From Province House to Home by Leo Glavine
It is my contention that pharmacists deliver more primary health care, free of charge or covered in a minimal way, more than any health care professional. While they are saving health care dollars now, the figure could grow to millions in our province. The Pharmacy Association of Canada has developed a plan, called “9,000 Points of Care,” to improve patient outcomes, contain costs and ensure the sustainability of our healthcare system. The cost savings, verified by the Conference Board of Canada, will save billions across the country, and millions here in Nova Scotia.
The plan involves expanding the scope of practice through greater use of generic drugs, supporting chronic conditions, using the pharmacies proven distribution networks during times of major emergencies and preventing adverse reactions. Remember those long lineups and sporadic distribution of the H1N1 vaccine? Well, 300 pharmacists were trained to deliver the shots, but were never given the green light.
Pharmacists are on the front line of health delivery and are already making a significant difference in having primary care available, especially in communities without a doctor. Most Nova Scotians can tell you who their pharmacist is and place the highest level of trust in the care, knowledge and preventable medicine they offer.
There are six areas where the Pharmacy Association of Nova Scotia would like to extend their services. At a time when our province needs better use of every health care dollar, the NDP continue to focus on how 42 cents of every dollar can be distributed a little differently. Now is the time to be bold and seize the opportunity for real, cost-saving change in how we deliver health care to 938,000 Nova Scotians. I will focus on two that can have profound impact.
• Minor ailments - ones we can usually self-diagnose and will resolve on their own, including seasonal allergies, indigestion, cold sores, contact dermatitis and insect bites to name a few.
It is estimated that 18-40 per cent of GP visits are spent dealing with a host of minor ailments. In addition, 57 per cent of ER visits in our province are described as minor or relatively minor conditions. The time is right to utilize the almost 1,300 pharmacists spread throughout the province to treat minor ailments.
Five to six per cent of Nova Scotians do not have a family doctor and those that have one often say they are waiting too long to see their doctor. Some people, particularly in rural communities, do not have timely access to family doctors and other primary care providers. This puts pressure on emergency rooms and hospitals. In addition, there are gaps in services and uneven access to health care throughout the province. The current structure of health care delivery is severely challenged to meet the needs of our population. The problem is heightened by having the oldest average age population in the country.
Starting in 2014, the new Canada Health Accord, as directed by Prime Minister Harper, will see Nova Scotia treated the same as Alberta and thriving British Columbia. Health transfer dollars based on per capita funding will mean a loss of millions, while Alberta gains a billion new dollars for health care. I think the first premise of the accord should be the development of a population profile that includes age structure, burden of disease and special population health needs, such as those in our fast-growing aboriginal community.
• Expansion of Medication Review Program - targeted at improving non-adherence to medications which lead to better health and lower cost. In other jurisdictions, medication management programs have shown to improve adherence rates by 20 per cent. It is estimated that our province could avoid up to $170 million in healthcare expenditures annually. Nova Scotia should expand the current medication review programs about 50 per cent of all medication-related hospital admissions are due to non-adherence.
Four other areas where pharmacists can make enormous cost savings are a mental health care program, smoking cessation services, prescription renewal program and a trial prescription program.
Pharmacists are already recognized as one of the most trusted and are the most accessible health care professionals. We could become this country’s leader in utilizing highly trained, accessible health care providers in a connected network of health care practitioners.