Nth Qld pharmacy trial has doctors worried

Nick Gibbs |

Giving pharmacists the power to diagnose and treat a wider range of conditions is not the answer to health shortages in regional Queensland, doctors say.

A trial proposed for north Queensland would allow pharmacists to prescribe medicine for serious conditions and chronic illnesses, AMA Queensland says.

The 23 conditions include asthma, type 2 diabetes, heart failure and middle ear infections, and it would mean patients could access medicine without a GP consultation.

It has been proposed for 37 local government areas in north Queensland that have “significant indigenous populations and serious doctor shortages”, the AMA says.

Speaking ahead of a state parliamentary inquiry on Friday, president Chris Perry says medical association members “overwhelmingly” oppose the proposed pilot.

“”It’s fundamentally flawed and will deliver second rate health care to people in North Queensland,” Professor Perry said.

Looking at extending the scope of work for pharmacists in regions where GPs are harder to come by was an election promise, Health Minister Yvette D’Ath said on Friday.

The scope of the trial is not finalised, and pharmacists would have to do up to 12 months of extra training, Ms D’Ath said.

“We have already been running a trial on urinary tract infections for example, and I believe that this has been very successfully applied,” she said.

But while pharmacists are a vital part of health care, they do not have the training to diagnose serious health conditions, AMA Queensland Council of General Practice chair Maria Boulton.

“GPs on average have 12 years of training under their belts before they start diagnosing and treating these conditions,” she said.

Increasing pharmacists’ scope of practice could save about $1.3 billion over two decades by diverting non-urgent emergency department presentations, the professions’ peak body says.

“Practising to full scope is not a world first solution,” Pharmacy Guild of Australia Queensland president Chris Owen said.

“OECD countries like the United Kingdom, Canada and in part, in New Zealand, have shown that this solution works.”

Time frames for the start of the Queensland pilot are under review.

The AMA has written to the Therapeutic Goods Administration seeking advice on the trial’s potential impact on Australia’s health system.

“For example, the trial will allow pharmacists to prescribe the oral contraceptive pill – a move expressly outlawed by the TGA late last year given the health risks for patients,” Prof Perry said.

“We are seriously concerned that this trial will lead to significant misdiagnosis of potentially serious conditions plus undermine attempts to manage antimicrobial resistance.”

The AMA initially agreed to take part in a steering committee for the pilot, but now says it fundamentally rejects the proposal. 

The Royal Australian College of General Practitioners has also withdrawn from the advisory committee in protest.

“While it’s important to have a seat at the table in order to influence change, we cannot provide representation on an advisory group for this pilot which compromises patient care – this is why we are withdrawing,” Queensland Chair Bruce Willett said.

The National Council of Primary Care Doctors has also written to Queensland and federal health ministers recommending that the pilot be stopped.

AAP