When bushfires ravaged the country across 2020, the government announced the continued dispensing emergency measure, allowing pharmacists to provide medications without a repeat prescription in emergencies.
It meant that if a patient was unable to schedule a GP appointment, had been taking the medications within the past three months for a stable condition, and it was necessary and safe to do so, a pharmacist could renew their prescription.
The program was temporary and scaled back at the end of June, though has been replaced with ongoing continued dispensing programs that allow pharmacists to prescribe medicines for the management of chronic health conditions such as asthma, diabetes, high cholesterol and heart disease.
As floods cause mass evacuations across the east coast, Pharmaceutical Society of Australia national president Dr Fei Sim is calling for an extension of the powers to assist those in need and help ease the GP shortfall.
“The continued dispensing program was so successful and so needed that it continued from the bushfires across the pandemic,” Dr Sim told Crikey, adding pharmacists could now only prescribe around 100 medicines, down from 900 under the emergency program.
“But the consequence [of reducing the eligible medicines] means things like antidepressants, antiarrhythmics for abnormal heart rhythms or epilepsy medicines such as anticoagulants — different medicines that people need to take on an ongoing, routine basis — can’t be dispensed [without a prescription].”
Pharmacists providing these kinds of medications, even for those evacuated from floodwaters, would be breaking the law, Dr Sim said.
She’s also calling for pharmacists to work more closely with GPs to allow “collaborative prescribing” to allow continued dispensing of particular drugs for people with certain ongoing conditions.
A trial is currently underway in Queensland to allow pharmacists to diagnose and prescribe drugs for 23 conditions, ranging from type 2 diabetes to heart conditions. The Australian Medical Association is against the trial, arguing it puts the public at risk and pharmacy profits before patients.
Royal Australian College of General Practitioners president Dr Karen Price has also voiced concerns about the proposed expansions, questioning their efficacy given pharmacies often have the same opening hours as GPs and the ethics of putting pharmacists on the patient frontline.
Australia has been in the grips of a decade-long GP shortage, with a predicted deficit of 11,517 GPs by 2032. Nearly half say it’s financially unsustainable for them to continue working as a GP as practices turn away from bulk billing due to low Medicare rebates. The decrease has been exacerbated by COVID-19, with 73% of GPs reporting they experienced feelings of burnout across the past year.
It’s not the first time pharmacists have pushed for more prescribing powers: last year Monash University conducted a federally funded trial for pharmacists to offer counselling on birth control options for those seeking emergency contraception and dispensing oral contraceptive pills without a prescription. The trial is still underway.
Pharmacists also aren’t immune from the nationwide workforce shortage, especially in regional areas. But, Dr Sim said, greater collaboration between GPs and community pharmacies could ease the burden for both professions.
“We need to look outside the box about how can we more effectively and efficiently administer health care to allow health professionals to practice to the top of scope care,” she said.
“GPs’ skill sets are so much better utilised in more complex conditions.”
The Health Department and Health Minister Mark Butler have been contacted for comment.
I’m not going to trust pharmacists to diagnose and prescribe anything until they stop selling homeopathic concoctions.
Was offered homeopathic melatonin by my pharmacist a week ago – my reply was somewhat tart!
One simple fix would be to allow doctors to prescribe more than 6 months supply of certain medications.
I need to treatment for a condition for the rest of my life. It is reviewed by a specialist once a year. However every 6 months I must make a totally unnecessary appointment with my GP for another 6 months worth. She can’t check the condition – she doesn’t have the specialised equipment.
We could emulate New Zealand. There the standard pack size is 3 months supply (not 1 month like it is here) and your prescription is valid for 18 months.
Watch pharmacists scream if we did this, as their passing trade and the chance to flog all manner of other items drops.
At least your GP can monitor your condition every 6 months and if there is a significant change in your condition he/ she can contact your specialist. It is amazing how the doctor to doctor phonecall gets you into the specialist today or tomorrow.
No, my GP doesn’t have the equipment to monitor my condition.
Sorry, I misunderstood.
As specialists go, I have a Dermatologist, Gastroenterologist, Endocrinologist,Chest Physician,Infectious Diseases Specialist, Hypertensive Specialist Physician,Pain Management Specialist, Colo-rectal Surgeon and Neurosurgeon.
Some years I feel as though I move from one waiting room to another and I actually feel joy when only needing my very switched on GP.
The doctors’ want to defend their monopoly and the pharmacists want to expand their business. They clash. Each says it is looking after the public interest, which by a remarkably happy coincidence is the same as their own interest. No surprises there, it’s another round in the turf wars between the various health professions.
This should be resolved by an independent and disinterested referee tasked with finding where the balance should be set in the public interest. Will the politicians do that, or will the power of political donations from the two powerful lobbies, along with party political self-interest, once again settle the matter?
Medical bodies such as the AMA and the College of General Practice do not make political donations. The Pharmacy Guild does. Pharmacist prescribing means they benefit financially from the dispensing, whereas doctors do not dispense.
ok, that’s a good clarification. However, while doctors do not dispense, they still have a financial interest in seeing the patients who want a prescription. And then there’s the empire-building endemic in any profession.
A pharmacist can own medical practices, whilst a doctor is not allowed to own a pharmacy/s.
The Pharmacy Guild is the most powerful lobby group in Australia.
This is just a further example of two of the most powerful Unions in the country having a demarcation dispute.
Forget the FEMMEU, the Governments are terrified of the Doctors Union and the Chemists Union.
It will be interesting to see who wins this standoff.
BTW. I would trust a Doctor rather than a chemist for a diagnosis anytime.
As an afterthought, perhaps if we let Barbers do surgery, like in the old days,that could reduce costs also.
Hairdressers and barmaids could replace shrinks and psychos, and grandmothers a whole mob of so called experts on Motherhood and Child shrinks.
How many more like this could there be?
The ADA make the AMA look like a bunch of rookies.
One answer. which doesn’t seem to get much traction, is Nurse Practitioners. They are common in North America (including Canada), and are part of the healthcare set up in general practice in many other countries. All are very well educated…usually having post-graduate degrees as generalists, or in their chosen field: obstetrics, paediatrics, aged/chronic disease, paliative care, etc. These NPs can write prescriptions limited to their particular field (as I understand it), and they are far less expensive than doctors or pharmacists. It is a mystery why we do not have Nurse Practitioners in this country.
We do have nurse practitioners here, in fairly limited roles.
And not that many of them.
We do have nurse practitioners. The pathway to practitioner status is diffcult, and the roles they are given are often very circumscribed. But it is very much a part of any solution, particularly in regional areas.
I am aware that there are a few Nurse Practitioners in this country, but don’t think there are many (if any) working in general practice or in the community. Certainly it is not like other countries where they are located quite freely in both urban and rural settings…and very well accepted.
Canada has no baseline for the outcomes delivered by the nurse practitioners, just as New Zealand has no baseline for the outcomes delivered by their midwife led model.
If you are willing to accept that or know no better, they bury their mistakes.
There are Nurse practitioners in Australia and their practice is restricted to very rural areas with limited prescribing/ dispensing rights.
The paperwork you sign when you attend one of these clinics means that you have no right to sue, if they fail to diagnose correctly, just as it in Canada.
There are no private medical practices in Canada and so I suspect the cost of a co-payment would be less. Drugs are cheaper in Canada than the US, but certainly not as inexpensive as those prescribed on the PBS in Australia.