• Pharmac’s relationship with patient and consumer groups has been criticised in an independent report. 
• It follows two emotionally-charged meetings last year which aimed to reset the relationship between management and advocates. 
• Chief executive Sarah Fitt resigned last month after a turbulent period in which the Government and the board refused to publicly back her. 

Pharmac’s rocky relationship with patient advocates has been highlighted in a new report which said the medicines agency was slow to respond, lacked respect for patients and was highly defensive. 

The report, based on two workshops held last year, said there was a “gulf” between Pharmac management and patient and consumer groups. It recommended immediate changes and broader reform of the organisation. 

The organisation’s chief executive, Sarah Fitt, resigned last month after a turbulent period in which her leadership was heavily criticised by patient advocates. 

Associate Health Minister David Seymour and Pharmac chairwoman Paula Bennett had refused to express confidence in her. 

A second review, of Pharmac’s organisational culture, is yet to be released. 

It is understood that Fitt was was singled out for criticism in the emotionally-charged workshops in November, which were arranged by the board and independently chaired by Dame Kerry Prendergast. 

The consensus from the first workshop, which involved 30 patient and consumer representatives, was that resetting the Pharmac-patient relationship was “long overdue”, the report said. Nothing should be off the table, these representatives said, including funding levels and possible law changes. 

“Because there is no existing framework for engagement, the way Pharmac currently engages with consumer/patient representatives is regarded as uneven, unequal and inconsistent,” the report said. 

“Pharmac’s organisational culture is also a problem, seen as slow to respond, lacking respect for consumer/patient representatives, and highly defensive when called to account.” 

Consumer representatives were also highly critical of Pharmac’s Health Treatment Assessments (HTAs), which determine which medicines are funded. 

A second workshop which included Pharmac management left patient groups unsatisfied and unheard, the report said. 

“The workshop mood was that nothing new was learned from Pharmac’s formal responses, and that management had lost an opportunity to be more open / less defensive when dealing with the consumer/patient representatives present.” 

All representatives agreed that the HTAs needed to be transformed rather than tinkered with. 

Associate Health Minister David Seymour, who is responsible for Pharmac, said it was clear that the relationship between the organisation and consumers was “unproductive”. Photo / Alex Burton 

Prendergast recommended a new reference group to work with Pharmac management on changes that can be made within the board’s existing remit. 

Among the issues that group could consider were developing a fast track process for medical technologies already adopted overseas. 

Pharmac chairwoman Paula Bennett said participants had identified a number of areas for the organisation to improve the way it engaged with advocates. 

“We’ve heard very clearly that we need to make sure our interactions are respectful and meaningful, and that people’s voices are valued and included throughout our work,” she said. 

“There’s a lot for the board and Pharmac’s senior management to think about, and we’re considering the next steps. This work is part of a wider reset for Pharmac to become an outward-focused organisation.” 

Associate Health Minister David Seymour said it was clear that the relationship between Pharmac and consumers was “unproductive”. 

“I hope the board takes this opportunity to continue to prioritise expanding opportunities and access for patients and their families by expanding access to more medicines for more groups,” he said. 

Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues.