Concerns Queensland pharmacy trial will ‘widen the gap’

A proposed pharmacy trial in Queensland, labelled as ‘truly inappropriate’ by the college, continues to dominate headlines and draw criticism from doctors and advocacy groups alike.
 
This time it is from one of the very groups the Pharmacy Guild says the trial aims to help.
 
Despite the Guild arguing that rural and remote communities would benefit from pharmacy-driven care due to a lack of hospitals and GPs, NACCHO and the Aboriginal Community Controlled Health Organisations (ACCHOs) in Queensland have come out in strong opposition to the proposal, which would allow pharmacist to diagnose and treat more than 20 complex conditions including type 2 diabetes and heart failure.
 
They join the RACGP and AMA, among many other groups and individuals, calling for the trial to be scrapped.
 
‘The trial is proposed for a region in Australia with a very large Aboriginal and Torres Strait Islander population, but the proposal makes no mention of the increased health needs of Aboriginal and Torres Strait Islander people and the need for culturally-safe, comprehensive primary healthcare,’ NACCHO Deputy CEO Dr Dawn Casey said.
 
‘There has been insufficient consultation with the community-controlled sector on the proposed trial. Furthermore, the proposed trial will fragment care and result in missed opportunities for comprehensive team-based primary care.
 
‘An example is the proposal to diagnose and treat acute otitis media – a condition that needs extensive and comprehensive follow-up of hearing health to help address hearing loss in Aboriginal and Torres Strait Islander kids.’
 
RACGP President, Dr Karen Price, agrees and says the lack of consultation is concerning and indicative of a poorly though-out pilot.
 
‘This is just another example of why this pilot was doomed from the beginning,’ she said.
‘Not only has proper consultation not occurred, but there has also obviously not been adequate thought given to how this pilot will impact the health of Aboriginal and Torres Strait Islander patients.
 
‘North Queensland has a higher proportion of Aboriginal and Torres Strait Islander people, and the stark reality is that that many of these patients have complex health needs that require careful monitoring and follow-up from a GP.
 
‘This pilot will compromise their long-term health because we will see a fragmentation of care.’
 
Earlier this month, the RACGP, the Queensland branch of the AMA and the Australian College of Rural and Remote Medicine (ACRRM) all withdrew from the pilot steering committee.
 
In a statement to the media, the Guild said ‘if doctors wanted to work collaboratively, they would have remained on the pilot steering reference group and collaborated’.
 
‘The AMA and RACGP have a history of pulling out of pilots instead of working together,’ it said.
 
But now they have also lost the Queensland Aboriginal and Islander Health Council from the committee.
 
‘I’m not surprised that the Queensland Aboriginal and Islander Health Council has joined the RACGP and other health groups in withdrawing from the steering committee,’ said Dr Price.
 
Multiple Aboriginal community advocates and representatives have also come out in opposition, citing concerns over the lack of consultation and fragmentation of care, to the potential of the trial to increase morbidity and mortality, and widen the gap, for Aboriginal and Torres Strait Islander people.
 
Dr Jason King, Gurriny Yealamucka Health Services Aboriginal Corporation Senior Medical Officer, believes pharmacists play an important role in primary healthcare but is another opposed to the pilot.
 
‘Their proposed scope of practice expansion is a bridge that will see low quality, disconnected healthcare that places the lives of our communities at risk with no indication of cultural safety or holistic approaches that we know are necessary for success,’ he said.
 
‘Our communities deserve the highest quality care.  The pilot project fragments healthcare for some of the most vulnerable [and] it undermines the decades of work the ACCHO sector has done to bring us closer to closing the gap.’
 
Wuchopperen Health Service CEO, Dania Ahwang, agrees and points out that ACCHOs are best placed to provide client-centred, culturally safe, integrated and holistic health and wellbeing care for Aboriginal and Torres Strait Islander communities.
 
‘We are concerned with the lack of consultation to date regarding this pilot project given that the proposed service model being implemented by the pilot will seriously fragment and undermine the high-quality primary healthcare services that we provide to our communities,’ she said.
 
‘This also raises further concerns with [the] potential for increased morbidity and mortality for Aboriginal and Torres Strait Islander communities of Far North Queensland which, instead of closing the gap, will make it even greater.’
 
Meanwhile, Apunipima Cape York Health Council CEO, Debra Malthouse warned about the harms in only seeing and treating the condition, and not the person as a whole.
 
‘We expect that this pilot will focus on the patient’s condition, with little or no consideration of the multiple factors that impact on the health and wellbeing of First Nations peoples,’ Ms Malthouse said.
 
‘The implementation of this pilot will only serve to widen the gap.’
 
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Aboriginal and Torres Strait Islander health closing the gap Pharmacy Guild pharmacy prescribing trial