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RACGP President accuses Pharmacy Guild of ‘classic overreach’


Matt Woodley


13/12/2019 3:04:53 PM

The powerful lobby group has again called for expanding pharmacists’ scope of practice following a new report that predicts a major GP workforce shortfall by 2030.

RACGP President Dr Harry Nespolon
RACGP President Dr Harry Nespolon believes allowing pharmacists to treat serious diseases like asthma is a recipe for disaster.

The Deloitte Access report, commissioned by general practice medical centre chain Cornerstone Health, forecasts a 37.5% increase in the demand for general practice services by 2030 that it says will contribute to a shortfall of 9298 full-time GPs, or 24.7% of the GP workforce.
 
Pharmacy Guild National President George Tambassis seized on the findings to claim that ‘empowering pharmacists’ to take on a greater role in Australia’s healthcare system is needed to ‘relieve’ pressure on GPs.
 
‘Deloitte’s report underlines why we need to make better use of pharmacists to help relieve some of the stresses and strains on our health system just by using our training to the full,’ Mr Tambassis told the Australian Journal of Pharmacy.
 
‘In countries such as the UK and Canada, pharmacists are playing a greater role in their healthcare systems, which has reduced strain on overworked GPs and overcrowded emergency departments, made access easier and more affordable, while improving health outcomes.’
 
The Guild has long called for major changes to Australia’s health system that would allow pharmacists to treat ‘common ailments’ and prescribe certain medication such as contraceptive pills.
 
RACGP President Dr Harry Nespolon told newsGP Mr Tambassis’ response was ‘predictable’ and based on the false claim that pharmacists are able to fulfil the role of GPs, despite not possessing the equivalent training, experience or expertise.
 
‘This is classic overreach from the Pharmacy Guild, which looks for any excuse to expand scope of practice in order to fill their already burgeoning pockets,’ he told newsGP.
 
‘“Empowering” pharmacists to treat serious diseases like asthma is a recipe for disaster, as we have discovered in places like the UK, where there is an increasing number of serious incidents, including deaths, due to unsafe practice.
 
‘The fact that there is a shortage of GPs does not change the skill levels of pharmacists – patient care is more effectively and safely delivered within general practice.’
 
Dr Nespolon went on to say that anything less than ensuring there are enough GPs to cover every corner of Australia would ‘short-change’ patients and result in ‘inadequate health outcomes’.
 
In a foreword to the report, Cornerstone Health founder and CEO Henry Bateman blamed the predicted shortfall on a lack of locally trained GPs, as well as policy changes that have ‘significantly restricted’ access to overseas-trained doctors.
 
‘The diversion of overseas-trained doctors to rural, remote and regional areas will have unintended consequences for patients’ access to healthcare in urban areas,’ he wrote.
 
‘We believe that there needs to be the right policy settings and incentives in place to encourage doctors to practice in areas of unmet need.’
 
The report predicts the deficiency of GPs will be most extreme in ‘urban areas’, though its definition of urban is based on Greater Capital City Statistical Area (GCCSA) classification, which includes some inner-regional and outer-regional locations.
 
Cornerstone operates seven primary care facilities across Victoria, New South Wales and Queensland, including a number of locations affected by the Visas for GPs initiative implemented earlier this year.
 
But Dr Michael Wright, Chair of the RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), told newsGP chronic underfunding of primary care is having a greater effect on workforce numbers than changes to the overseas-trained doctor policy.
 
‘What these results show is that unless there is some shift in focus to increase the number of GPs, we are not going to have enough in the future and this has major implications for our population,’ he said.
 
‘The RACGP General Practice: Health of the Nation report showed that for every GP graduate, there are nine non-GP specialist graduates.
 
‘We have more than enough local medical graduates without changing rules for overseas-trained doctors. Our doctors just need more support to train in the right speciality that our country needs – general practice.’
 
According to the OECD Health at a Glance 2017, self-employed non-GP specialists received more than twice the remuneration earned by GPs in 2015, a substantial increase from 2010 when the gap was around 30%.
 
‘After years of underfunding, general practice has become a less attractive career option for medical graduates,’ Dr Wright said.
 
‘There is a need to make general practice a long-term career, and this means supporting Australian graduates to experience general practice, support for supervisors and educators, and support for practices to help train our next generation of GPs.’
 
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Dr Nell De Graaf   14/12/2019 3:31:05 PM

No good training more GPs if they dont get paid more-they wont stay in General Practice


Dr Peter James Strickland   16/12/2019 11:54:58 AM

It all has a number of simple solutions. The pharmacists will need to take responsibility for ALL possible and probable side=-effects of any medication or treatment they prescribe ---this will necessitate a big increase in Indemnity Insurance for them all. Training by doctors and pharmacists are different, and are suppose to complement each other, and not go into each others' expertise and administration training --- GPs will simply have to set up systems of not only prescribing medications, but actually dispensing them as well --- the latter can be done by trained staff who can connect directly with the PBS electronically, and have extra space in surgeries to store medications, and a few other things like antihistamines, antacids, mild analgesics, eye and ear drops etc ---shouldn't be too hard to administer (especially for larger medical practices), and would take the pressure off patients having to travel to pharmacies, and could be cheaper for these patients all round!


Dr Suzie Ma   17/12/2019 12:00:12 PM

Well said Dr Strickland. If there is a shortage of doctors in 2030, there would be of high possibility in shortage of pharmacists, nurses and other healthcare workers too. How are the pharmacists here to fulfill the roles of other healthcare workers at that time if they are so concern about it? We have shortage of nurses at present already and some of them are now working at the pharmacies giving out vaccination who could be working at the doctors' offices instead to deliver more coordinated heath care. If there is a shortage of doctors in 2030, would it make more sense to provide more training positions and incentive for doctors to be GP instead of passing the jobs to pharmacists who are only trained as pharmacists and could potentially cause fragmented care and "unsafe" practice? May I suggest for those pharmacists who are interested to take on the role as a GP should consider to do Medicine. This will solve the problem in 2030.