Moss Vale Medical Centre GP Vincent Roche on prescription changes

The government will allow people to buy two months' worth of subsidised medicines on a single prescription, rather than two separate prescriptions.

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More than 300 medicines will be on the list, including treatment for conditions such as heart disease, cholesterol, Crohn's disease and hypertension. The medicines will be phased in during three stages, with the first on September 1.

However, Moss Vale Medical Centre GP Vincent Roche is concerned about the impact this will have on the local pharmacies that provide a critical "safety net" for patients.

"The pharmacies are a really important part of healthcare," Dr Roche said.

"They're a safety net for people that don't go and see their doctor every month. They go into the pharmacy every month and when the pharmacist is giving them their pills they also a screen for side effects and interactions between the drugs.

"Not a week goes by; probably not a day; that we don't have somebody sent over to us by the pharmacist. So it is an important part of our safety net," he said.

Dr Roche was not overly concerned by safety implications related to the dispensing of medications every two months.

"Can they safely be dispensed every two months? In many cases yes, they can," he said.

"The biggest concern I have is for the part of the safety net that's not going to be there. My mum was a pharmacist and I have a fair idea about the economics of pharmacy. My gut feeling is that 35 to 40 per cent of their income will disappear. Now I don't know any business that can take a 35 to 40 per cent pay cut and remain viable."

He pointed at the recent sale of a Bowral pharmacy as evidence.

"It's just changed hands and it was a good sale. Ironically enough it's the son of the original owner. He's just bought it valued at what its current income is and suddenly its annual income is going to be 35 to 40 per cent less. He's literally just bought in," Dr Roche said.

"You've got to remember that pharmacies are not owned by the Coles and Woolworths or the big chains; they're owned by the individual pharmacists. They belong to franchises but each of those is a small business and a very important part of a community."

He said this was particularly so in regional communities but that the city pharmacies would experience the same impact.

"If suddenly your income drops by 35 to 40 per cent you either go bankrupt or you have to put a significant number of your staff off, which is a disaster," Dr Roche said.

"I don't think that part has been thought through."

He said he was only quoting "back of the envelope calculations" but that the changes came at a time when pharmacists had been given permission to do limited prescribing for common conditions.

"That takes personnel to do," Dr Roche said.

"You can't lose a third of your staff and still be able to provide a service like that; vaccinations. I mean pharmacies have really done their share of the heavy lifting during COVID-19 vaccinations and that takes staff."

Despite his support for pharmacists, Dr Roche also said that the increasing cost of prescriptions was hurting patients.

"Everybody's budgets are tighter. Rents have gone up; if you're a younger family mortgages have gone up; the cost of everything has gone up," he said.

Southern Highland News asked Dr Roche if he could see another way forward?

"You've got a lot of learned people; some of them have vested interests but those vested interests need to be declared and visible and have a public discussion about it," he said.

"You don't just announce it. About four or five weeks ago a little thought bubble appeared in the media and then it went quiet. Now suddenly it's out again but it doesn't have to be about government by decree."

He called for an open discussion: "What are the impacts; what are the pros; what are the cons; what's the best way of doing it; is it something you bring in slowly and steadily?"

"The pharmacists are right to be upset," Dr Roche said.

"There are ways that maybe we could have moved in the right direction a little bit more steadily. Instead of just saying that this is something the pharmacists can all wear because they're rich enough. I don't think they are, at the end of the day they're small businessmen and women."

Dr Roche also touched on supply chain issues and admitted that two months supply of 12 to 15 medications could "aggravate" those sources.

"To me the major thing is the impact on small businesses that are an important part of our health delivery system in the community," he said.

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