Pharmacy services face growing criticism from GPs despite broader appetite for health reforms

The Queensland Government’s decision to expand the Community Pharmacy Hormonal Contraception Pilot state-wide has drawn praise from some stakeholders but sharp criticism from the Royal Australian College of GPs (RACGP), who warn that it may jeopardise patient safety.

Queensland Minister for Health, Mental Health, and Ambulance Services, Shannon Fentiman, defended the move, stating, “This decision will help break down the barriers women currently face to accessing contraception – including lack of access to primary care. It will also ease the burden on GPs, freeing up appointments for sicker Queenslanders in need of care.”

The Pharmacy Guild of Australia, Queensland Branch Vice President Cate Whalan, lauded the initiative as a significant advance for women’s health.

“This Pilot is a game changer for women’s health in Queensland,” she said. “With services now available, patients across Queensland can expect better access to hormonal contraception services.”

The National Women’s Health Strategy 2020-2030 underscores the importance of accessible maternal, sexual, and reproductive healthcare, linking it to positive health, social, and economic outcomes. However, as highlighted in the inquiry Ending the Postcode Lottery: Addressing Barriers to Sexual, Maternity, and Reproductive Healthcare disparities in the availability, quality, and affordability of such care persist, often influenced by factors like location, income, visa status, and cultural background.

Despite the government’s intentions, RACGP Queensland Chair Dr Cathryn Hester expressed concerns about the safety implications of the pilot.

“The Queensland Government is gearing up for a challenging election, and it is clear they are more concerned about political expediency than the safety of Queensland women,” Dr Hester said.

She stressed that prescriptions are intended to safeguard patients, a responsibility that falls under the purview of the Therapeutic Goods Administration (TGA).

“Prescription medicines have potential side effects that are well beyond the scope of pharmacists’ training, and a six-hour course and minor pharmacy renovation doesn’t change that. This is a political decision, not an evidence-based health decision,” Dr Hester added.

She also pointed out that the TGA previously decided against down-scheduling oral contraceptives due to safety concerns.

“To quote that decision, ‘Consumers can identify when they require (oral) contraception, but consultation with a pharmacist is not sufficient to ensure safety, particularly over extended periods of time.’”

She further argued that consultations for renewing prescriptions provide crucial opportunities for broader health discussions.

“Governments need to consider the second-order effects of their decisions. You could have fewer unplanned pregnancies, but more people with STIs, which are already on the rise. All that is lost with this reckless approach,” she emphasised.

The expansion of the pilot comes amidst broader discussions on healthcare practices, including an independent Scope of Practice Review led by Professor Mark Cormack. This review, which emerged from the Federal Government’s Strengthening Medicare Taskforce Report, is evaluating how to optimise the roles of health practitioners within primary care.

Rather than perpetuating the fee-for-service model, the review seeks to explore funding arrangements that allow healthcare organisations to flexibly employ the personnel needed to meet the needs of their populations. The review has received over 1,100 submissions and held 31 consultation sessions, with a final report expected by the end of October.

Despite the broader appetite for reforms, Dr Hester raised concerns about the evaluation methods used in the pharmacy pilot’s rollout.

“The evaluation for the pilot reads like market research – it’s not a rigorous trial and isn’t evaluating patient health outcomes. Questions put to patients as part of the evaluation were the same as you might review a pizza delivery service – was it easy to book? Was it convenient? What did you think about the cost?

“There are appropriate ways to evaluate health services, and this isn’t it. It’s a health service, and the priority should be health outcomes,” she stated.

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