Opening Address to New Zealand Self Medication Industry Conference, 30 October 2014.

  • Peter Dunne

Good morning and welcome. It is a pleasure for me to be here this morning to open and welcome you to this year’s New Zealand Self Medication Industry Conference. This year’s conference will continue to promote self-care as a solution to some of challenges facing the health care system in New Zealand.

I would like to take this opportunity to quickly acknowledge and welcome my fellow speakers here today:

  • Tim Roper, Chief Executive, NZSMI;
  • Shamubeel Eaqub, Principal Economist, New Zealand Institute of Economic Research;
  • Nicholas Hall, Chairman and CEO of Nicholas Hall & Company;
  • Dr Stewart Jessamine, Medsafe;
  • Scott Koslow, Professor of Marketing at Macquarie University, Australia;
  • Bernie McKone, Owner, Quins Pharmacy in Gore; and
  • Rob Waddell, Chef de Mission of the New Zealand Olympic team.

Driving the notion of Self Care

We are all aware that New Zealand has one of the best health systems in the world. We are also aware that despite this we are faced with increasing levels of chronic diseases caused by poor lifestyle choices as well as an ageing population. This is why the work and promotion of self-care to our populations is so important.

Throughout the years, many of the strategies associated with Government health targets have been ingrained with the principles of self-care. For example, strategies associated with reducing smoking or reducing the impact of cardiovascular disease and diabetes have all been largely based on educating people and giving them knowledge and tools to manage their health and prevent disease.

Many conditions are best addressed at a number of levels. It is not  just about seeing a GP or the local hospital Emergency Departments. It is also about lifestyle changes, working with health professionals within our communities and self-care.

Patient self-management or self-care is an important part of the wider healthcare environment. At its core it is a shift from cure to prevention, and a focus on activities and decisions that people make for themselves so that they maintain a good level of physical and mental health.

Self-care does not imply that individuals are left to look after themselves. Rather, the emphasis is on partnership and the relationship between consumers and their healthcare professional including GPs and pharmacists.

For self-care to be truly effective the consumer must be given enough information to be informed about health issues and treatment options, so they make informed decisions as to about the best option for them and their family. This requires information to be accurate, evidence based and unbiased; it also requires that information is presented in an open transparent way in a manner that everyone can understand.

One good example of this is the Government’s initiative of promoting self-care through the whānau ora approach. This strengthened direct engagement with whanau and families and empowered them by increasing the choice and control they have in their care.

The Government has been driving and supporting the need for a more integrated model of care where primary, secondary and community providers deliver more patient centred services. This will ultimately lead to a more effective health system. This integrated approach should also take into consideration how individuals and families can be more proactive in managing their healthcare.

I am aware that the consumer healthcare industry is keen to play a greater role in making meaningful contributions to the development of a sustainable health system. I strongly encourage all members of industry to continue to seek opportunities for greater collaboration with other healthcare professionals and organisations to promote the importance increasing awareness of self-care so that this goal can be achieved.

Medicines Reclassification

The reclassification of medicines also plays a key role enabling effective self-care management. In New Zealand some medicines, where appropriate and with established safety profiles, have been down-scheduled from prescription only, or further down-scheduled to pharmacy over the counter medicines.

This has reduced barriers to access and enabled further opportunities to increase the notion of self-care. Examples of this are reclassification of many vaccines such as influenza, pertussis and meningococcal vaccines. The recent reclassification of Sildenifil also shows better use of pharmacist skills in supply of medicines based on consultation and patient health check.

Better use of pharmacist in the management of medicines

The role of pharmacy within the primary care sector is becoming increasingly important for the delivery of health services within a more integrated model. Pharmacists have actively pursued opportunities to increase their scope of work to enable them to work more broadly within the wider health sector. 

There is good evidence that making better use of pharmacists’ skills has positive impacts on the delivery of primary health care services. It also improves patient access, experience, health outcomes, and better medication safety.

There are already some great examples of where better use of pharmacists skills are having positive impacts on the management of medicines. For example the new services introduced under the current Community Pharmacy Services Agreement such as the Community Pharmacy Anti-Coagulation Service. Another example is new service models that place greater emphasis on helping patients with Long Term Conditions.

Together these services not only allow community pharmacists to operate higher in their scopes but they improve access to primary care and improve patient outcomes. They support patient’s medicines adherence and provide other treatment options to assist patients to be educated in the management of their medicines.

To date pharmacists have registered approximately 137,000 patients into Long Term Condition services and are helping this high needs group to better adhere to their medicines. There are also 125 pharmacies providing anti-coagulation management services to approximately 2,500 patients. The Ministry of Health will continue, where appropriate, to support opportunities for better use of pharmacist skills as a means to improve access to primary care services and to improve management of medicines.

IT Enablers

The Government will continue to support and provide the infrastructure needed for self-managed care and new ways of interacting with the health sector. Greater sharing of patients’ health information will reduce the administrative burden and reduce waiting times for treatment. We need to keep this in mind when we invest in improvements to the IT infrastructure of the whole health sector.

The Government, supported by the National IT Health Board, has a clear eHealth vision – that all New Zealanders will have their personal health information available electronically to them and their treatment providers, regardless of where or who they are. To achieve this, we are investing in IT systems that make it easier to share patient information:

  • eHealth initiatives such as Patient Portals and Electronic Prescription Systems, and
  • (ePrescribing) that will help drive the notion of self-care.

The implementation of Patient Portals in general practice will empower people to take more control of their own care. Patients can book appointment, order repeat medications and view their clinical information online, at any time of day.

The Medicines Strategy

Most of you will be familiar with the Government’s Strategy for our medicines system, Medicines New Zealand. This strategy sets out the overarching framework for medicines by aiming to ensure they are:

  • safe and effective,
  • accessible to those who need them, and
  • used optimally.

The Medicines Strategy is supported by an Action Plan which sets out a range of activities aimed at kick-starting the delivery of these outcomes. The Action Plan was launched in 2007 and then updated in 2009 all of the actions under the plan have been completed and some have now become business as usual.

Successes to date include the New Zealand Formulary, changes to prescribing rights through the Medicines Amendment Act 2013, and a range of other changes around pharmacy workforce and services. Many of the completed actions have played some role in enabling better opportunities for self-care. Tomorrow, we begin the next stage of its development with  a sector workshop to discuss new ways of achieving the three core outcomes of the Medicines Strategy. This will be achieved through focussing on the development of impact areas of the medicines system where targeted, deliberate action will deliver the greatest benefits for New Zealanders.

In closing, I would like to thank you all for being here today and for the opportunity to speak with you. Self-Care is indeed an important solution to some of challenges facing the health care system in New Zealand. By working together, I am looking forward to the progress that we can make towards this.