Here is the content of it written between their email:

29 January 2003

 

 Dear Anne-Marie Jefferies

 

complaint concerning pharmac

Thank you for your email of yesterday, and attachments.  As you suggested, I have consulted the Pharmac web site, including the pharmaceutical schedule.

As you are aware, Section F of the pharmaceutical schedule sets out the criteria for exempting pharmaceuticals from monthly dispensing and it is these criteria which form the basis of your complaint. 

Section F makes clear that there are two categories of exemptions from monthly dispensing:

·        Certified exemptions which apply to patients whose medical condition could seriously deteriorate in 48 hours if they could not access their medication.  Section F stipulates that to qualify for the exemption, the prescriber must write “certified exemption” beside the prescription items in question.  The medication required by your son comes within this category.

·        Access exemptions which apply to patients who have difficulty getting to and from a pharmacy.  Patients who qualify for this exemption must sign the back of the form to certify that they meet one of the following criteria:

o       Have limited physical mobility

o       Live and work more than 30 minutes from the nearest pharmacy by their normal form of transport

o       Are relocating to another area

o       Are travelling extensively and will be out of town when repeat prescriptions are due.  

The essence of your complaint is that people with an ongoing medical conditions such as your son’s, who at times of illness are required to increase their medication, should be able to qualify for the second category of exemption: the “access exemption.”  

The Human Rights Commission has the power to resolve disputes that involve breaches of Part IA or Part II of the Human Rights Act 1993 (“the Act”) as amended by the Human Rights Amendment Act 2001.  Parts IA and II prohibit, amongst other things, discrimination on a number of grounds including sex, race, disability in key areas of public life such as employment,  the provision of goods and services and government activities.  Since Pharmac is a Crown entity established pursuant to the New Zealand Public Health and Disability Act 2000, its activities fall within the terms of section 20J of Part 1A of the Act (a body performing a public function imposed on it by law.)

Hence, Pharmac is not permitted to breach Part 1A by any actions that limit the rights to freedom from discrimination.  However, if Pharmac can establish that its discriminatory act is “demonstrably justified in a free and democratic society” it would be permitted under the Act.  You allege that Pharmac is discriminating against you and your son by not extending its access criteria to your son’s disability.

Although “discrimination” in Part 1A of the Act is not defined, the Commission considers that it has to involve different treatment leading to a reasonably  significant element of detriment or disadvantage.  We note that your son’s medication already comes under the first exemption category and the major disadvantage you cite is your doctor’s having to remember or be reminded by you to endorse the script.  I am sorry to advise that we consider this is not a significant enough detriment or disadvantage to warrant the complaint being actioned under Part 1A of the Act. 

If this is not a significant enough disadvantage or detriment to an individual with physiological disability to have to ask their GP time and time again (or remind them) about signing the script “certified exempt” then why do they separate the two types of disability?  The vast majority of people who are physically disabled and covered by the Access Exemption criteria are quite able to vocally communicate their need for their script to be certified exempt also.  That is because the majority of that group are physically disabled but are able to communicate orally.  In fact no less so than someone whom has a physiological disability.  So basically here, what you are stating is that it is acceptable for people with my sons type of physiological disability (which is life long and will always need these medications) to have to do this, but that people who are wheel chair bound for anything more than any amount of months (even if it is only temporary for some reason and NOT life long) can be considered by Pharmac as more deserving of this particular access exemption criteria. 

It is not acceptable in any way shape or form.  They base their regulations on the idea that every Doctor in New Zealand will remember to sign that script “Certified Exempt” for people that visit them every three months for life without being reminded.  It is simply not fair.  If it does not matter, and it is no big inconvenience for people to have to remind Doctors at each visit, or dash back and get the script amended when they realise it is written wrongly, then why have they excluded the other physically disabled group from having to do this?  Pharmac are assuming that most Doctor’s even know how to write this on a script.  Most of them don’t.  I have had several Doctor’s look at me like I am clueless when I have asked them to make sure that the script is noted “Certified Exempt” and most of them don’t even know where to put it on the script.  Some have even turned around and said, “ Oh I don’t need to do that, the pharmacy will sort that matter out,” and have ushered you out of their office…”Next patient please," type of stuff. 

So if it were not THAT much trouble I can say here, I would not even be bringing the matter to your attention.  However, you seem to be saying that your organisation fights for the human rights and equality and that these regulations make ALL disabled people equal.  Not so at all is it?  If they were equal we would not have two clauses at all.  We would have one clause full stop with two descriptions of what disability is and what is covered by their access exemption.

It is also likely that Pharmac would be able to demonstrate that its exemption criteria are justified.

How?  Please elaborate?  I am just a simple Mother of five children who wants to sort through those issues.  How could they ever justify that they feel they need to be more lenient to one type group with a disability over the other when there are pit falls with the way NZ Medical Practioner’s write scripts?  I am pointing those out to them and yourselves here.  I am saying, this IS a big deal to me.  Let alone when my son grows up and has the hassle of doing these things for himself. 

So you think it is acceptable that out of ten Doctor’s for example, when I get a script, I need to remind nine of them that he needs it all up front?  Don’t they know their jobs?  I pay a GP to look at my son’s records and KNOW what he is prescribing drugs for.  They should know that it is needed in one quantity of three months.  However, most of them never do.  Now I remind them.  I allow them to print it out and then I note what they have done and have to point it out to them.  So this is a fair system is it?  You think it is ok for new parents to learn the hard way from all this and have countless scripts written like this before they learn what they need to be doing to get them noted as “Certified Exempt?”  Well here is a parent telling you I don’t like it, and that it is wrong for these people to discriminate like this.  Who in life get’s anything sorted out if they don’t bring these matter’s up?  I have a son with this type of disability (physiological) and has anyone else approached you about this?  I doubt it.  They have more than likely felt as frustrated as I have, but it only takes ONE to step forth and start this type of thing. 

I mean if this were made public (and I am sure Pharmac would prefer to sort it out properly) and people knew that other’s similar to them felt the same and had actually approached yourselves about it and how do you think this would turn out?  I can guarantee you would have many people following in my footsteps.  That is because it is discrimination when someone seeks to differentiate between any type of disability or ability where it comes to supplying the New Zealand public with goods and services.  Yes Pharmac is part of the crown, but it would be interesting to find out what other countries of the crown have decided where this is concerned.  To see how drugs are dispensed in the UK for example.  Have you done that? 

Yes I am terribly disappointed and I would like to push forwards and continue with my complaint.   Feel that all options have not been explored at all.  Ten years of dealing with this and it is dealt with in two days and the person dealing says he, “does not think that it is a detriment or disadvantage?”  It is!  But I should like your idea of detriment and disadvantaged explained in more depth and to know exactly what criteria you have used to determine that much.  There are thousands in the country who have this problem.  When Pharmac implemented those regulations in 1996 they simply had no idea at that point of what problems it could cause for some people or a minority group with this type of disability.  Whats more, if they can feasibly alter their schedule to adopt a more sympathetic stance or to "include” this minoroty group that they HAVE excluded from that schedule set down in 1996 and don’t, then as far as I can see that is not just discrimination but irresponsible. 

Why irresponsible?  Well if they have been complained to about this and approached by people who HAVE physiological disabilities and can ignore that, or ignore complaints suchas the one I put forth, then does this foster responsibility that they should have for making sure ALL disabled people are catered for ibn their provision of goods and services?  No it does not.  In your rulings it clearly states that if a certain body can reasonably “include” a minority group within their rulings and don’t then that this is also discrimination.  I think we know that they could.  But it is down to Human Rights to make an issue of that with them and push the issue.  I cannot do that alone.

 

Please not that I would like to appeal under the section 92B of the Human Rights Act 1993 and bring further proceedings before Human Rights Review tribunal. 

 

Yours sincerely

A Jefferies

 

 

I appreciate you will be very disappointed with the Commission’s decision.  However, if you disagree with our decision, you are able (under section 92B of the Human Rights Act 1993) to bring proceedings before the Human Rights Review Tribunal. The contact details for the Tribunal are as follows:

 

 

You may also apply to the Director of Human Rights Proceedings for free legal representation in such proceedings. You should note that this may not be granted as this will depend on the Director’s view of your complaint. The address is:

 

           

 

Yours sincerely

 

MANAGER DISPUTE RESOLUTION SERVICES

Kaihohourongo Tumuaki

   

 

 

 Further correspondance later after a search on google:

 

Your Ref: 

Mrs A Jefferies

28th January 2003

Further to my previous correspondence I have now laid my hands on a section
that refers to people with disabilities where the NHS is concerned in the
UK.  This is also governed by the crown as you will appreciate.  Please
include this correspondence in my appeal as is laid out below and
investigate with the NHS further from their web site if necessary.

SUPPORTING TEXT FROM HERE


NHS Script Rulings around exemption where cost of scripts is concerned but
also covering I should imagine HOW that script is dispensed and especially
tablets:

SECTION 5: PEOPLE WITH A SPECIFIC MEDICAL CONDITION

You can get free NHS prescriptions if:

you suffer from any of the medical conditions listed below and
you have an exemption certificate from the Health Authority
The conditions are:

a permanent fistula (for example caecostomy, colostomy, laryngostomy or
ileostomy) requiring continuous surgical dressing or requiring an appliance
forms of hypoadrenalism (for example, Addison’s disease) for which specific
substitution therapy is essential
diabetes insipidus and other forms of hypopituitarism
diabetes mellitus except where treatment is by diet alone
hypoparathyroidism
myasthenia gravis
myxoedema
epilepsy requiring continuous anticonvulsive therapy
or people who need help to go out
NOTE
If you are unsure about the name of your condition, check with your doctor.

*Only the conditions listed above count.

We ask doctors to advise you about free prescriptions. But it is up to you
to find out if you are entitled or not.

When you are diagnosed as having one of the conditions listed get a form
FP92A (EC92A in Scotland) from your doctor, hospital or Health Authority to
apply for your exemption certificate. The form tells you what to do.

*My son Ashley’s condition comes under this section and therefore he would
be TREATED just the same as anyone on that list.  In every way. He comes
under it as " forms of hypoadrenalism (for example, Addison’s disease) for
which specific substitution therapy is essential" and you will see below
that that they include within "the same criteria" the "people who need help
to go out."

They make NO distinction.  A physiological disability is lumped in with a
physical disability where script cost and more than likely ACCESS of that
script is concerned.    THEY do not discriminate.  As a UK citizen and
having emigrated in my 30’s to NZ to have the terms Pharmac set down where
disability and access to scripts is concerned, this DOES feel like an
inconvenience and discrimination.   Pharmac’s schedule is altered ALL the
time.  They can do this it is THAT simple.  Should they choose not to, it is
discrimination in the eyes of a lot of people around the world..UK being
just one of them.  I am in touch with many other people in many other
countries who have this condition.  I run a support forum and have access to
what other’s scripts allow in this respect and I have not heard of anyone
being discriminated against in the way that Pharmac choose to discriminate.
Note the word choose.

My web site has been a tremendous way of learning such and you could help
with this by doing far more than I have here with looking at the NHS in the
UK for examples.

I found this section from the NHS site in the UK at this URL:

http://www.doh.gov.uk/nhscharges/hc11.htm

Now they thought about the situation.  When my son was born in the UK, they
did not include his disability on there--point of fact.   The Doctor’s at
the time had to "devise" a way and just shove him into the diabetic
category.  However, they obviously saw the errors created with not being
elaborate enough and they fixed them.  This is what a responsible goods and
services providers of goods and services do.  Especially when it concerns the provision of a
patients medications and when they are dependant upon them for life.  If
Pharmac cannot do this much, then it is sheer neglect pure and simple.  I
pointed it out to them and yourselves.  I do hope that something can be done
about it to bring the standards of this company who may be governed by the
crown, but whom are no more governed or restricted by such than the other
goods and service provider named NHS in the UK.  They can amend such if they
needed to and should.

END OF SUPPORTING TEXT

Sincerely

A Jefferies