The 2015 federal budget delivered some unexpected bad news for the residents of Collingwood, Melbourne, with the announcement that the unique mode of funding supporting the not-for-profit pharmacy at their community health service, cohealth, was to be discontinued. After more than twenty years, cohealth pharmacy seemed set to close.
But as CEO of cohealth, Lyn Morgain writes below, the community that use the pharmacy and co-located medical services simply weren’t having it.
After an extended community campaign, in April this year federal health Minister Sussan Ley, approved an application for cohealth to operate as a community pharmacy within the Pharmaceutical Benefits Scheme, ensuring its survival. This year’s federal Budget included provision for this transition.
As the cohealth team celebrate, Lyn Morgain recounts the highs and lows of this successful community campaign below.
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Tucked in amongst the various initiatives in the recent Federal Budget Papers was a small, and at first glance somewhat obscure, line item:
“The Government will delay the implementation of the 2015‑16 Budget measure Ceasing the Alternative Arrangement Transfer to the Pharmaceutical Benefits Programme — removal of anomaly from 1 January 2016 until 1 July 2016. This will ensure that the cohealth Pharmacy, which provides pharmacy services in inner Melbourne, can transition to arrangements which introduce equitable patient contributions for Pharmaceutical Benefits Scheme medicines resulting in savings of $18,000.”
Health stakeholders and analysts would be forgiven for scratching their heads about this inclusion, particularly when most of the other initiatives specifically mentioned in the papers had attached figures in the millions.
But for staff at cohealth, one of Australia’s largest community health organisations, and for our Board, clients, supporters and local community, that one obscure reference was cause for considerable celebration.
Birth of a community campaign
Almost exactly one year ago the situation was very different. When the 2015 Budget was released, we discovered that funding to the cohealth community pharmacy located in Collingwood, Victoria, had been axed. After operating successfully for twenty years, and having received no warning or consultation about the impending cut, the decision was devastating. As the news filtered through to the Collingwood community, we were inundated by service users who were angry, upset, and very concerned about the impending loss of a service they rely upon to support and manage their health needs. A community campaign was born!
Garnering support
Our service users were keen to be involved in the fight to save ‘their’ pharmacy, and cohealth took on the role of supporting and resourcing them to do so. We held community rallies and meetings each interpreted into multiple languages, and our communications staff and interpreters worked with clients to help them produce posters, photographs, letters and social media posts
For many of our community supporters – individuals of advanced age, low literacy, experiencing disability or homelessness, from low socio-economic status, or non-English speaking refugees and migrants – this was the first time they had participated in an advocacy campaign (and definitely the first time they’d ever made a social media post!) It was not however the first time they had had to fight for the right to access services, and their passion and commitment was very strong.
Working together; fostering friendships
Alongside the community actions, we ran more typical advocacy activities. We issued media releases, some of which made the facts and stats arguments for the value of the pharmacy, others that told the personal story of its value.
We built a coalition of campaign supporters. Both our local, and State and Federal Members of Parliament were willing to use the official (and unofficial) channels open to them to ask questions and apply pressure on our behalf. And we lobbied hard the old fashioned way, meeting with the Minister and key bureaucrats to put our case.
Noting that there are some very powerful stakeholders in the pharmacy space who are committed to the primacy of existing models, ensuring the service and its community was well buttressed by equally visible and powerful interests was key to the creation of some clear air within which to run our arguments. To this extent we owe a great debt of gratitude to the many associations and networks in the public health, primary care sector who spoke compellingly of the merit of the model and the need to retain this to contribute to the evidence base in an evolving system.
The path to success
The campaign lasted 11 months. The end result was captured in those obscure few lines in the 2016 Federal Budget, with the Federal Health Minister eventually exercising her discretionary powers and approving our application for the pharmacy to operate as a community pharmacy within the Pharmaceutical Benefits Scheme. That decision secured the long term future of the community pharmacy, saving a service that is much wanted and needed by the local Collingwood community.
I’m not sure that it’s possible to pinpoint any one thing, any one part of the overall campaign that can be credited its success, but I did walk away from the experience with two important reflections.
Firstly. In service delivery focused organisations such as our own, it is almost always contentious to devote resources to non-service delivery functions such as advocacy, research, policy, communications or government relations. In our financially constrained environments, these investments can be criticised as diverting funding away from front line service delivery.
In this case our pharmacy campaign was largely operationalised by the ‘non-service delivery’ staff of cohealth. They worked in lock-step with our service delivery staff and our consumers, and it was thanks to their work that we are able to continue delivering this service at all.
For services to survive in the changing and complex environment we operate in, we need to resource both people to deliver services, and people to work alongside them, ensuring that they remain evidence based, and are evaluated, understood and supported, including financially, outside of the organisation.
Secondly, and ultimately though, this is always about those we serve: the groundswell of spontaneous support comprehensively demonstrated that the community pharmacy was valued by its many users, and I have no doubt that our task would have been much more difficult had this not been so.
A lasting legacy?
Because we were able to facilitate community members’ participation in the fight to save the pharmacy, they can each now feel a sense of pride in the success we’ve had, and sense of ownership of the service going forward. This was possibly the most wonderful part of the campaign – witnessing those who are too often voiceless, gain the ability to have their voices heard. I hope they come away from this experience feeling empowered. I hope they have some new tools, some new optimism and confidence so that they can continue to advocate for their needs. After all, we all know an empowered consumer is a healthier one.
Lyn Morgain is the CEO of cohealth. on twitter @MsLynM
