The doctors’ lobby has ramped up its attack on government plans to give pharmacists more prescribing powers by launching a campaign that alleges authorities are failing the public and putting their safety at risk.
An Australian Medical Association (AMA) scare campaign that began this week escalates a long-standing turf war that is now playing out ahead of the May budget over prescription packet sizes and whether pharmacists should be allowed to prescribe some medicines, such as UTI treatments and the contraceptive pill.
But health policy experts and consumer advocates say the public conflict between professional bodies – particularly the AMA and Royal Australian College of GPs on behalf of doctors, and the Pharmacy Guild on behalf of pharmacy owners – serves the interests of the professions and ignores consumer voices.
The AMA’s campaign, which will run online indefinitely, says: “Instead of improving access to your doctor, governments are funding services which will threaten your safety, fragment your care, and undermine Australia’s world-class health system.
“These services [pharmacist prescribing] are not backed by evidence and bypass the national checks and balances intended to protect you,” the website says. “As a patient, you deserve more.”
The Albanese government has promised the biggest overhaul of Medicare in 40 years. Health Minister Mark Butler has indicated the first steps in the reform will be revealed in the budget on May 9, which has prompted medical lobbyists to escalate their campaigns before the changes are revealed.
Butler has also said that red tape and turf wars were limiting health professionals including pharmacists from stepping in to help fix a Medicare system strained by rising costs and demand.
Doctors have argued that allowing pharmacists to both prescribe and dispense medicines creates a financial conflict of interest. Trials for chemist-prescribed UTI medication started rolling out in Queensland last year, while NSW and Victoria are now pursuing similar schemes.
In an online video, AMA president Steve Robson says that: “State and territory governments are failing you. They’re taking the easy way out. They’re promoting cheap second-class alternatives rather than putting your health first … Governments are putting profits before your wellbeing.”
He said that by allowing pharmacists to prescribe medicines, state and territory governments were also “trampling over decisions of independent regulators” and bypassing processes intended to assure safety, transparency and accountability.
But Adjunct Associate Professor Lesley Russell, from the Menzies Centre for Health Policy and Economics, said the AMA’s rhetoric “strikes me as just about protecting the same-old, same-old”.
“It’s pretty disheartening, really,” she said. “They’re poking at each other with pin pricks, just to needle each other, when the real issue is about the patient.”
Russell said that pharmacists had the same regulatory and legal requirements as doctors to protect patient safety. “The implication that pharmacists would do something harmful is pretty scary,” she said.
“And what it doesn’t address is there will be circumstances when a patient can’t get to a GP, and a pharmacist is better than nothing. Isn’t it better a pharmacist give you a prescription than you go without?”
But she said neither the prescribing issue, nor the fight about boosting the quantity of medicine packs from 30 to 60 days’ supply – which doctors support but would reduce pharmacy income from government dispensing fees – was going to save Medicare.
“What’s needed is much bigger and bolder. But this political and policy infighting over the small things means that doing the big things becomes increasingly more difficult and requires increasingly more political bravery,” she said.
Consumer Health Forum chief executive Elizabeth Deveny said Australian patients were not being prioritised.
“Consumers have strong views and Australians aren’t idiots. But we seem to be a sidebar. You see large peak bodies arguing over whose view about how the system should work should be funded. What you don’t see is what ordinary Australians would like,” she said.
Her organisation’s surveys found most people were broadly supportive of some form of pharmacy prescribing, but felt there needed to be restrictions and that pharmacists should have less scope to write scripts than GPs.
“We look at this and say: yes, there are questions about changes to prescribing practices … [but] I don’t know I would be as concerned as the AMA seems to be,” Deveny said.
“I think a lot of what’s driving this is the vested interests of professional groups, all who benefit financially from whatever policy is put in place … Sometimes they align with the general public and sometimes they don’t.”