The Remote and Isolated Pharmacist Association of Australia (RIPAA) is inviting a fresh dialogue on the future of healthcare in thin markets. By shifting the focus toward locally embedded, full-scope pharmacy models, RIPAA believes the government can better support the seven million Australians living outside major metropolitan hubs.
Home Medicines Reviews: Why Simple Uncapping Isn’t Enough
National pharmacy bodies have been campaigning for the total removal of the 30-review-per-month Home Medicines Review cap. However, RIPAA maintains that without targeted rural protections, merely uncapping risks opening rural and remote communities to volume-based urban models that do not provide long-term care.
“We aren’t simply asking for more numbers; we are asking for a model that works for the bush,” says RIPAA President Fredrik Hellqvist. “Removing or lifting the cap nationwide might help some consultants to provide more reviews, but in a thin rural market, it doesn’t solve the sustainability of the locally embedded clinical pharmacist. We need a nuanced policy that prioritises the practitioner who works in the community over ‘fly-in’ services.”
The Locally Embedded Model: Supporting the Individual Practitioner
RIPAA is championing the role of the locally embedded clinical pharmacist—practitioners who provide face-to-face care within the community, whether they are based in a local pharmacy or operating as independent clinical consultants within the rural health team.
| Feature | RIPAA’s Position |
| HMR Monthly Cap | Supportive of flexibility, provided it favours locally embedded practitioners to prevent parachuting urban services from cannibalising thin markets. |
| Service Model | Practitioner-Centric: Prioritising the permanent, face-to-face presence of local clinical pharmacists. |
| Thin Market Strategy | Rejecting program silos; advocating for a “Full Scope” model where local pharmacists are funded to provide a total range of services. |
| Rural Loading | Demanding a tiered system (MM5–MM7) that reflects the exponential cost of maintaining a local clinical presence. |
The Workforce-Funding Gap: A Hidden Penalty
RIPAA highlights that the current workforce crisis is creating a funding deficit for rural towns.
“Because we can’t always find the staff, the health dollars are redirected to cities where the workforce is more plentiful,” Mr. Hellqvist says. “When you don’t have the workforce, you can’t deliver the service; and unless you can deliver the service, you cannot access the funding. We need a system where funding follows the local presence, not just the volume of claims.”
The Data Black Hole
Crucial to RIPAA’s advocacy is the demand for data transparency. Currently, the Department of Health does not publicly release a breakdown of pharmacy services (like HMRs) by Modified Monash Model (MMM) category.
“We are flying blind without public data,” says Mr. Hellqvist. “We need to know what pharmacy services are being delivered and where. We need to know where the service gaps are. Without a clear breakdown of service provision by MMM, it is unclear how the pharmacy system is performing by measurement of rurality and difficult to design cost-effective and ‘fit-for-purpose’ models.”
RIPAA is calling for:
- Prioritisation of Local Practitioners: Policy settings that ensure the locally embedded clinical pharmacist is the primary provider of HMRs and other services.
- Tiered Rural Investment: Moving to a funding model that recognises the high cost and low volume of “thin” remote markets.
- MMM Data Transparency: Immediate release of pharmacy service provision data by remoteness category to inform rural-specific health policy.
