The ACT government has announced plans to allow pharmacists to provide over-the-counter medication for urinary tract infections (UTIs), in a move similar to a pilot program heavily criticised in Queensland by local doctors.
From the middle of the year, the ACT will join a trial currently being run by the New South Wales government, allowing pharmacists to prescribe antibiotics to treat uncomplicated UTIs in women.
"Enabling pharmacists to assess and initiate treatment for women with uncomplicated urinary tract infections is expected to help patients access treatment more quickly and reduce pressure on other primary healthcare providers," ACT Health Minister Rachel Stephen-Smith said in a statement.
"We will continue to work closely with the pharmacy sector to ensure that they have the necessary training and resources to deliver these services safely and effectively."
But a similar pilot implemented in Queensland was shrouded in controversy, with the scheme receiving criticism from several national medical bodies.
The Australian Medical Association (AMA) said it ran a survey of those who participated in the Queensland pilot, which found multiple women had medical complications.
"It wasn't a scientific trial, it was just a pilot, and it's been called a success but the reality is when you look at the results, 270 women who were given an antibiotic during the trial ended up with complications and ended up needing further treatment," AMA Queensland president Maria Boulton said.
Dr Boulton said in the trial, pharmacists falsely diagnosed women with UTIs when they actually had pre-cancerous conditions, sexually transmitted infections or even an ectopic pregnancy — where a fertilised egg grows outside of the uterus, often in the fallopian tube.
"We know there was at least once case where a woman had an ectopic pregnancy and that's a life-threatening condition that was missed," she said.
Dr Boulton said she had concerns about pharmacists being unable to properly diagnose a UTI, due to a lack of medical training.
"It takes every one of those 12 years of [medical] training to make sure you don't miss something that is seriously wrong," she said.
"When you talk to doctors who were pharmacists in their previous life, what they tell you is that they didn't get the training needed to diagnose conditions such as this because they can't examine and they didn't get the diagnostic training."
While Dr Boulton acknowledged complications could come from misdiagnosis and treating UTIs in a GP clinic, she said GPs have recall processes and access to investigations that pharmacies don't have access to.
Dr Boulton said women in the ACT and Queensland were being "sold out" and that state and territory governments should work on putting money behind GP access instead.
"I don't understand why the government just does not find adequate access for people to access their GP at the time that they need to access their GP, rather than play around with pilots that were unsuccessful."
Pharmacists will also be able to administer broader range of vaccines
Under a separate change, that will come into effect by the middle of this month, Canberra pharmacists will also be able to provide a wider range of vaccines for hepatitis A and B, typhoid and herpes without needing to see a prescription.
Pharmacists can already provide vaccines including influenza, tetanus and COVID-19, but the ACT government said the expansion would improve access to immunisation and better help protect Canberrans from preventable diseases.
"Pharmacists play a key role in our health system, providing access to healthcare support and advice for many members of our community," Ms Stephen-Smith said.
The decision has been applauded by the Pharmacy Guild of Australia, which described the government decision as a "win" for the territory.
"With nearly 2,000 people presenting to emergency in the ACT for an uncomplicated UTI in a 12-month period recently, I think it demonstrates there is a need to continue to have evolution of the health system," ACT branch president Simon Blacker said.
"We believe this will ease some pressure on the healthcare system.
"The Pharmacy Guild welcomes the minister's decision to allow pharmacists to have a broader role in assisting the community with their health needs."
