The turf war between official GP groups and The Pharmacy Guild of Australia has ratcheted up a notch with verbal insults exchanged.
The comments were made in a speech by Pharmacy Guild President Trent Twomey at the National Australian Pharmacy Students’ Association Congress event in Canberra (15 – 21 January 2023), during which he labelled GPs “twits” and said that greater funding was not required for general practice.
President Twomey also reportedly claimed that pharmacists should be able to prescribe, dispense, administer, and review all medicines for all people, stating that these tasks are not specialities and that “no one gives a shit.”
He said the idea that pharmacists should only prescribe medications when working in cohort with a medical practitioner was “bloody insulting” and likened it to a “plumber needing to look over the shoulder of an electrician” when installing air-conditioning.
On 20 January 2023, RACGP President Dr Nicole Higgins claimed that Professor Twomey’s comments revealed “what many healthcare experts have long suspected, the Pharmacy Guild is out of control.”
“In this extraordinary speech, Trent Twomey has laid bare the Guild’s future intentions for their sector and the future of healthcare in Australia. According to them, the limits on pharmacy prescribing should be done away with,” she said.
“Describing the idea of pharmacists only having extended powers if working in cohort with trained medical professionals as ‘bloody insulting’ shows the true mindset of the Pharmacy Guild. In this speech, there is no mention of patient safety, it is all about exerting power and extending the role of pharmacy to maximise pharmacy owner profits at any cost.
“The speech is nothing short of astonishing, it should send a shiver down the spine of politicians everywhere. The language used, the brazen way he addresses very serious healthcare issues and the underlying arrogance informing this speech demonstrates that the Pharmacy Guild should be approached warily.”
Dr Higgins believed that there may be worse to come, noting that The Pharmacy Guild did not seem satisfied with many authorities already extending the scope of pharmacy, or speaking of plans to do so – “They want more.”
“Let’s just pause for a moment and consider what he is suggesting here, which is pharmacists acting as quasi-GPs without any supervision treating a myriad of complex health conditions and prescribing the most serious of medications, including those with the potential to cause severe side-effects or lead to dependence,” Dr Higgins said.
“Part of the skill of general practice is knowing when not to prescribe, [yet] The Pharmacy Guild seems to think that everything can be fixed with a drug.
“Pharmacists just do not have the expertise and training to perform the function of prescribing medications, that is a job that should be left to medical practitioners.”
The RACGP and other health groups including the Australian Medical Association (AMA) have previously warned that experiments such as the North Queensland Pharmacy Scope of Practice Pilot are fragmenting care and leading to poorer patients’ health outcomes.
The college also criticised the Queensland Government’s decision to extend the Urinary Tract Infection prescribing pilot and expressed strong concern that other authorities, including New South Wales and Victoria, are following suit, and handing more prescribing powers to pharmacists without due regard for patient safety and wellbeing.
“Already, we have seen in Queensland many concerning incidents including a patient in their 50s being prescribed antibiotics for a presumed urinary tract infection who turned out to have a 15-centimetre pelvic mass,” Dr Higgins said.
“GPs have a good relationship with their local pharmacy colleagues, but we must be wary of money grabs from the Guild – patient safety must come first.”
The Pharmacy Guild of Australia has stood by Professor Twomey’s comments, responding to Dr Higgins through a statement issued in the Pharmacy Daily on 20 January 2023.
“The Pharmacy Guild is disappointed but unsurprised, by the Royal Australian College of General Practitioners (RACGP) comments made last week,” a Guild spokesperson said.
“It is disappointing, but unsurprising, that the RACGP has repurposed Guild President Prof Trent Twomey’s comments to whip up a media frenzy.
“The speech was described by attendees as unifying, inspiring and patient centred. Prof Twomey stands by his speech and will always speak out in the best healthcare interests of patients, promoting safe and evidence-based healthcare.”
The whole episode may have contributed to the comments made by the Minister for Health and Aged Care, Mr Mark Butler, at his press conference the following Monday, 23 January 2023.
“I have been very clear that at a time of skyrocketing demand for health care, and workforce shortages, that it doesn’t make sense not to have every single one of our health care professionals working to the top of their scope of practice – whether that is doctors, nurses, allied health professionals, pharmacists, and others,” Minister Butler said.
“There are too many regulations, too many constraints within the MBS system, too many turf wars that constrain the ability of people who want to deliver their full range of skills and training – training delivered by taxpayers to hundreds and hundreds of thousands of health care professionals.
“So, you know, I want to see out of this Strengthening Medicare process, a much more liberated ability for all health care professionals: doctors, nurses, allied health professionals, to be able to contribute to the need that we have out there to deliver world class health care to Australian patients.
“That is not going to be easy. But I sense a level of consensus around that, lifting that ability for other healthcare professionals to use their skills and training, than I have ever seen before.”