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18 Oct 2018

The Queensland pharmacy inquiry has recommended that options be developed for what it is describing as “low-risk” prescribing by pharmacists.

The AMA has condemned the recommendation, saying patients will lose out if it is adopted.

Recommendations are listed in the Queensland Parliament’s Health, Communities, Disability Services, and Domestic and Family Violence Prevention Committee Report into the Establishment of a Pharmacy Council and Transfer of Pharmacy Ownership

Chairman of the Inquiry, Aaron Harper said: “We see potential for pharmacists to do more than they currently do – with some prescribing of medications in low-risk situations and subject to a range of safeguards.”

But AMA President Dr Tony Bartone said that and some other recommendations add up to bad news for patients.

“The Report contains recommendations to expand the role of pharmacists, including in relation to the prescribing of medications,” Dr Bartone said.

“It is well known that the more other non-medical health professionals are involved in prescribing, the higher the risks of medication error and adverse reactions.”

Other recommendations include lowering the minimum age for pharmacist-administered vaccinations to 16, retaining current pharmacy ownership laws, and establishing a new pharmacy advisory council for the State.

Dr Bartone said GPs were the only trained primary health professionals who have the skills needed to properly and comprehensively diagnose patients, prescribe the right medications, and refer patients to other health care providers as appropriate.

“These are skills that come from years of observing and examining patients, and understanding how text books and the real live patient overlap,” he said.

“Clinical training is an art that has its foundations over the centuries, and cannot be learnt by simply and solely reading texts.

“GPs currently work closely with their pharmacist colleagues on a daily basis, and respect the unique skills they bring to the care of patients, particularly with respect to the quality use of medicines.”

Dr Bartone said the AMA was in the middle of a real effort to introduce the medical home concept in Australia, where GPs are able to coordinate patient care, with full access to a patient’s medical history.

 “But let me be very clear about this Report, which completely overlooks the reality of quality primary health care,” he said.

“It totally ignores the well-understood need in our health system to strengthen the coordination of care, and the need to encourage patients to have a long-term relationship with a usual GP or general practice.

“The Report also opens up a serious conflict of interest for pharmacists who will gain commercially through prescribing of medications, and then being able to dispense them.

“We already know that pharmacies sell many complementary medicines that are not backed by clinical evidence. This highlights the retail pressure they are under to sell products to consumers regardless of patient need.

“The recommendations in this Report, if adopted, would set Australia on a dangerous course.”

Dr Bartone said Australia had a GP-led model of care that is the envy of the world, with GPs highly accessible in most parts of the country.

Australia has primary care outcomes that are second to none.

He said the Australian community deserved better than what was recommended in the Report. The focus of policymakers, he said, needed to be on building on the proven model of GP-led care, rather than undermining it by giving in to the retail interests of the pharmacy sector.

 “Any access concerns cannot be solved by providing a second-best alternative,” Dr Bartone said.

CHRIS JOHNSON


Published: 18 Oct 2018