Dominic’s Perrottet’s sudden announcement of an expanded scope of practice pilot for pharmacists has some doctors concerned about who’s pulling the strings.
The RACGP said earlier today NSW’s program to expand pharmacists’ scope of practice is putting politics above patient health and safety, with the Perrottet government facing an election in March next year.
The Pharmacy Guild-backed program mirrors a similar initiative in Queensland. From today, NSW pharmacists will be able to give a wider range of vaccines, while a UTI pilot and broader scope of practice program are set to follow.
But Associate Professor Charlotte Hespe, the RACGP’s NSW and ACT faculty chair, said the program not only puts patients at risk but also represents a political play.
“It’s an incredibly political move,” Professor Hespe told TMR. “The NSW government has got an election in March and what they’re doing is rushing through some significant changes to the way in which you can access primary health care because they know that GP access is a crucial issue in some of their key seats.
“This policy change is costing them nothing. They don’t have to pay anything to anybody because the Pharmacy Guild is promising to deliver it all and provide the education for free. So the program is free for the NSW government who can say it’s solving the GP access issue.”
The NSW Government said it aims to increase community access to primary care by:
- authorising pharmacists to administer a wider range of public health and travel vaccinations from today, including Japanese encephalitis, hepatitis A and hepatitis B, poliomyelitis, typhoid and zoster
- funding a 12-month trial to evaluate allowing pharmacists to prescribe medication for urinary tract infections; and
- supporting a state-wide pilot where appropriately trained pharmacists can prescribe medications for certain conditions, such as skin ailments, ear infections, and hormonal contraception
In announcing the program, Premier Perrottet also called on the federal government to boost its support for primary care.
“We are stepping up to provide yet another innovative policy to improve the lives of people by offering more support for primary care,” said Mr Perrottet, who faces an election on March 25 next year.
“The federal government should be providing more support for GPs and a greater amount of free bulk-billing services, but we can’t sit around and wait for them to catch-up and meet the growing demand.”
But Professor Hespe believes there was inadequate consultation with doctor groups in the lead-up to yesterday’s announcement.
“They’ve not consulted the GPs or the AMA at all,” she said. “They’ve just guessed, and they’ve consulted the Pharmacy Guild who are going to make a profit out of this. Have they actually consulted with the pharmacists who are at the coalface? Funnily enough, no – they’ve just consulted with the owners.”
In a statement on the announcement yesterday, the Guild’s NSW branch said the programs would ease the pressure on GPs and EDs while recent research carried out by the branch showed that 9 out 10 NSW voters support pharmacists increasing their scope of work.
“Pharmacists are calling on the other Premiers to follow the lead of the Perrottet and Palaszcuk governments,” Guild national president Professor Trent Twomey said in the statement. “Now that we have clinical alignment on the eastern seaboard, national consistency is needed to see genuine system reform.”
TMR asked the NSW branch about any discussions that had been held between the Pharmacy Guild and the NSW Government prior to the announcement but was referred to yesterday’s press release.
RACGP president Adjunct Professor Karen Price urged the NSW government to put patient safety ahead of pharmacy owner profits.
“I strongly urge the state’s leaders to resist the lure of the powerful Pharmacy Guild lobby group and to look at what has happened in Queensland and overseas when greater power is handed to pharmacists,” Professor Price said. “For example, incidents have emerged from Queensland’s UTI pharmacy pilot which should make policy-makers second guess expanding pharmacy scope of practice.
“Rather than handing over responsibility to the pharmacy sector as part of a band aid solution for rural and remote healthcare we need government to look at long-term solutions for the GP workforce nation-wide.”
The proposal that pharmacists should be able to prescribe hormonal contraception as part of the state-wide pilot comes despite a TGA ruling in December 2021 that it should not be down-scheduled from being prescription only.
Professor Hespe said this concerned her greatly.
“We have a really good medication safety record in this country and really good policy around what medicines are appropriately available over the counter,” she said.
“Recently, the only things [the TGA] has been doing is up-scheduling because they’ve appreciated that a lot of these medicines are inappropriately accessed through pharmacy because they’re much too easy to get.
“We also need to address our stewardship around antibiotics,” she added. “99% of the patients in the North Queensland UTI trial were given antibiotics even though it wasn’t proven to be a UTI.”
