The scathing response from a GP-turned-parliamentarian has reopened interest in the NSW pharmacy trial.
It’s not clear what the NSW government is hoping to achieve with the latest pharmacist led prescribing trial, says the RACGP.
In April, NSW health minister Ryan Park announced the existing pharmacist-led prescribing trial for the contraceptive pill would be expanding.
Since late 2023, some pharmacists have been permitted to dispense resupplies of the oral contraceptive pill to women with an expired or misplaced prescription.
From June this year, pharmacists will also be able to write prescriptions for the pill.
Speaking in the NSW legislative council last week, Greens MP and former GP Dr Amanda Cohn called out the fanfare surrounding the new initiative.
“I understand that people are celebrating this because they are desperate and it makes the pill easier to access,” she said.
“But the Government is spending $4.5 million on pharmacist consultations rather than actually supporting people to see the GP and have a holistic consultation about all of their options for contraception to get the best option for them.
“… One of the key advocates in the media for this change is someone who takes the pill to manage polycystic ovarian syndrome, which is a complex hormonal condition that needs care from a GP. That person is now going to get that care from a pharmacist who is not trained to do that.”
She went on to say she was “sad” that healthcare had come to this and that it was a “desperate stopgap measure which, of course, in the dire circumstances we are in, is very popular”.
Other choice words Dr Cohn had for the scheme included calling it “a frightening creep towards a Donald Trump United States approach to healthcare” and saying the Minns government was telling women “they should be happy to accept a lesser quality of care than what they deserve”.
When the pharmacist-led prescribing trials were first announced, the NSW government promised a thorough evaluation led by the University of Newcastle.
An evaluation of the UTI and oral contraceptive pill phases were meant to have been provided to NSW Health in 2025, with a report on the dermatology phase of the trial to be provided this year.
“… The Government still has not released the results of that trial,” Dr Cohn said.
“All stakeholders, including the Royal Australian College of General Practitioners, supported that trial being done in a rigorous manner by the university. The trial has been extended to pharmacists to be able to initiate a script for the pill.”
RACGP NSW chair Dr Rebekah Hoffman said Dr Cohn was “spot on” in her criticism.
“GPS weren’t involved in the decision making [for the latest contraceptive trial],” she told The Medical Republic.
“It was done at a time that key spokespersons were away, and we weren’t given the right to either collaborate, co-design or have any involvement in this announcement at all, which was really disappointing when we thought that we had really good relationships with the government.”
Dr Hoffman confirmed that the RACGP had never seen either of the evaluation reports which were scheduled to be completed last year.
“We’ve asked for the findings from both studies, and they’ve not been released,” she said.
“But what’s bothering is that these trials are announced and they’re undertaken, and they become business as usual without that outcome of the study.
“And we neither know what the outcome is or for the UTI trial, [nor] is it even clear what they were looking for as part of the outcome.”
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While Dr Hoffman said the logic behind the original contraceptives trial had made sense – women do occasionally run out of their oral contraceptive script by accident – she said the extended version of the trial was less clear.
“The continuation [trial] was really sensible, it actually had really clear guidelines, and it actually was solving a problem,” she said.
“My other concern with this OCP initiation one is, what is the problem that the government’s actually trying to solve?
“People universally can get into their GPs for initiation of contraception and to have that conversation. It’s not an access problem.”
The RACGP is now calling for a seat at the table to ensure that any permanent changes prioritise patient safety.
NSW is not the only jurisdiction currently looking at expanded prescribing rights for pharmacists.
From today, pharmacists in the Northern Territory can diagnose and prescribe for 21 separate conditions, similar to their Queensland-based counterparts.
“These initiatives empower pharmacists to deliver more frontline care, improving access for patients while easing pressure on GPs and hospitals,” territory health minister Steve Edgington said.
