Concerns remain over the NT Country Liberal Party’s proposal to expand pharmacy prescribing to treat 21 conditions, after their decisive election victory over the weekend.
After a landslide Northern Territory election win for the Country Liberal Party, concern remains over its proposal to significantly expand pharmacy prescribing.
Before the election, the Country Liberal Party touted a proposal to allow pharmacists to treat 21 conditions.s
Unsurprisingly, the proposal attracted the ire of the Royal Australian College of GPs, which warned that it contravened the Therapeutic Goods Administration rules for medicine.
Speaking to The Medical Republic on the proposal, RACGP NT Chair Dr Sam Heard said supplying antibiotics over-the-counter wasn’t a solution to the workforce crisis in rural and remote Australia.
“Everybody wants access to everything as easily as possible, don’t they, so I get it, it’s a real populist standpoint,” he said.
“But we have regulations that are in place for a reason, and although everybody would like to be able to go in [to a pharmacy] and ask for whatever they think they need, we [must] protect our healthcare system.
“We’ve got to have proper diagnoses for use of antibiotics.”
Dr Heard pointed to countries like Indonesia and India, which are suffering from significant problems due to antibiotic resistance resulting from lax antibiotic access.
“Even in Australia, we had 1200 people die last year because they didn’t respond to antibiotics,” he said.
“The more we use them, the more problem there’s going to be.
“I don’t have a problem if it’s a very short course of a specific antibiotic that works for a urine infection … when it might give a lot of relief to somebody.
“But to make broad spectrum antibiotics available over the counter … it’s a really problematic idea.”
Dr Heard said he recognised that it was “not very pleasant” to have to wait for treatment for some symptoms.
“There are clearly things that are good to get over the counter … like if you take omeprazole for stomach acid,” he said.
“It used to be that we had to get authority to give it to people … it’s now over the counter.
“We don’t see people with ulcers anymore, largely because that drug is available, and if people take a short course of it when they’ve got indigestion, it really is very safe and probably solves lots of problems.
“I [also] think it’s terrific to have your vaccinations at a pharmacy. T,at suits people.”
Dr Heard said it would be good to sit down to discuss where pharmacy scope expansion could be of benefit.
But a significant part of the problem was access to proper care, due to the limited number of GPs in the area.
Dr Heard said he would like to see “proper primary care services” bolstered, including dispensing within primary care.
“If you look at the Territory, we’ve got regulations that allow [dispensing], when you’re in remote areas … There’s a recognition already that that’s the appropriate way to go.
“We haven’t set up pharmacies in all the remote communities.
“[But] I think we’ve got to accept good care for certain conditions involves some tests and diagnosis, when we’re using antibiotics.”
He added that there were innovative solutions like single-dose nitrofrancon, that’s used for UTIs in WA.
“That’s a good compromise: it’s urine specific, it’s concentrated in urine, we don’t use it for anything else.
“It’s very effective.”
Dr Heard said many parties – including the interim Australian Centre for Disease Control – were concerned about antibiotic overprescribing.
He suggested that the Pharmacy Guild was driving the CLP’s proposal, but its motive was unclear.
Implementation of the proposal should involve the approval of the chief health officer, said Dr Heard.
“I don’t think it’s an entirely political decision,” he said.
“[It] would usually involve discussion with the profession and we’ll be very happy to talk about this.
“We recognise this is a shortcut [that] can make life easier for people, but there are some areas where we think [it’s] not appropriate.”
The Country Liberal Party did not reply to TMR’s request for comment on their ongoing commitment to the pharmacy prescribing proposal prior to deadline.
