Push to ditch the ‘wooden spoon award’ on pharmacist scope of practice

A Queensland inquiry into the pharmacy sector will look at ownership laws, a wider scope of practice including pharmacist prescribing, and the establishment of a Pharmacy Council

The Queensland branch of the Guild has been pushing for such an enquiry for decades, according to the Guild.

“The inquiry is supported by the Guild, and follows advocacy by the Guild to bring Queensland into line with other jurisdictions in terms of licensing pharmacies,” the Pharmacy Guild says.

“The Guild supports an annual system of registration of pharmacies, something which is in place in all other jurisdictions in Australia except Queensland.

“The registration process would require all applications, particularly those involving complex franchise-style business structures, to be subject to rigorous examination to ensure that non-pharmacist enterprises do not find ways to circumvent the ownership requirements.”

The Parliamentary Inquiry will look into a range of scope-of-practice issues. Mainstream media including the Courier-Mail suggested that changes flowing from the review could see pharmacists able to prescribe medicines including asthma preventers, sildenafil and oral contraceptives without prescription.

The Guild says it plans to make a “full submission” to the Parliamentary inquiry.

“It is likely that aspects of pharmacy practice we will focus on will be scope of vaccination approval, and inclusion in the National Immunisation Program, as well as any extension of continued dispensing that would add to the contribution of community pharmacists to patient benefit,” it said.

The mainstream media has largely concentrated on the scope of practice issues, with the Courier-Mail speaking to Brisbane GP Richard Kidd, who chairs the committee of general practice for the AMA Queensland, and who said that pharmacists are “not trained in whole of body care”.

Wider pharmacist vaccination risked patients’ lives if they had an anaphylactic reaction, and pharmacists “might not notice something about the patient that is a potential side effect or bad outcome of the medication,” Dr Kidd said.

But Queensland branch president Trent Twomey told 4BC1116 News Talk’s Chris Smith that he doesn’t expect animosity between GPs and pharmacists at the coalface level.

“If you ask the average pharmacist in the community and the average GP, there’s great relationships between pharmacists and general practice at the grassroots level,” says Mr Twomey.

“This type of silly politicking tends to just happen in places like Canberra and Brisbane.”

He addressed the issue of fragmentation of care, an often-cited concern for GPs, by pointing out that by Christmas 97% of Australians are expected to have a My Health Record, which should give pharmacists a significantly improved picture of patient history.

“Pharmacists can do more to relieve pressure on hospital systems… and quite frankly step up to the plate and do the same thing that pharmacists do in other developed countries,” he said.

“Australia wins the wooden spoon award for allowing pharmacists to step up to the plate and do more to relieve the pressure.”

He praised Queensland Health Minister Steven Miles as “very productive” and “quite pragmatic” in his dealings with the Guild to date.

An opinion piece in the Adelaide Advertiser by Tory Shepherd said that pharmacists had “come a long way” since the “snake-oil days” of the apothecary, and that the Queensland branch of the Guild’s desire to widen scope of practice “makes sense”.

Ms Shepherd examined arguments, frequently made by GPs against pharmacy moves into areas like vaccination and pharmacist prescribing, such as “that there would be too much temptation to profit if the same person who prescribed drugs also sold them”.

“That points to a far bigger problem,” she wrote. “Most of our health practitioners — those in emergency aside — have incentives to keep you coming back, rather than send you off, healthy, forever.

“Doctors have an incentive to keep you coming back in, for spurious test results, for example. So it’s a little cheeky of doctors to pretend they don’t have business goals.”

But doctor concerns did have some justification while pharmacies continued to sell non-evidence-based products such as homeopathy, she said.

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