RACGP: Queensland pharmacy trial risks poor health outcomes and higher costs for patients

The Royal Australian College of General Practitioners (RACGP) warns that Queensland’s watered-down pilot scheme allowing pharmacists to diagnose and treat patients remains a serious risk.

It comes after the Queensland government announced it was going ahead with the controversial pilot project, which has been 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 Organization.

President RACGP Deputy. Professor Karen Price said the pilot project would lead to poor health outcomes and should be stopped.

“Enough is enough, patient safety and well-being must come first,” she said.

“We are extremely disappointed that Queensland is continuing with the North Queensland Community Pharmacy Expanded Scope Pilot, despite opposition and concerns from the medical community. Not to mention the evidence showing that a similar Queensland pilot allowing pharmacists to prescribe antibiotics for urinary tract infections has gone horribly wrong for many Queensland patients who have been misdiagnosed and whose serious conditions have not been processed.

“This pilot project will lead to poor patient health outcomes and much higher healthcare costs. Because under the pilot project, consultations with pharmacists will not be subsidized by Medicare, nor will prescriptions be covered by the Pharmaceutical Benefits Scheme. Additionally, not all purchased drugs will count towards a patient’s PBS safety net threshold, meaning they will be even more out of pocket.

“Patients in this pilot project will pay between $20 and $55 for a consultation with a pharmacist, plus the full cost of all medications and medical conditions or other diagnostic tests. Most people are used to having diagnostic tests charged in bulk when they go to a GP and buying drugs at a cheaper price through the PBS subsidy, so these increased costs will likely be a very bad surprise.

“It is shameful that the Queensland Government is trying to argue that this pilot project will give people in North Queensland better access to cost-effective care, when in reality it will cost patients far more. And it will do nothing to improve access to care for those who really need it, who are disadvantaged and cannot afford to pay, or even make matters worse.

“It is a particularly dangerous experiment to undertake 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 who need to be carefully cared for by a GP.

“We can expect this pilot to end up putting more strain on the state’s already overburdened hospital system and compounding the ramp-up of ambulances. The only ones to benefit appear to be pharmacy owners, as this model shifts the cost of healthcare services, usually subsidized by the Commonwealth, onto patients. It’s short-sighted policy and will cost taxpayers more in the long run by increasing hospital spending – not to mention the cost of this pilot project, which has yet to be disclosed by the Queensland Government.

“Let me be 100% clear – there is no substitute for GP care, this route leads to poor health outcomes for patients.

“The Queensland Government must find real 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 denounced the workforce shortages affecting pharmacies and putting a strain on already burnt-out pharmacists, as well as the continuing difficulties in recruiting and retaining pharmacists in all settings.

“Instead of wasting money on this pilot project, the Queensland Government should consider solving the state’s hospital crisis, which is seeing the rise of unsafe ambulances and skyrocketing patient waiting lists. outpatients.

“Additionally, there are more GPs than pharmacists, and GPs are better distributed across Queensland, particularly in rural areas, so it makes sense to build on and expand these existing services. who provide evidence-based care.

“Everyone in Australia should have access to high quality primary care, regardless of postcode or income. And the people of North Queensland deserve nothing less – they shouldn’t be treated like second-class citizens, with second-class services.

RACGP Queensland Chairman Dr Bruce Willett said it was very concerning that the medical community continued to be sidelined and misinformed about the pilot.

“The medical community has been excluded once again; we heard about this announcement in the news, although we were promised detailed information about the pilot before any official announcement,” she said.

“This pilot project will allow pharmacists to diagnose and treat patients when they do not have the necessary training or experience. Taking a 120-hour prescribing course will never be equivalent to training a doctor, but that’s all pharmacists are required to do under this pilot project.

“A GP like me usually has more than 10 years of training, including medical school and professional training in hospitals and general medicine. This is what is needed to be able to diagnose and recommend treatment to patients – diagnosis is not a simple task, it requires a history, discussion with a patient and the exclusion of all other possibilities.

“The Queensland government and the pharmacy lobby have claimed that similar pharmaceutical prescribing models are used in other countries including New Zealand, the UK and Canada. But each country has different healthcare systems and levels of pharmacist training, supervision and experience, and different services that have been approved – so identical comparisons cannot be made.

“Will people entering this pilot project be informed of the difference between medical training and pharmaceutical training? And what rights will they give up this experience by giving their consent? There are many questions the Queensland Government should answer, and we hope to hear more of them first.

“Allowing pharmacists to diagnose, treat and prescribe patients for complex medical conditions without the necessary training or medical supervision is a recipe for disaster.

“I can’t say enough – the RACGP is deeply concerned that the retail pharmacy sector is pushing for policy changes that put financial gain ahead of patient care and safety. This pilot project must be stopped, because the safety and well-being of patients must always come first, and no one deserves second-rate care. »

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