Doctors criticise "risky prescribing agenda"

In a joint letter to the Pharmacy Board of Australia, the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) have expressed disappointment in the board’s so-called “uncollaborative pursuit of widespread pharmacy prescribing”. The Pharmacy Board showed a complete disregard for meaningful debate at its recent national forum, AMA President Dr Danielle McMullen said, and restricted opportunities for stakeholders to raise concerns about the proposed endorsement, which could potentially support pharmacists prescribing Schedule 4 and 8 medicines.

“The board set the forum up in a way that ensured any opposing views — even when grounded in rigorous evidence and supported by data — were discouraged,” McMullen said. “Australia has traditionally restricted prescribing to medical practitioners, which remains the safest and preferred model. If health ministers and the board are intent on changing this, it’s important to recognise that global evidence shows the most effective non-medical prescribing models involve pharmacists working as part of a collaborative clinical team. This approach is essential to preventing fragmented patient care.

“However, the board chose to hold a forum where key issues were excluded from discussion. It appeared intent on supporting a model that risks fragmenting care, creating conflicts of interest, and removing a key safeguard for patient safety — by supporting pharmacists to both prescribe and dispense medicines,” McMullen added. “If the board chooses to ignore the evidence-based concerns that we tried to raise during this forum, then Australia will go down the same track as the National Health Service in the UK.

“Australia has a strong health system, and we should build on what works rather than adopt ideas from other countries that have been independently assessed as having poorer healthcare outcomes,” McMullen said. In a recent statement, the AMA and RACGP have urged the Pharmacy Board to reconsider its consultation process “by enabling a more meaningful and substantive dialogue that addresses legitimate concerns about the proposed model”.

“Recent discussions around pharmacy prescribing have raised serious concerns. We’ve already seen the risks of prioritising profit in the telehealth space, and it is critical that these mistakes are not repeated in the rollout of pharmacy-based prescribing,” RACGP President Dr Michael Wright said. “The forum was not constructive in terms of genuinely attempting to explore the real issues. While there was some acknowledgement of the conflict of interest pharmacists face when both prescribing and selling medications, there was little substantive discussion on how to address this issue. This silence is troubling and will have serious consequences for patients.

“There appeared to be a lack of understanding and desire to deal with the risks involved in expanding prescribing rights to all medications. Of particular concern is the absence of safeguards around Schedule 8 medications, and the broader risks of fragmented care and patient confusion when multiple providers deliver overlapping services,” Wright added. “The future of health care is collaborative, and that collaboration must be safe, structured, and centred on patient wellbeing.

“GPs and pharmacists each bring vital expertise to the healthcare system. But integration must never come at the cost of clinical rigour or trusted care. We will continue to advocate for a model that prioritises safety over shortcuts, because we know that when health care is rushed, patients bear the risk,” Wright said. “The GP–patient relationship is built on trust, continuity and clinical judgement. Undermining that relationship for the sake of profit is not progress; it’s a step backwards, and one we cannot afford to take.”

You can read the joint letter here, via the AMA’s website.

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