The Royal Australian College of General Practitioners (RACGP) has warned Queensland’s pilot allowing pharmacists to diagnose and treat patients was "a serious risk."
The warning comes after the Queensland Government announced it was pushing ahead with the controversial pilot, widely opposed by medical groups, including the Australian Medical Association, the Australian College of Rural and Remote Medicine, and the National Aboriginal Community Controlled Health Organisation.
RACGP President Adj Professor Karen Price said the pilot will result in poor health outcomes and must be stopped.
“Enough is enough, patient safety and wellbeing must come first,” she said.
“We are extremely disappointed that Queensland is pushing ahead with the North Queensland Community Pharmacy Extended Scope of Practice Pilot, despite the opposition and concerns of the medical community. Not to mention the evidence showing a similar Queensland pilot allowing pharmacists to prescribe antibiotics for urinary tract infections has gone horribly wrong for many Queensland patients who were wrongly diagnosed and had serious conditions go untreated.
“This pilot will result in poor health outcomes for patients and much higher healthcare costs. Because under the pilot, consultations with pharmacists will not be subsidised by Medicare, neither will prescriptions be covered by the Pharmaceutical Benefits Scheme. Furthermore, any medicines purchased won’t count toward a patient’s PBS safety net threshold, meaning they will be further out of pocket.
“Patients in this pilot will pay between $20 to $55 for a consultation with a pharmacist, plus the full costs of any medicines and pathology or other diagnostic testing. Most people are used to having diagnostic tests bulk-billed when they go to a GP, and purchasing medicine at a cheaper price thanks to the PBS subsidy, so these increased costs will likely be a very unwelcome surprise.
“It’s shameful that the Queensland Government is trying to argue that this pilot will give people in North Queensland more access to cost-effective care, when in reality it will cost patients much more. And it will do nothing to improve access to care for those who really need it and are disadvantaged and cannot afford to pay, if anything it will make matters worse.
“It is a particularly dangerous experiment to be undertaking in a community with a high proportion of Aboriginal and Torres Strait Islander people. And a higher than average proportion of people with complex health needs and multiple chronic conditions that need to be carefully managed by a GP.
“We can expect that this pilot will ultimately put more pressure on the state’s already overburdened hospital system and worsen ambulance ramping. The only ones benefiting appear to be pharmacy owners, as this model shifts the cost of healthcare services, ordinarily subsidised by the Commonwealth, back on to patients. It’s short-sighted politics and it will cost taxpayers more in the long-term by adding to hospital expenses – let alone the cost of this pilot, which is yet to be disclosed by the Queensland Government.
“Let me be 100% clear – there is no substitute for GP care, that path leads to poor health outcomes for patients.
“The Queensland Government needs to find genuine solutions to address healthcare workforce shortages, which are affecting the pharmacy sector just as much as general practice and hospitals in Australia. The Pharmaceutical Society of Australia has spoken out about the labour shortages affecting pharmacies and putting strain on already exhausted pharmacists, and persistent challenges in recruiting and retaining pharmacists across all settings.
“Instead of wasting money on this pilot, the Queensland Government should be looking at addressing the state’s hospital crisis, which is seeing dangerous ambulance ramping and skyrocketing out-patient waiting lists.
“Moreover, there are more GPs than pharmacists, and GPs are better distributed throughout Queensland, especially in rural areas, so it makes sense to build on and expand these existing services which provide evidence-based care.
“Everyone in Australia needs access to high-quality primary care, no matter their postcode or income. And the people of north Queensland deserve nothing less – they should not be treated as second class citizens, with second class services.”
RACGP Queensland Chair Dr Bruce Willett said it was very concerning that the medical community continues to be sidelined and not properly informed about the pilot.
“The medical community has been excluded once again; we heard about this announcement in the news, despite being promised detailed information about the pilot prior to any official announcement,” he said.
“This pilot will allow pharmacists to diagnose and treat patients when they don’t have the necessary training or experience. Completing a 120-hour prescribing course will never be equivalent to the training a doctor does, but this is all that’s required of pharmacists as part of this pilot.
“A GP like myself has usually well over 10-years training, including medical school and vocational training in hospital and general practice settings. This is what is required to be able to diagnose and recommend treatment to patients – diagnosis is not a simple task, it requires history taking, discussion with a patient, and ruling out all the other possibilities.
“The Queensland Government and pharmacy lobby have been claiming that similar pharmacy prescribing models are being used in other countries, including New Zealand, the United Kingdom and Canada. But each country has different health systems and levels of pharmacist training, supervision and experience, and different services that have been approved – so like-for-like comparisons cannot be made.
“Will people walking into this pilot be educated about the difference between medical and pharmacy training? And what rights will they be signing away for this experiment in providing their consent? There are a lot of questions that the Queensland government should be answering, and we hope to hear more from them as a matter of priority.
“Allowing pharmacists to diagnose, treat and prescribe to patients for complex medical conditions without the necessary medical training or supervision is a recipe for disaster.
“I can’t say this strongly enough – the RACGP has deep concerns about the retail pharmacy sector pushing through policy changes that put financial gains ahead of patient care and safety. This pilot should be stopped, because patient safety and wellbeing must always come first, and nobody deserves second rate care.”
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