23 March 2015
Mr John Feneley (Chair), Prof Alan Rosen, Prof Andrew McLachlan, Ms Sam Stott, Ms Kerin O’Halloran, Dr Rod McKay, A / Prof Timothy Wand, Dr Michael Tam, Ms Judith Mackson, Dr Murray Wright, Dr Titia Sprague
A / Prof Tim Chen
Ms Victoria Smyth
Mr Carlton Quartly
Titia Sprague provided an acknowledgement of Country and Sam Stott an acknowledgement of people with a lived experience of mental illness.
2. Welcome and apologies
The Commissioner welcomed members. The apologies of A / Prof Tim Chen were accepted. Dr Murray Wright was welcomed to the group as the new Chief Psychiatrist.
3. Declaration of any conflict of interest
No declarations were made.
4. Minutes from previous meeting
The minutes of the meeting held 13 October 2014 were accepted.
5. Commissioner update
John Feneley updated members on the release and adoption by the NSW Government of the Strategic plan for Mental Health in NSW.
6. Member update
Members discussed the potential of adding a new member to the group. Tim Lambert recently resigned from his position in the group.
Members discussed public lectures delivered by Professor Peter Gøtzsche in Sydney on the topic of medication and mental illness. Prof Gøtzsche is leader of the Nordic Cochrane Centre, co-founder of the Cochrane Collaboration and author of Deadly medicines and organised crime: How big pharma has corrupted healthcare. These lectures questioned the efficacy of psychopharmacological treatments for depression, highlighted the withdrawal symptoms associated with some selective serotonin reuptake inhibitor (SSRI) medications and critiqued the influence of the pharmaceutical industry upon prescribers.
Carlton Quartly updated on the work being carried out by New South Wales Therapeutic Advisory Group (NSW TAG). John Feneley and Carlton Quartly met with Dr Sasha Bennett, Executive Officer NSW TAG to discuss amongst other things National Quality Use of Medicines Indicators and how the Commission may support their adoption.
Mr Quartly brought to the attention of the group the Pharmaceutical Society of Australia’s (PSA) Election Manifesto, entitled Better health for NSW: unlocking pharmacist’s skills. In the Manifesto, the PSA continue to advocate for the delivery of better community based mental health care with pharmacist expertise. One of the main planks of the proposal includes $9m investment over five years to embed pharmacists in community mental health teams in each Local Health District in the state.
The PSA also propose the introduction of a program in NSW to increase access and adherence to therapy by reducing cost barriers, by covering the consumer co-payment for prescriptions, Dose Administration Aids and other related services for mental health consumers.
7. Commission update
Mr Quartly informed the group about a project by the Australian Commission on Safety and Quality in Healthcare which is being carried out by the University of South Australia. The project focus is medication safety in mental illness. The Commission has been invited to attend a project round table on this topic which will take place in May.
Mr Quartly also informed the group of a submission the Commission made to the Australian Department of Health. The Department of Health was seeking comments on implementing changes to the Pharmaceutical Benefits Scheme (PBS) to improve community access to:
- HIV antiretroviral therapies; and
- clozapine in the treatment of schizophrenia (maintenance therapy only).
The submission by the Commission provided comment on implementation of the revised PBS arrangements for clozapine, which seek to increase patients’ independence. The Commission considered there was merit in the proposal but that it would be most appropriate to trial the approach with a group of interested pharmacists and clinical support services so as to explore the model and related governance and communication issues.
Members commented on an election commitment by Premier Baird released in media pledging to end the co-payment for chronically ill patients where medication is featured on the Highly Specialised Drugs ‘Section 100’ list. The only medication for mental illness included on this list is Clozapine. Therefore Clozapine will be available at no cost for people prescribed it as out-patients, or on discharge from hospital.
8. Medication and mental illness paper
Victoria Smyth presented on the process of the Medication and Mental Illness project.
The Issues Paper approved at the last PAG meeting was distributed along with a Call for Submissions in November 2014, throughout Commission and partner networks. Key stakeholders were also contacted. This was followed by a phase of targeted consultations. Over 200 submissions were received.
The Commission analysed the submissions received and has created a draft paper detailing perspectives and experiences of those who responded. Members of the group provided comment on the draft. Members commented on the success of the call for submissions. The members commented on the need to ensure the paper was suitable for all stakeholders and discussed how to produce a document that would reach out to clinicians, without diluting the voice of consumers and carers.
Key points members felt would help this were:
- Members to provide Feedback and suggestions for commentary by Mid April
- That the paper include patient journeys
- That the paper would remain as one paper
- That the paper needs to include points for action.
9. Any other business
In accordance with the Terms of Reference the next meeting will take place in six months time. Members will provide feedback on the paper out of session.
The date for the next PAG meeting is Monday, 28 September, 4pm – 6pm.