Nth Qld experiment must be stopped

AMA President Dr Omar Khorshid will be in Cairns today to hear firsthand the concerns of doctors and patients about the dangerous North Queensland pharmacy prescribing pilot. 

The pilot, due to start this month, would allow pharmacists in communities north and west of Mackay to diagnose, treat, prescribe and sell medications for 23 serious conditions including asthma and diabetes without any medical consultation or oversight and without undergoing the many years of study and training required to be a GP.

Despite the looming deadline, the Queensland government is yet to publicly release any information about the start date, the final list of conditions to be treated, the online training program for pharmacists, how many pharmacies will be taking part, or how to report adverse outcomes. 

The scheme is touted as a solution to GP shortages, yet there are no pharmacists in at least 13 of the 37 local government areas included in the pilot. 

This pilot is based on a state-wide urinary tract infection prescribing trial. However, the Government-funded evaluation of that trial shows most services delivered were in cities and major towns, not regional and remote areas. 

“This pilot should not go ahead. It is a short-term, short-sighted proposal which is going to complicate healthcare for rural and regional communities and potentially cause real harm.

“Regional and rural doctors are genuinely concerned about the dangers this poses for their patients, particularly in First Nations communities. 

“We have serious concerns over patient safety, the clinical governance of the trial and the conflict of interest between having a pharmacist diagnose and make a profit from selling a product. 

“This is clear from the UTI prescribing trial. Almost 97 per cent of women who took part were prescribed antibiotics because pharmacists felt they could not charge the consultation fee if they did not supply antibiotics. 

“This not in the best interests of patient health. This is simply a quick fix that devalues the years of training GPs and other specialists put in before they have the knowledge and experience to properly diagnose and treat a medical condition.

“If the Queensland government is determined to proceed with this dangerous proposal, they should at least be honest with doctors and the community and release all the details, instead of working behind closed doors with unknown parties to design this scheme,” Dr Khorshid said.

AMA Queensland President Dr Maria Boulton said the 677,000 people living from Mackay west to the border and north to the Torres Strait deserve the same quality healthcare the other 4.5 million Queenslanders enjoy.

“The UTI trial did nothing to relieve pressure on emergency departments – it just led to women waiting longer for treatment for conditions that are easily mistaken for UTIs – pregnancy, pre-cancerous conditions, and sexually transmitted infections that can lead to infertility,” Dr Boulton said. 

“None of the women in the UTI trial had a basic urine test to determine if they had a bacterial infection or were pregnant. 

“They were prescribed antibiotics they may not have needed, they may have been allergic to, or that are dangerous in the first trimester of pregnancy. 

“We know from our survey of Queensland doctors in March that rather than fixing workforce issues, this proposal will actively deter doctors from moving to regional areas. 

“Pharmacists are experts in medication. We work with them collaboratively every day to ensure the best outcomes for patients. As the granddaughter and niece of pharmacists, I have the utmost respect for their profession. 

“But they do not have the years of training and experience in diagnosis needed to tell the difference between a simple condition and something much more serious. 

“It is time to stop this dangerous experiment with the health of Queenslanders.” 

The AMA Queensland survey of doctors is available here.