Scott Lynda: Questions for Oral Answer — Questions to Ministers 
Scott Lynda: Questions for Oral Answer — Questions to Ministers 
[Volume:608;Page:5471] 
11.  
Dr LYNDA SCOTT (NZ National—Kaikoura) 
 to the  
Minister of Health 
: Why is Pharmac proposing to change from 1-month dispensing to 3-month dispensing of prescription medicines when as a result of that change it is estimated the wastage of discarded medicines will increase by $35 million a year? 
Hon ANNETTE KING (Minister of Health) 
: 
 I am advised by Pharmac that should this initiative be implemented it would mean district health boards would have an extra $35 million to spend on services—for example for improved hospice care child health or aged care. It would also make it easier for patients to get the medicines that doctors have prescribed which would mean an extra $24 million a year of medicines being dispensed to patients in need. 
Dr Lynda Scott 
: Is she aware that the residential care association estimates this change will cost every resident on medications $264 per year—that is $7.5 million per year for all New Zealand—and who will pay for this increase: the Government the rest homes or older people? 
Hon ANNETTE KING 
: The decision as to whether a medication is dispensed for 3 months 4 days or 1 month can be made by the patient’s doctor. This proposal is an extension of an existing policy that allows 3-month dispensing for any patient who lives 30 minutes away from a pharmacy who has limited mobility who is travelling abroad or who is relocating. So a person who is receiving a prescription is very much in the hands of his or her doctor who will decide whether and when that patient should get it. 
Steve Chadwick 
: What consultation has Pharmac undertaken to date? 
Hon ANNETTE KING 
: Pharmac has held a number of public meetings with pharmacists. It has called for public submissions and has received 191 to date. Overwhelmingly the public and patients are in favour of the change. It has met with Opposition MPs—for example Dr Don Brash who supported the proposal and Dr Lynda Scott who opposed the proposal. 
Heather Roy 
: Why does the Minister not trust doctors to decide whether patients whose health is their professional responsibility should be dispensed their medicines every month every 2 months or every 3 months? 
Hon ANNETTE KING 
: I certainly trust doctors to make those decisions and they make them every day. They are able to make those decisions. But because they are required to dispense monthly when they would like to be able to dispense 3-monthly it means they cannot do that. 
Judy Turner 
: Has she received any indication from Pharmac that it would be willing to review dispensing fees to compensate for this proposal in the light of the savings that will accrue notwithstanding the potential wastage? 
Hon ANNETTE KING 
: Pharmac is listening to all proposals at this stage. That is why there is consultation and that is why the consultation has been extended to 30 May. 
Sue Kedgley 
: Is the Minister aware of estimates of the effect of bulk dispensing on high users of medicines especially the elderly who will have to collect huge quantities of drugs at once and of real-life examples that show some elderly New Zealanders will have to collect over 1300 tablets five inhalers 3 kilograms of laxatives and so forth at one time and does she acknowledge that under this sort of bulk dispensing regime it will be practically impossible to monitor patient compliance amongst high users and that it will inevitably result in an increase in the incorrect use of medicines in overdoses and in child poisonings? 
Hon ANNETTE KING 
: Should a patient require such a large amount of pharmaceuticals a doctor can decide that they are to be dispensed every day every week or every month. It is not a requirement that patients have to have them every 3 months. But I have received from many many patients—and in fact from some members in this House—advice of their concern about people who have to pick up their prescriptions every month. I notice that members in this House are nodding. 
Dr Lynda Scott 
: I will ask again who is to pay for the $7.5 million in extra costs that will be incurred: the Government the rest homes or older people? 
Hon ANNETTE KING 
: The member is making it up. There are no such figures. 
Dr Lynda Scott 
: Does she believe that pharmacy viability will be affected by this proposed change; if not why not? 
Hon ANNETTE KING 
: Some pharmacists have said that they may have to close if this is undertaken and that certainly must be considered by Pharmac and also by the Ministry of Health. However it may be necessary— 
Dr Lynda Scott 
: And the Minister. 
Hon ANNETTE KING 
: Can I just tell the member that it is not a decision for the Minister. I will tell the member why that is. When we changed— 
Mr SPEAKER 
: I am sorry to interrupt. I want quiet. I want to hear what the Minister says. 
Hon ANNETTE KING 
: This is not a decision for the Minister. The member I know is new to the House and she probably does not know that when we changed from 3-monthly dispensing to 1-montly dispensing in 1996 the Minister of Health did not make the decision then either. It was made by Pharmac. The decision will be made by Pharmac this time based on the submissions that it receives. The member asked me whether this would affect pharmacies. There are some pharmacies that say they may have to close and that needs to be looked at by Pharmac and by the Ministry of Health. However if that were the case it may be time for this House to re-examine pharmacy ownership and pharmacy service provision. There is an opportunity for that to happen under the Health Practitioners Competence Assurance Bill. 
Dr Lynda Scott 
: I seek leave to table Residential Care New Zealand’s submission which shows that a 60-bed facility will pay $18000 more per annum and I think it knows more about that than the Minister. 
Mr SPEAKER 
: Leave is sought to table that document. Is there any objection? There is.