A national coalition of doctors, nurses and a pharmacy boss has spoken out against what it calls a lack of oversight of the rushed moves that have given pharmacists the power to prescribe medications, saying it puts patients at risk of complications.
The open letter, signed by the Royal Australian College of General Practitioners, the Australian Medical Association, the Australian College of Nurse Practitioners, and the chief executive of Choice Chemist, was sent to state and federal health ministers and the Pharmacy Guild of Australia on Thursday.
The pushback comes after several states and territories, including NSW, Victoria and Western Australia authorised specially trained pharmacists to prescribe oral contraception and medications for urinary tract infections and shingles, with each jurisdiction enforcing separate training requirements for pharmacist prescribers.
The Pharmacy Board of Australia and AHPRA are considering instituting a national standard for pharmacists and prescribers with consistent qualifications, and are expected to make their decision in July.
The federal government will also begin a nationwide pharmacist prescriber trial in January 2027, offering an estimated 250,000 female concession cardholders cheaper contraceptives and treatments for uncomplicated UTIs through qualified pharmacist providers.
“This is not a statement about the capability of any profession,” the letter read.
“Safe prescribing is not a single moment of care or simply symptom relief. It relies on systems that support continuity, oversight and accountability, not solely on individual practitioner skill or intentions.”
One of the letter’s signatories, pharmacist and chief executive of Choice Chemist and Choice Aged Care, Michael Bonner, said while he supports the regulator’s proposal in principle, it is conditional on systemic safeguards being put in place first.
Bonner said as an employer of about 150 pharmacists, he was concerned that pharmacists with new prescribing powers run the risk of operating in isolated silos, and that without safety systems and without collaborating with GPs and nurses, “there’s going to be a risk, not just to the patient … but to the pharmacist themselves”.
His on-site aged care pharmacists work within a multidisciplinary team, a model he wants to see implemented widely.
RACGP president Dr Michael Wright said the letter’s signatories were concerned about “the rapid expansion” of pharmacy prescriber programs.
“It’s not just about individual competence or the intent of any particular provider, it’s really about making sure that we’ve got a co-ordinated system that keeps people safe,” Wright said.
He said in pharmacist prescriber trials treating UTIs, more serious conditions such as sexually transmitted infections have been missed: “Because they haven’t had that ability to test the urine or to follow up, there’s been delays in other presentations.”
The open letter is the latest outcry from doctors’ groups, who have historically been against what they characterised as pharmacist prescribing creep. It called for the introduction of a continuity-of-care model that would ensure patients have a pathway to follow-up support, clear provider accountability for each patient, information integration across the healthcare system, and harm-detection procedures.
University-led clinical trials across Queensland, Victoria and NSW have not found any significant adverse impacts on patients who accessed prescriptions through a qualified pharmacist, but Wright said the college wanted to see more evidence that these schemes are safe, such as randomised controlled trials comparing patients who received a pharmacist prescription with those who saw a GP.
The letter also expressed concerns about the potential conflict of interest when pharmacists with commercial interests are responsible for both prescribing and dispensing a medication.
Bonner said it was “mind-boggling” that pharmacists cannot claim Medicare benefits.
“We’re excluded from the fundamental mechanism that supports safe team-based services for patients, particularly vulnerable patients.”
A spokesperson for the Pharmacy Guild of Australia said: “Patients need access to safe and accessible care for everyday health conditions. Enabling specially trained pharmacists to examine, diagnose and treat patients means more people getting the care they need when and where they need it.”
“For conditions like shingles, ear infections and UTIs, early diagnosis and treatment reduce significant complications,” the spokesperson said, with specially trained pharmacists available to provide care when patients cannot secure a timely GP appointment.
A federal government spokesperson said: “We encourage all parties to work constructively and acknowledge the efforts from all in the health sector to get these settings right.”
NSW Health Minister Ryan Park said his government’s pharmacist prescribing initiative included a mandate that information be provided to a patient’s GP with the patient’s consent.
Start the day with a summary of the day’s most important and interesting stories, analysis and insights. Sign up for our Morning Edition newsletter.
