New scope expansion for pharmacists ‘fragments care further’

Tasmanian pharmacists could soon be paid to extend their opening hours and prescribe additional medications under a Liberal Party pledge to broaden the profession’s scope and access.
 
Ahead of the state’s 19 July snap election, the promise would see community pharmacies able to apply for grants to extend their hours later at night or over the weekends.
 
The Liberal Party has also vowed to expand pharmacy prescribing in the state to include ear infections, reflux, skin conditions such as shingles and eczema, rhinitis and wound care.
 
However, RACGP Tasmania Chair Dr Toby Gardner says the prescribing expansion would ‘realistically not make much of a difference’ for GPs in the state, except to further fragment care.
 
‘We know it’s not going to do anything to really help with access to GPs, which is what the Government is saying,’ he told newsGP.
 
While Dr Gardner agrees that late-night pharmacy hours would better enable Tasmanians to access medication, he says it is ‘not really an issue’ pharmacy needs to address.
 
‘We do have urgent care clinics (UCCs) for that reason, and I think we’ve got more UCCs per head of population than anywhere else,’ he said.
 
‘It may be something [of benefit] in rural communities – we’ve got a lot of really isolated satellite communities who only have pharmacists in town and no GP.’
 
The pledge is a move to build on what Tasmanian Premier Jeremy Rockliff says are ‘significant benefits’ gained from supporting pharmacists to prescribe antibiotics to treat urinary tract infections (UTIs) and prescribe oral contraceptive pills.
 
‘This will free up thousands more GP appointments, reduce pressure on our emergency departments and save Tasmanian families time and money,’ he said.
 
But Dr Gardner said the State Government would get better ‘bang for buck’ by putting the funds towards supporting the existing GP workforce, including supporting them to provide more complex care.
 
‘In Tassie we have the highest rate of disability and chronic disease in the country,’ he said.
 
‘What we’re trying to do is work out what workforce exists that has the capacity to help in this space, to help deal with these complex chronic patients who use up a lot of the tertiary health dollar by bouncing back to hospital all the time.
 
‘What sort of programs can the Government invest in to help prevent these people being re-admitted to hospital? Because that’s where the biggest cost savings are going to be.’
 
Dr Gardner is also concerned about the state’s pharmacy workforce, saying it is too understaffed to take advantage of potential further funding for expanded treatments and operating hours.
 
‘Talking to all my pharmacy colleagues on the ground, there’s no pharmacy workforce in Tassie at the moment,’ he said.
 
‘Currently, there’s a huge workforce shortage of pharmacists in Tasmania, as there is nationwide.’
 
Under the UTI pilot program, which began in January 2024, pharmacists are paid $20 per consultation by the Tasmanian Government.
 
Dr Gardner does not believe the same remuneration, if offered under the proposed expanded scope of practice, would appeal to pharmacists.
 
‘They’re already doing a lot of diagnostic stuff, and they have for years, with selling some of those over-the-counter medications. So, they are already really strained as it is,’ he said.
 
‘Having to spend 20 minutes sitting down with someone and doing a proper examination, like we do as GPs, but being paid $20 for it, doesn’t make a lot of sense.’
 
Moving forward, Dr Gardner would like to see funding to maintain rural practices in Tasmania.
 
‘We’ve got a lot of retiring older, amazing rural GPs around the state,’ he said.
 
‘You can’t [just] put a pharmacist into these places; these are people needing doctors who’ve got that rural generalist type background, because you can be stuck in the middle of nowhere, stabilising patients and so forth.
 
‘We need to be turning our attention to what’s going to happen as all of these doctors retire.’
 
A form of pharmacy prescribing is now available in every Australian state and territory.
 
Last month, the Victorian Government made its Community Pharmacy Statewide Pilot permanent, committing $18 million to fund free consultations in community pharmacies.
 
The UTI pilot in Tasmania concluded at the end of February 2025 and is currently being evaluated.
 
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pharmacy pharmacy prescribing pilot scope of practice Tasmania Tasmanian Government