Doctors Furious At Plans To Allow Pharmacies To Prescribe The Pill And Other Ongoing Medications

Pharmacies could hand out prescriptions for medicines under major WA healthcare reforms





Pharmacies would be given a dramatically expanded role in the healthcare of WA patients under new proposals, with their scope widened to include mental health care, chronic disease management and issuing repeat prescriptions for ongoing medications including the contraceptive pill.

Key points:

• The report raises a long list of areas where pharmacies could play a bigger role
• The AMA has called the report a "wish list for pharmacists who want to be doctors"
• WA Health Minister Roger Cook says the recommendations will now be considered

Under a Health Department review of community pharmacy ownership that has left doctors furious, the WA Government has been urged to acknowledge there is a "potential underutilisation" of pharmacies and pharmacists within the system.

The report has raised a long list of potential areas for the role of pharmacists to be expanded, including:

• Increased involvement in hospital discharge
• Supporting mental health
• Prescribing for chronic illnesses, citing asthma and diabetes as examples
• Monitoring and managing chronic diseases
• Expanded immunisation services

"The Government should seek to work on an ongoing basis, with the industry, towards adopting policy approaches that will make best use of the sector's specific capabilities," the report said.

"The review recommends that progress on these proposed directions should be supported, within certain limits."



Those proposals were raised by pharmacist submissions to the review, which examined the industry more broadly in WA.

The review, which was quietly published online by the Health Department within the past week, calls for the Government to seek advice about which additional services it should fund pharmacists to provide.

Pharmacists are not doctors, AMA says
The Australian Medical Association described the report as a "wish list for pharmacists who want to be doctors".

"If they want to diagnose and treat illness properly then pharmacists should go to medical school," AMA WA president Andrew Miller said.

"We do not go down to a shop to find out what the symptoms in our body might be causing. That is not appropriate.

"Pharmacists are not doctors, and to try to short-change patients by suggesting they can be is not going to be good for anybody's health."

Tensions have long existed between doctors and pharmacists over who was best placed to provide healthcare.

That issue has flared up in recent years as pharmacists have played an increased role in the provision of flu vaccines.

Pharmacy Guild rejects 'ill-informed' criticism
The Pharmacy Guild of WA said it thoroughly endorsed the review.



"We think it was comprehensive, far-reaching, and it's come out with some excellent recommendations for the health of West Australians," guild director Matthew Tweedie said.

"We look forward to working with the Government or whoever, to improve the healthcare that West Australians can access … we're often in positions where others aren't, in particularly rural and remote locations.

"It's about taking steps to utilise the workforce you've got. It's trained, it's ready, it can do things. We need to ensure that it can."

Mr Tweedie rejected assertions from the AMA that the proposals would compromise the quality of healthcare.

"No-one is planning to be the doctor," Mr Tweedie said.

"There is a role here for general practice and pharmacy to work together. We're happy to work with whoever to make that a reality for West Australians.

"The AMA's view of what this is … it's ill-informed."

'Role of the pharmacist is changing'
Health Minister Roger Cook said thousands of West Australians already relied on pharmacies for basic healthcare and medications.

"The review made a number of recommendations which will now be considered by the Department, in accordance with the final report of the Sustainable Health Review," he said.

"The role of the pharmacist is changing and we need to ensure we regulate and support the industry appropriately.

"Our recent announcement to allow pharmacists to provide flu vaccines to children aged 10 years and above underpins our view of the important role pharmacies play in the provision of community healthcare."

Idea worth pursuing, patients' group says
The Health Consumers Council of WA said there were merits to allowing pharmacies to provide extra services.



PHOTO: Pharmacies are already playing an increased role in the provision of flu vaccines. (Unsplash: Hyttalo Souza)

"From the consumers' perspective the pharmacy offers no barriers to attending," the council's executive director Pip Brennan said.

"You don't have to book an appointment and you don't have to pay. So from that access point of view that can be a real positive."

She also said there may be privacy concerns for some patients.

"If you are at your pharmacist to get a subscription you may not have the private space, or they might not have a private space to have the discussion with you," she said.

"There is also the concept that you might be getting sold vitamins when you're there.

"But I think there's plenty of room to include this kind of service into the system without undermining the central relationship of patients with their GP."

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