The announcement of a national pharmacist prescribing trial sparked backlash from GPs and rural pharmacist bodies alike.
One prominent GP leader has accused the Pharmacy Guild of Australia of using women’s health as “trojan horse”, as the fallout from last week’s announcement of a nationwide pharmacist-led precribing trial begins.
Speaking at the Australasian Pharmacy Professionals (APP) conference at the Gold Coast on Friday, Health Minister Mark Butler unveiled new changes to pharmacy prescribing.
Mr Butler confirmed that, under a pilot program, pharmacists would be subsidised to the same level of PBS-eligible prescribers for oral contraceptive scripts and some antibiotics scripts from January 2027.
This comes after nearly every state and territory has implemented their own sets of reforms allowing pharmacists to prescribe for various conditions.
Allegations that the federal government is choosing to follow lobbyists, rather than health professionals, have come from GPs nationwide.
Here’s what some of Australia’s most prominent GPs had to say.
Who: Former RACGP president Adjunct Professor Karen Price.
Top Line: “This is the lowest point in Australia’s medical history for patient care, it is politically motivated, it’s foolish, and it’s fragmenting care and it’s reducing oversight of patient safety.”
Both the pharmacy guild and federal politicians have argued the move is a big win for women’s healthcare, to the dismay of GPs.
“90% of patients can access a GP and a pill script once per year,” Professor Price told The Medical Republic.
“This is distortion of political process for the Australian people and their healthcare.
“I’ve said that healthcare should be above politics, and this is definitely down in the bottom bucket.
“If it’s that critical, why should women have to go to a pharmacy to get it?
“It’s ridiculous commentary.
“Outcomes that they quote from overseas jurisdictions have lower public health outcomes than Australia … so they’re quoting lower performing health systems as a justification to introduce fragmented care.
“It’s a shame for Australian women, I find it is using women’s health care as a Trojan horse.
“In my years of being a GP, it’s the lowest point of Australia’s healthcare – to see a government so blatantly disrespect the expertise that their GPs have performed for the country over many decades.”
Pharmacy prescription reform pushes are not a new affair, with the TGA issuing advice in 2021 warning against cutting GP management out of oral contraceptive prescribing.
Who: Former AMA president and deputy chair of the Australian General Practice Alliance (AGPA) Dr Mukesh Haikerwal.
Top Line: “We do not need to follow the NHS in any way, shape or form.”
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Prominent GP advocate Dr Mukesh Haikerwal also took issue with the government citing the pharmacist prescribing models of other countries.
“The NHS is a complete dog’s breakfast now and has been allowed to diminish into that state with multiple pieces of policy that have diminished people’s access to care, people’s quality of care,” he told TMR.
“What we’ve seen is all coming to a crescendo, partly because of the fiscal needs of pharmacy owners.
“Fragmenting care is reducing quality and safety in the sector and is taking away a key tenet of the system, where a prescriber doesn’t dispense, because there are obviously commercial benefits in prescribing.
“It’s a very unscientific way of doing it and is breaking some of the actual laws and regulations have been put in place to protect the public.
“They’re sacrificing quality, safety and better outcomes on the altar of convenience, which actually will be very inconvenient when people drop into significant illness from disinvestment from these processes.”
Who: GP and clinical researcher Associate Professor Louise Stone.
Top Line: “It should be more concerning to patients, knowing that health policy is being guided by politician benefit as opposed to public benefit.”
Professor Louise Stone told TMR that the nationwide prescribing trial made a “mockery” of the TGA.
“The point of regulation is to protect the most vulnerable consumer from the least competent practitioner,” she said.
“Unless something special happens on graduation for pharmacists, they’ll be like the rest of us, with good ones and bad ones.
“It has been a long-standing ethical concern that health professional spaces should be free of pharmaceutical marketing, to avoid conscious and unconscious bias.
“It is my view that this contravenes the ethical question of keeping marketing and healthcare separate.
“Having the Prime Minister and other leading politicians publicly endorsing these trials lends weight to the safety and efficacy of pharmacy prescribing, I think this is ethically concerning.
“I know that a pharmacist earns $35 for a usual consultation, plus dispensing fees, plus any other purchases of products that are recommended.
“$35 is only $8 less than a GP earns for the same care, despite the GP having twice the training.
“In general practice, we have pharmacists as partners checking scripts, pharmacists have designed a model that has no safety net.
“Women deserve private holistic care from practitioners who can recognise outliers and examine accordingly.
“Access is nice, but access to poorer care is not access at all.”
Who: Remote and Isolated Pharmacist Association Australia
Top line: “Safe prescribing in the bush is not a solo endeavour; it relies on collaboration and team-based care among resident health professionals.”
The Remote and Isolated Pharmacist Association Australia (RIPAA) has also expressed concerns about the pilot program being painted as something to assist rural and remote communities.
“We risk a scenario where patient subsidies exist, but the lack of a sustainable framework prevents the pharmacist from being a viable, permanent part of that local healthcare team,” a spokesperson told TMR.
“When policy is designed for metropolitan scalability rather than remote viability, it creates a strategic disconnect that risks leaving the most isolated patients behind.
“RIPAA advocates for a ‘Structural Bridge’, a hybrid funding model that supports practitioner residency.
“This ensures that clinical prescribing is economically viable and that pharmacists can remain a stable, collaborative pillar of the rural health team where population density is low but health needs are high.”
