Health) 
: 
 Yes. A doctor can determine the period of supply for which a medicine is to be prescribed and dispensed. Under Pharmac’s proposed changes to the close control rules the number of medicines that can be dispensed more frequently would be restricted. I have been advised that there have been a lot of submissions regarding this aspect of the proposal and Pharmac is currently considering this feedback before any decisions are made. 
Sue Kedgley 
: Is it not true that under the present Pharmac proposal patients will lose their subsidy and have to pay much more for their drugs if their doctor decides for clinical reasons that a drug on the 3-monthly Pharmac schedule—such as warfarin sodium which is not on close control but could be dangerous to supply on 3-month lots—should be dispensed on a 1-monthly basis by their doctor? 
Hon ANNETTE KING 
: That is correct if the close control protocols that Pharmac put in its proposal were followed through because the close control was on anti-psychotics antidepressants antibiotics and class B controlled drugs. That particular part of Pharmac’s proposal as I said has received many submissions which are now being examined by Pharmac before any final decision is made. 
Janet Mackey 
: How many submissions has Pharmac received on its proposal to make changes to the monthly dispensing of commonly used medicines? 
Hon ANNETTE KING 
: I have been advised that Pharmac has received 2500 submissions and it is currently analysing them. As I said there was a lot of comment on the proposed changes to close control rules and this feedback focused on whether the proposals were too restrictive and whether a more flexible system needs to be considered. That is now being considered by Pharmac. 
Dr Lynda Scott 
: Does the Minister stand by the answer of the Acting Minister of Health on 22 May who agreed with the Pharmac statement that the change from 1-monthly to 3-monthly dispensing has the full support of all district health boards; if so how does she reconcile that with the minutes of the Nelson Marlborough District Health Board meeting of 20 May that carried the motion: “That the board make a submission to Pharmac noting their considerable misgivings about the stat dispensing as proposed including that there has been inadequate information and time for meaningful advice to be given; that the board prefers to develop local solutions; and that there is potential for waste and safety issues to arise.”? 
Hon ANNETTE KING 
: Yes I do stand by my associate’s answer. I have the press release here from Graham Edmonds in which he states that all district health boards accept the proposal. However that did not stop boards themselves from making submissions to Pharmac. In fact their submissions were welcomed. 
Sue Kedgley 
: Has the Minister seen the confidential strategy document that Pharmac sent to chief executive officers and chairs of district health boards which shows quite clearly that the recently completely 4-week consultation was a sham as Pharmac had made up its mind to switch to 3-monthly dispensing before it had even begun to consult; and does she agree that this document calls into question the credibility and legality of the consultation process; if not why not? 
Hon ANNETTE KING 
: No I have not seen the document and no Pharmac has not made a decision on stat dispensing. It went out to consultation. It increased the consultation period—it has now changed. It received 2500 submissions. It will now examine those submissions and make its decision in the light of those submissions. 
Dr Lynda Scott 
: What is the cost of the communication strategy that Pharmac has developed for the volume initiative with a communications company; how much has that cost us? 
Hon ANNETTE KING 
: I do not have that figure with me. I am not aware of that figure. I will certainly be happy to provide that figure when I get it. I imagine that it would be a figure that is comparable to the figure when Pharmac changed from stat dispensing to monthly dispensing. However I will ask what it is because I do not know what it is. 
Sue Kedgley 
: What will her Government do if Pharmac proceeds with its proposal and as the Pharmacy Guild predicts hundreds of small rural and suburban pharmacies around New Zealand close as a result? 
Hon ANNETTE KING 
: Pharmac has given an undertaking to pharmacists and the community that it will listen to the consultation and to the submissions and I expect that it will do that. However the decision to move to stat dispensing is a change to the pharmaceutical schedule which is in the domain of Pharmac. The decision to change from stat dispensing to monthly dispensing was made by the four regional health authorities and Pharmac in 1996 not the Minister of Health. I expect that this time Pharmac will make this decision itself taking account of those issues. In terms of closure of pharmacies the Government would obviously have to consider how we would provide pharmacy services if they did close. 
Mike Ward 
: Is the Minister concerned that Pharmac’s 3-monthly dispensing proposal will lead to rest homes becoming targets for criminals in search of large quantities of prescription drugs held on behalf of residents; if not why not? 
Hon ANNETTE KING 
: If that was the case I would be concerned. But I would also be concerned if rest homes do not hold all their pharmaceuticals under a very secure environment. If the member is telling me that he knows that they are not then I would like to know where that is happening. 
Sue Kedgley 
: Can the Minister confirm that under the health and disability legislation she is entitled to issue any instructions to Pharmac; and why therefore is she leaving a decision that will have a huge impact on the entire pharmacy sector—and indeed on the whole primary health sector—simply to Pharmac; and why is she given its impact on the sector not intervening but trying to avoid responsibility for this far-reaching decision? 
Hon ANNETTE KING 
: I am certainly not avoiding a decision if I thought it was one that I ought to make. However I do look at the precedent set when it changed from 3-monthly dispensing under a National Government to monthly dispensing. It was decided then that it was appropriate for Pharmac to make the decision. I have looked at the idea and the concept. I also take account of the many many letters that I have received—and that Roger Sowry Bill English and Jenny Shipley received—from members of the public around the need to have their prescriptions filled every month when they are perfectly able to pick them up 3 monthly. 
Dr Lynda Scott 
: I seek leave to table a document from the draft minutes from the Nelson Marlborough District Health Board opposing the stat dispensing. 
Document by leave laid on the Table of the House. 
Hon ANNETTE KING 
: I seek leave to table the press release from Graham Edmonds who is managing this issue on behalf of district health boards. 
Mr SPEAKER 
: Leave is sought to table that document. Is there any objection? There is objection. 
Sue Kedgley 
: I seek leave to table the confidential document outlining the Pharmac strategy confidential to chief executive officers chairs and Pharmac. 
Document by leave laid on the Table of the House.