I would like to thank you for meeting with the Winnipeg Ostomy Association Delegation on December 18, 1995. The purpose of this letter is to recap the substance of the meeting.
We opened by expressing the concerns of the WOA which are to maintain current standards for ostomates in Manitoba including:
We understand that the province is going through major upheaval in the health care sector and that changes are inevitable. But as we have the most efficient and cost-effective ostomy program in Canada the adage "If it aint broke, dont fix it!" seems appropriate. We put forward an ostomy supply cost-comparison at the meeting to confirm the cost efficiency of the Manitoba Program. As the cost of supplies is shared by the consumer and the government, it is in the interest of both parties to keep costs down. The current program is accomplishing this, without doubt.
We hope that this outlines the contents of the December 18th meeting and if there are any areas which need further clarification, please contact the Winnipeg Ostomy Association.
We would like to thank you for the time and consideration which you have given our concerns. We believe that you have gained valuable insight into the health care needs of ostomates in Manitoba and look forward to working with you in the future.
Stan Sparkes. President,Winnipeg Ostomy Association.
November 14, 1995 (Delivered by courier)
Members of The Winnipeg Ostomy Association
c/o Mr. Mike Leverick, Editor
Inside Out Newsletter
Dear Members of WOA:
We read with concern the recent editorial dealing with the Manitoba Society of Pharmacists proposal regarding ostomy products.
First and foremost, let me point out that our proposal does not in any way change the amount that Manitoba ostomates will pay for their supplies. That seems to be your greatest fear. As for the financial implications to the Department of Health, I assure you the government will not make any changes that will cost them MORE money. The MSP believes they have presented a financially responsible proposal which will improve management of health care dollars. Lets leave the numbers to the accountants within government to determine if there are savings. As taxpayers, Im sure you will favour a close financial examination.
We were remiss in our original presentation in failing to clarify that counselling by pharmacists in the patients community, as an extension of contemporary practise, would supplement and not supplant the role of the ET nurse. Pharmacists are not, and will never be, ET nurses. Nor are paramedics heart surgeons. However, should I ever find myself in need of either specialist, Ill gladly avail myself of the expertise of the generalist paramedic or pharmacist until I can be seen by the specialist.
Your rebuttal omits the most important aspect of this whole proposal, that is the new Drug Programs Information Network or DPIN. DPIN is a computer network which links all pharmacies to a central database and monitors drug utilization and financial aspects. Phase one of DPIN dealt with drugs dispensed through the Pharmacare program. Social Allowance or provincial welfare is now coming on-line. It would be very simple to program in an ostomates personal health information number (PHIN) and link it to the current payment system for the Manitoba Ostomy Program and COST YOU NOTHING EXTRA. Instead of travelling to Transcona, my patients, for example, could come to my pharmacy, get their ostomy supplies and have me put the information through the DPIN network. Technology is here to stay and a $6 million dollar computer system can bring about many efficiencies. More importantly, drug interactions - which can be of particular criticality for ostomates - may be more accurately monitored.
We understand and agree that not all pharmacies will carry ostomy products, just as not all pharmacies carry every drug. However, no Manitoba has ever suffered because a pharmacy wouldnt obtain a prescription drug and I can assure you that our proposal will not see any ostomate suffer either. In recent Gallop polls, pharmacy was rated as the most trusted profession. We deal with the needs of a variety of patients in an empathetic manner every day.
Our ostomy patients tell us they want the right to buy whatever product they want AND ARE WILLING TO PAY THE EXTRA COST FOR THAT PRODUCT. How can anyone argue with that? Pharmacies will order in requested products and receive same within 24 hours, so your concern about limited shelf lives and stocking costs should not be a factor.
Yet another concern is your statement that "pharmacists are not qualified to give ostomy counselling" and "pharmacists get no training in proper use of equipment or counselling of ostamates". Ostomy products are part of the curriculum for the Bachelor of Science in Pharmacy degree in Canada. However, Manitoba is the only province in Canada in which ostomy products are not sold in pharmacies. Throughout the United States, pharmacists are also involved in this area and the American National Association of Retail Druggists offers the certificate course in Ostomy products. Manitoba Pharmacists will need continuing education courses to update them, but we see no problems in offering these.
My patients, some of whom are members of your Association, tell me they would much prefer to purchase their ostomy products from me in their community rather than driving out to Transcona in the middle of the workday. If their $300 deductible remains the same, and it can be put through the DPIN computer network, how could your association propose to deny them this benefit.
In closing, we look forward to meeting with your representatives Wednesday evening.
Brenda Parrott, B.Sc.Pharm.
It was with great concern when I read the proposal to the Provincial Government from the Manitoba Society of Pharmacists to give up the distribution of ostomy supplies through the Home Care Depot and let pharmacies handle it.
Since the inception of this Home Care Depot by the Manitoba Government twenty years ago, it has been the envy of all ostomates across Canada. Distribution from a single source has kept prices the lowest in Canada, but, most important, the Enterostomal Therapist (ET) nurses have provided excellent support to all ostomates in the province. Although other provinces have cost sharing plans, this is the only plan whereby ostomates have constant access to this highly specialized nursing care. This care has been both cost effective and beneficial to ostomates.
The Manitoba Ostomy Program, under the watchful eye of ET nurses has probably been very instrumental in keeping hospital and medical costs down. This is accomplished by solving ostomy problems before they escalate that require hospitalization or even what can be needless and repeated visits to the doctor. Without their expertise and left to community pharmacists who state they will be "better able to manage the total health needs of each individual patient and provide accessible consultation" (as stated in their presentation), will very shortly be seen as a regressive step to both ostomates and the health care system.
It is rather perplexing how ostomates are going to benefit by the "professional pharmaceutical counselling in the community", when doctors and surgeons rely on ETs to counsel their patients. As my own surgeon stated, he was able to do the sophisticated segment, but could not do the follow up. ETs take a highly specialized course to gain their designation. The position of the patient having ostomy surgery, their prosthesis and ET, is the same as those patients who have lost a limb and have therapists with special training do their follow-up prosthesis care.
It is hoped that the Government will consider this proposal very carefully and not change from a health and cost efficient system that is the envy of all other programs in Canada.
President. UOA of Canada Inc.