The Ontario government cleared the way Tuesday for pharmacists to renew most prescriptions and offer some services previously provided only by doctors, but there's no agreement on how they will be paid for their increased role in health-care delivery.
"I think all of us have been in circumstances where we would have much preferred to be able to just go to the pharmacist, get that prescription renewed, than have to make an appointment to go back to see the doctor," Health Minister Deb Matthews said after meeting with pharmacy students at the University of Toronto.
Pharmacists now have authority to prescribe drugs to help people stop smoking and will be able to start giving flu shots when this season's campaign begins Oct. 22.
Regulations were also changed to allow them to renew non-narcotic prescriptions for up to six months, and to provide advice to people with chronic conditions.
Pharmacies will be paid $7.50 for each flu shot they give out, and the government said new regulations allow pharmacists to add a charge for renewing prescriptions.
However, the Ontario Pharmacists Association said the conversation with the government about how much to pay them for renewing prescriptions and other increased duties has just started.
"It's all very positive, and now we look forward to seeing the minister implement this, because the only thing that's right now ready to implement is the flu shot," said pharmacists' spokesman Dennis Darby.
"All the other things in the scope of practice, that's where we have to sit down with the government and talk about how do we implement that, how do we pay for it, because providing new services, pharmacists expect to be paid for it."
The Ontario Medical Association said doctors believe that collaboration between health-care professionals will strengthen the system, as long as they are properly trained and governed.
"It is important that when health-care professionals take on new roles and responsibilities that we also improve lines of communications between providers, training opportunities and monitoring practices to ensure that the quality of care, patient safety and continuity of care are all enhanced," OMA president Dr. Doug Weir said in a news release.
The NDP said the Liberals introduced legislation to increase pharmacists' scope of practice three years ago, and still took only a "tiny" step instead of bringing them into family health teams and giving them access to patient files.
"At the end of the day, pharmacists will continue to be on the margins," said New Democrat health critic France Gelinas.
"They will continue to work behind their counters, away from the rest of the team, not having access to your medical charts."
The government is always looking to lower costs to trim a $14.8-billion deficit, but expanding the scope of practice for pharmacists was more about convenience for patients than about saving money, said Ms. Matthews.
"This was driven by a desire to give people the care they need (and) to give our health-care professionals the ability to use all the education that they've got," she said.
Just two years ago Ontario pharmacists were locked in a bitter battle with the Liberals after the government outlawed $750-million they received each year in so-called professional allowance fees from drug manufacturers.
The two sides are working together now and the expanded role will help pharmacies overcome the loss of the allowance fees, said Mr. Darby.
"This is the start of rebuilding that foundation because it was hard for a lot of pharmacy owners to continue with the old model when the economics had changed," he said.
Ontario hopes allowing pharmacists to give out flu shots will increase the province's 33 per cent take-up rate closer to the 50 per cent level seen in British Columbia.
There are about 600 pharmacies that will offer flu shots this season, but the Ministry of Health can't say exactly when it will be able to post a list of those pharmacies, which will be searchable by postal code to find the nearest location.
The government expects all 3,500 pharmacies in Ontario will be able to offer the flu shots next year.