Make Your Voice Heard

Updated on August 23, 2018 (Originally posted on August 21, 2018) The Tablet

Join the BC Pharmacy Association’s MLA Outreach Program to advocate for community pharmacy in B.C.
By Angie Gaddy

Some may argue that if there were ever a profession most impacted by government decisions, it would be pharmacy. From federal regulations and decisions to provincial laws, private and public payers and College regulations, community pharmacists have a myriad of issues to keep abreast of.

And while governments and payers look for ways to deliver better patient care and try to stem the rising costs of health care, community pharmacists face challenging – but exciting – times if they become advocates for their profession and patients.

This summer the BC Pharmacy Association relaunched the MLA Outreach Program for members. The grassroots advocacy program provides training, education, support and resources to members who want to make outreach to political decision makers, especially their representatives at the legislature.

“We went to pharmacy school to learn about patient care and to become experts on medication,” says Linda Gutenberg, a former program member who now serves as the Association’s Deputy CEO and Director of Pharmacy Practice Support. “Only when we got out and started practicing and running the business did we learn how important it was to let government officials know how their decisions were impacting not only us, but patients.”

The Association began its MLA Outreach Program in 2012 at the time when the B.C. government planned to terminate the Pharmacy Services Agreement. A lack of a formal agreement between community pharmacies and the government payer left uncertainty for pharmacists. Members across the province joined to meet with their local MLAs to explain the impact the decision would have on pharmacy. And while the agreement was eventually cancelled, members’ feedback showed that many in the public eye didn’t understand the workings of pharmacy.

“Pharmacists have the power to educate members of the Legislature about health care in their local communities,” says Geraldine Vance, CEO of the BC Pharmacy Association. “MLAs care about the needs of their constituents, and pharmacists interact daily with patients and the public. They see issues of access and continuity of care and can help decision makers understand issues important to the community.”

Key to advocating to decision makers and stakeholders is understanding the problems the audience wants to solve.

Many new to advocacy think they can simply show up, present their demands to government and talk about what should be rightfully theirs, says Bill Tieleman, president of West Star Communications, a strategy and communications consulting firm.

“It’s not about what government can do for you, it’s about understanding what the pain points are for government and how you can help solve those problems,” he says.

Pharmacists interested in getting involved in the advocacy program must understand that advocating is strategic. It’s about convincing others to support your position and ultimately have them work with you. 

One of the top issues the BCPhA members advocating is pharmacist-initiated therapy, also known as prescribing for minor ailments in other provinces. Pharmacist-initiated therapy, which allows pharmacists to prescribe for issues that patients can self-diagnose and are limited, includes urinary tract infections, travel medicine, and smoking cessation, to name a few. With many British Columbians without a family doctor and those who do have one facing longer wait times for appointments, community pharmacists can meet the patient demand and free up physicians to handle more complex cases. All the while using the knowledge and skills they have gained through extensive education.

So what are the requirements of becoming an advocate with the MLA program?

  1. Become well-informed As part of the program, you will understand how government works, the legislative process and the top advocacy issues for B.C. pharmacy. Stay up-to-date on pending legislation and regulations and what impacts these have on pharmacy. Be willing to ask for research and find information that helps support your position. Be informed of the arguments counter to your position. The BCPhA provides background research and updates to members on top advocacy issues. 
  2. Understand your audience The average person or MLA does not understand the complexities of pharmacy or the important role that pharmacists can play in the health-care system. They may have little to no contact with pharmacy, had excellent care from pharmacists or, worse, a bad experience. Find out their experiences and perceptions and fill in the knowledge gaps. Understand the most pressing issues facing decision makers and the performance measures they use to determine quality health care.
  3. Become an advocate for all of community pharmacy While it’s tempting to ask an MLA during a meeting for a specific issue that will help your pharmacy or business, be aware you are there on behalf of the BCPhA and you are serving as an advocate for the entire profession.
  4. Present solutions Don’t just identify a problem. Have a specific ask and a suggested solution.
  5. Don’t be intimidated Advocacy is about good communication and persuasion. Don’t be intimidated by meeting your MLA. They are simply an average person who wants to make the province a better place. 

If you’d like to learn more about the program and how to get involved go to bcpharmacy.ca/advocacy
 

Government 101

So you want to get involved in the MLA Outreach Program but don’t remember the basics of government structure? Here’s your primer on B.C. government.
By Andy Shen

Elections in B.C.

Every British Columbian in the province is represented by one of the 87 Members of Legislative Assembly (MLAs). The 87 MLAs form the legislative branch and will have to face election, typically once every four years but not more than five years.

MLAs are elected as a result of a provincial general election. Qualified voters in each electoral district will cast a ballot for their preferred candidate of choice. In B.C., we use the first-past-the-post system, which means that the candidate who receives the most votes will get elected in that electoral district.
The electoral districts are determined by a judicial commission after every second election to ensure similar population in each electoral district, known as redistribution. This ensures each MLA represents a similar amount of population in the province. 

Most candidates will run under a political party. The political party that wins the most seats in the legislature will be given the opportunity to form government. In B.C., political parties with current seats in the legislature include the BC New Democratic Party, the BC Liberal Party and the BC Green Party.

To stay in government, the winning political party must have the confidence of the legislature. This is determined by whether the government can pass important bills, such as the budget. If an important bill goes to the floor for a vote and if the government cannot get enough votes to pass, then that means the government will have lost the confidence of the legislature.

If the government does not have the confidence of the house, then the lieutenant governor can turn to another party, which usually results in a coalition government, or call an election.

The executive branch
Once a political party has won the most seats in the provincial election, the leader of the political party, by convention, will become the new premier and chief officer of the executive branch, the arm of government that makes and implements decisions including policy and government spending. 

The premier will put together a team of ministers to head different ministries, which is known as the cabinet. The minister repsonsible for implementing health policies and priorities is the Minister of Health, a position currently held by Adrian Dix.

In the Westminster system – the system that we use in B.C. – a minister is also an MLA. The premier, when putting together his or her cabinet, will choose from his or her team of elected MLAs. The individual is part of both the executive branch, in his or her role as minister, and the legislative branch, in his or her role as MLA. A minister will serve for as long as his or her government is still in power. 

How do laws evolve?
A minister cannot create new laws. He or she does have the ability to create policy based on existing laws. If the minister finds that their policy conflicts with the law, then they will have to change the law before the department can implement the policy.

Any laws that are passed through the legislature started out as an idea. An MLA will take an idea and introduce it to the legislature in the form of a written document, known as a bill. After it is introduced to the house, the bill will proceed through stages of readings where members will debate on ideas and the text.

The bill will also go through committees where they can call experts to testify to determine the impact, and make recommendations back to the legislature. After the bill has gone through three readings and is passed by the legislature, it will be sent over to the lieutenant governor, who is the Queen’s representative in the province, for royal assent. Royal assent to a bill is the approval of the Crown to allow the bill to become law.

Opposition critics
Although the opposition party did not win enough seats to form government, they do have an essential task in the legislature. Their job is to keep the government accountable through Question Period, voice the concerns of their electoral district and to vote on legislation.

Some opposition MLAs are assigned a special focus, often mimicking the actual cabinet ministers. These special opposition MLAs form the shadow cabinet and those MLAs are most commonly known as critics. The Official Opposition Critic for Health is currently Norm Letnick, who serves as the MLA for Kelowna—Lake Country.

Legislative committees
Legislative committees are designed to mimic the composition of the legislature but on a smaller scale. They are appointed by the legislature to independently examine policy, provide the public with an opportunity to have direct input into the legislative process and to report back to the legislature with its findings.

Policies that impact health, including community pharmacy, are examined by the Select Standing Committee on Health, which currently includes nine members. 
 

This article is featured in The Tablet. The Tablet features pharmacy and industry news, profiles on B.C. pharmacists, information on research developments and new products.