Call for pharmacist OCP provision in bulk-billing drought

contraception women's health contraceptive birth control pill

The oral contraceptive pill should be available over-the-counter, writes a mainstream media journalist – and a Guild spokesperson hopes access could soon be easier

Cassandra Morgan, who has recently moved from Sydney to Canberra and now writes for The Canberra Times, wrote over the weekend of an “unexpectedly distressing ordeal” trying to access a doctor to prescribe her the Pill.

In Sydney, accessing a bulk-billing GP is easy, she wrote – but the Australian Capital Territory has the lowest rate of access to bulk-billing doctors in the country. It also has the lowest GP rate per 100,000 people in the country.

Ms Morgan found one or two bulk-billing doctors online, but “they were booked out days in advance, and there seemed to be some discretionary factor where receptionists tell you they don’t bulk bill, but they might”.

She eventually paid $90 (before the rebate) for an appointment where the GP only asked her whether the Pill she was using was working.

She wrote that if pharmacists needed to be consulted instead of a GP on the Pill, “it would offer peace of mind to millions of Australian women – particularly Canberrans”.

Simon Blacker, ACT branch president of the Pharmacy Guild, says the branch is closely watching the Queensland Pharmacy Trial, after a state government review found that Queensland’s Health Department should develop options to provide low-risk emergency and repeat scripts, such as that for the oral contraceptive pill, and low-risk vaccinations.

He said that the opinion piece represented a “true consumer point of view” on issues such as pharmacist prescribing, continuous dispensing and access to vaccinations.

“If a person has seen their GP within a defined time period and has a medication history for certain medications, we’d like to think there might be a possibility in the future of continuous dispensing, or pharmacist prescribing, so that medicines continuance and adherence is improved,” Mr Blacker told the AJP.

“The GP is really critical as well – you can’t have a system where a patient doesn’t need to see their GP – it’s about finding that happy medium where the patient’s getting a thorough review from their regular GP, but is also able to have a degree of convenience to their health care.

“That’s what the general public would like to see.”

He said that when economic times are tight, governments seek better value for money spent, including in the health care space.

“I’d expect things to be discussed with the newly re-elected [Federal] Government over the next 12 months would be increased productivity and efficiency in health,” he said.

“Hopefully, that will include looking at full scope of practice for pharmacists to be able to do more to help the health system, and patients.

“It’s critical that the health system have patients at the centre. When the right regulations are met, if that means changes to the health system, I think that’s a step in the right direction.”

Vaccination is another area where pharmacists should be doing more, he said, and the ACT branch of the Guild, like other branches, is hoping for harmonisation of vaccination across jurisdictions.

Currently pharmacists in the ACT can only provide vaccination against flu, and the dTpa to patients 16 years and over without a prescription.

However the Guild has had productive talks with the Territory’s previous Health Minister, Meegan Fitzharris, and hopes to conduct more with Rachel Stephen-Smith, who took the role on board in June 2019.

Work to date includes giving accredited pharmacists access to National Immunisation Program vaccines in a 2019 pilot, and Mr Blacker says this has to date been well received by patients and pharmacists who have been involved.

Another potential example is prescribing some asthma medicines – a suggestion also made in Ms Morgan’s column.

“In the context of a current asthma plan, could medication continuance be possible with some of the prescription medicines, where a patient has seen a GP or specialist, and we could see an updated plan?” Mr Blacker asked, citing My Health Record as a means of sighting up-to-date information.

“Around scope of practice, there’s an opportunity for pharmacists to do more, and they’re eager,” he said.

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