When laughter is not the best medicine

The pharmacy of your choice (POYC) scheme is either a roaring success or a crashing failure depending on which political party is consulted on the subject.

No surprises there then.

The incumbent government is naturally defensive of the scheme, whilst Labour candidate Adrian Meli weighs up the pros and cons of the POYC based on both his experience as a pharmacist and his political leanings.

"The Pharmacy of Your Choice scheme was another good idea that was poorly managed and executed by 'GonziPN'. As a pharmacist, with the recent addition of more pharmacies, I believe that the system is now grinding slowly to a stop," Meli claims.

The government finds any criticism of the scheme a very bitter pill to swallow. When asked to pinpoint the failings of the current system, POYC chief executive Roseanne Camilleri taciturnly notes that the scheme has been awarded ISO Standard 9001:2008 certification.

"This standard is based on quality management principles and incorporates robust client-centric approach, the motivation and engagement of top management, the process approach and promotes continuous improvement. This manifests that the POYC unit continuously strives to improve its operations to meet and possibly exceed its client expectations."

Although ISO certification is akin to a technocrat's wet dream, it does not necessarily mean that affairs run smoothly on the ground, Meli points out.

"To start with, the POYC department is understaffed. There has been a roll-out across the remaining localities, meaning that the number of pharmacies taking part in the scheme has increased. The POYC department was already under great pressure following a previous roll-out in 2011. Staff numbers have not increased in line with the increased demands. This affected the running of the whole scheme. Initially, pharmacies received their orders weekly. Now, due to logistical problems, deliveries are being carried out on a fortnightly basis."

Meli also claims that staff at the department are being pushed to their limits. "If a local pharmacist needs to consult with a pharmacist within the department we are usually asked to phone after 11am, as the department would be too busy to answer calls before then. There are times when one needs to consult on certain matters whilst dispensing medicines to the patient so this is a serious problem."

When asked by MaltaToday whether the current scheme was serving patients needs, the ever forthcoming Camilleri said: "Yes. Today, the POYC Scheme is available nationwide from 208 pharmacies and has over 95,000 registered patients."

Asked the very same question, Adrian Melia begs to differ. "In a word, no. If the problem of out of stock medicines had to be addressed properly then patients would indeed benefit from a better service. In the last year, due to a large number of medicines which were unavailable, patients were often faced with the harsh reality of having to go around different health centres or the out patient pharmacy at Mater Dei hospital in order to get their entitled medicines."

Asked whether the POYC scheme carries too much red tape, the POYC chief executive quoted lock stock from a national audit report on the effectiveniess of the scheme.

"The POYC Unit clearly emerged as a professionally managed entity, suitably equipped to administer a scheme of this magnitude and importance," Camilleri told MaltaToday. "The report concluded that the system of standard operating procedures employed by the POYC Unit were commendable, ensuring high levels of consistency thereby contributing towards the reduction of errors."

But Meli sees scope for reduction in POYC beuracracy within Labour's pledge to cut red tape by 25%.

"Labour has already pledged to introduce a system whereby a commissioner for bureaucracy will ensure that efficiency is increased across the board. There are various ways where bureaucracy can be reduced and the POYC scheme is no exception."

One pharmacy owner speaking to MaltaToday lamented the fact that there are "no hard and fast rules and no harmony, resulting in a free for all."

Meli delivers a very similiar assessment: "The problem with the POYC scheme is that there is no hard and fast rule as to how the individual pharmacies run the scheme. Some dispense the medicines immediately, offering a good service to the patient. But some pharmacies restrict the days when a person can collect his medicines."

It would appear that the POYC scheme has managed to square a circle. It is both overly bureaucratic without introducing sufficient standardisation in the ways that individual pharmacies provide their service. Perhaps laughter is the best medicine after all.