We are writing as a cross-sector coalition to support the safe and sustainable evolution of prescribing and diagnostic authority in Australia, in response to shared patient safety concerns regarding the Pharmacy Board of Australia's proposal for a registration-level endorsement for scheduled medicines for pharmacists.
We recognise and respect the importance of current consultation processes. This joint statement is intended to support those processes by focusing on system-level safeguards required to ensure patient safety over time.
Importantly, this is not a statement about the capability of any profession. Rather, it speaks to the conditions required for the safe exercise of diagnostic authority, particularly in contexts where uncertainty is inherent and harm may emerge after the initial consultation. Safe prescribing is not a single moment of care or simply symptom relief. It relies on systems that support continuity, oversight and accountability, not solely on individual practitioner skill or intentions. Current education and training pathways do not fully align with the competencies required to manage undifferentiated presentations in episodic, isolated settings.
To support clarity and transparency, we are providing two complementary documents:
Our central message is:
Safe expansion of prescribing authority depends on systems that manage uncertainty, ensure continuity of care and maintain accountability over time – not solely on individual competence.
These principles are particularly important in care contexts where diagnosis evolves over time and where harm may be delayed, diffuse or under-detected.
Yours sincerely,
Dr Michael Wright (RACGP President), Ms Elise Bryant (ACNP President), Dr Danielle McMullen (AMA President), A/Prof Kerin Fielding (CPMC Chair), Mr Michael Bonner (CEO Choice Chemist and Choice Aged Care), Ms Christine Muller (Executive GM, Wellness Partners Foundation).
Patient safety must come first as prescribing roles expand
Australians deserve safe, connected healthcare.
As changes are considered to who can diagnose illness and prescribe medicines, we are united in one position. Patient safety must come first.
This is not about professional roles or boundaries. This is about ensuring the health system works safely for everyone, especially older Australians and those with complex needs.
Most health conditions are not straightforward.
Symptoms can be unclear at first, shared across many conditions or changing over time. A correct diagnosis often cannot be made in a single visit. It becomes clearer with time, follow-up and ongoing care.
If diagnosing and prescribing are expanded without the right systems:
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Care can become fragmented
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Important warning signs can be missed
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No one may be clearly responsible for outcomes.
This puts patients at risk, particularly when problems emerge later.
We all agree that expanding access to care is important. But it must be done safely. Safe care depends on:
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Continuity of care: Patients need follow-up and a clear place to return if things change
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Clear accountability: Someone must always be responsible for the patient’s care – and patients need to know who that is
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Connected information: Providers need access to shared records, patient history and pathways to refer or escalate care.
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Systems that detect harm early: Some problems only appear days or weeks later. The system must be able to pick these up quickly.
Our shared position
Across healthcare, we agree:
Expanding roles can improve access. But without the right safeguards, it can also increase risk.
Our call to action
We call on governments and regulators to ensure that:
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Strong safety systems are in place before roles are expanded
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Care remains connected over time
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Accountability for patient outcomes is clear
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Models of care support safe diagnosis – not just fast access.
Our goal
A healthcare system that is safe, connected, accountable and designed around patients. Now and into the future.