The Royal Australian College of GPs (RACGP) is seriously alarmed by the Chief Minister’s announcement yesterday that Regulations were changed over a week ago to allow pharmacists in the NT to prescribe for 21 conditions.
RACGP NT Chair Dr Sam Heard said Territorians should be deeply concerned about this on a number of levels.
“The elected members of the government have decided to take this decision into their own hands and not listen to the experts. The government has been poorly advised by the Pharmacy Guild into making a pre-election commitment in the first place and then put under enormous pressure to deliver it, shortcutting all due process and expert advice,” he said.
The RACGP has worked collaboratively as part of an Expert Advisory Committee established by NT Health in April and has met three times, charged with developing a code of conduct for pharmacists and treatment guidelines that prescribing pharmacists could use to support clinically safe and appropriate care in the unique NT setting.
“The Minister’s announcement today shows that due process has not been allowed to occur,” Dr Heard said.
“The advice of the expert advisory group has been ignored. Pharmacists have been handed the right to prescribe before any of the usual patient safety guardrails have been established. Pharmacists will be flying blind without any NT-specific clinical guidelines or code of practice.
“This announcement undermines the Therapeutic Goods Administration, who are responsible for scheduling medicines nationally, and most alarmingly allows over the counter access to antibiotics at a time when the Northern Territory is seeing the highest antibiotic resistance rates nationally and a resurgence of ‘old’ disease likes diphtheria and syphilis.
“Open access to antibiotics is recognised as a significant factor in developing antibiotic resistance and will mean that we are more frequently dealing with infections that are difficult to treat or life threatening. There is no such thing as a simple skin sore in the NT where rheumatic heart disease and kidney failure are very real and life changing consequences that we see every day.”
The relationship between GPs and pharmacists is a fundamental tenant of primary care. The separation of prescribing and dispensing was established long ago to ensure any financial imperative was removed from the decision by the GP to prescribe (or not prescribe) a certain medicine. Patients should be mindful that when a pharmacist prescribes, this conflict of interest exists.
The RACGP says expanding prescribing without appropriate diagnostic oversight, continuity of care and clinical governance increases risk for both patients and pharmacists.
The RACGP is calling on the NT Government to pause the expansion and work with medical and Aboriginal health organisations on reforms that strengthen access to care without compromising safety, antimicrobial stewardship or continuity of care.
“Expanding access must not come at the expense of patient safety or long‑term health outcomes,” Dr Heard said.