NSW Premier is writing a prescription for the collapse of general practice

AMA (NSW) is opposed to the NSW Premier’s pharmacy plan, which undermines general practice and threatens long-standing protections for patients.

“The AMA is focused on good, accessible patient care and is calling for that to be properly funded by the Federal government. Rogue health policies being introduced in a piecemeal fashion by the States further threaten general practice and undermine the Commonwealth’s commitment to improving patient access to primary care,” said AMA (NSW) President, Dr Michael Bonning.

“The Premier should be introducing policies that support general practice, not contributing to its collapse. If the Premier wants to improve patient access to healthcare, he could act immediately to halt an unfair tax grab that is forcing many general practices to consider closing their doors.

“As Treasurer, Dominic Perrottet wrote to AMA (NSW) to say that GPs did not deserve any special consideration when it came to payroll tax.

“As a result, GPs who own and run practices could owe tax bills that run into the hundreds of thousands of dollars. Many are telling us that owning a practice is just no longer worth the risk.

“The Premier could immediately stop a mass exodus of experienced GPs from the system and provide the same exemption for general practices that applies to hospitals.

“Instead, he is launching major reforms to the health system that disrupt long-standing patient safeguards.

“The State government’s approach misses the fundamental separation of prescriber and dispenser. That separation provides independence, safety, and best care for the patient,” Dr Bonning said.

AMA (NSW) was supportive of the NSW Government’s plan for mass vaccinations to be offered in pharmacies.

Dr Bonning said that mass vaccination is a valuable public health measure and should be widely available including through community access, funding of general practice nurses and any other location that increases vaccination. However, expanding the role of pharmacists to treat other conditions including urinary tract infections, gastroenteritis, nausea and vomiting, and shingles, psoriasis and acne, and prescribing oral contraceptives is not acceptable.

“The process of diagnosis and appropriate, safe prescribing, and importantly not prescribing, in the context of someone’s entire clinical picture is critical. Where there is an established clinical relationship, such as with a GP, then there is the opportunity to have the hard conversation of when not to prescribe a medication.

“The independent medication scheduling body, the Therapeutic Goods Administration, recently recommended that the oral contraceptive pill remain a Schedule 4 (prescription only) medication for safety reasons, but some states are pushing ahead with downgrading it to Schedule 3 (pharmacist medication) via a political process rather than through an evidence-based process. Patient safety should be paramount, not pharmacy profits.

“Similarly, repeat scripts are an opportunity for planned care with a patient and as such should be organised so that the GP and the patient can review their condition and assess any changes that are necessary. The opportunity to do this is lost if the process becomes only about a repeat prescription.

“Providing individualised care for patients is complicated. GPs undergo years of training to provide the appropriate diagnosis and treatment for the conditions listed as part of this health policy reform. Are pharmacists going to be able to provide the same standard of documentation and investigation as GPs?

“The AMA recognises the contribution of pharmacy to healthcare and wants to continue to work in collaboration for the better care of patients. Mass public vaccination has been an area where general practice and pharmacy have excelled to provide a public health benefit to the community. However, vaccinations are not diagnostic healthcare, rather a response to a public health directive.

“The State Government and pharmacists need to ensure they work with doctors, and we call for open communication pathways and ensuring patient care is not compromised,” Dr Bonning said.

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