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NSW Health Minister rejects pharmacy trial for antibiotics and contraceptive pill

Health Minister Brad Hazzard has dismissed calls for NSW to begin a trial to allow pharmacists to prescribe antibiotics for urinary tract infections and issue one-off repeats for the contraceptive pill.

It comes as the NSW Labor opposition urged the state government to follow in the footsteps of the Queensland government, which earlier this month announced it would begin a statewide trial of both measures.

Mr Hazzard said he could see some merit in the proposal, but any change needed to be considered at a national level as it was “not entirely logical to have different prescribing practices in different states”.

“I can see the benefit in some regional areas where patients may not be able to get to a GP,” Mr Hazzard said.

“But I’m also being strongly warned by the Ministry of Health [that] there needs to be appropriate protocols in place such that patients are getting the full checks and balances around risks and benefits that exist when they see a GP.

“There are some quite difficult and challenging clinical issues that need to be considered. My view is it would be preferable to make these decision on an Australia-wide basis, not an individual state basis.”

The Queensland trial, which has not been given a start date, has been welcomed by pharmacist advocacy groups but slammed by other medical groups including the Royal Australian College of General Practitioners (RACGP) and the Australian Medical Association.

NSW Labor has backed a plan by the Pharmaceutical Society of Australia (PSA), which proposes allowing pharmacists to issue people aged 16-65 with a three-day course of the antibiotic drug Trimethoprim to treat urinary tract infection.

PSA NSW President Peter Carroll said urinary tract infections were “pretty easy to diagnose” and, under a proposed plan, pharmacists would only prescribe antibiotics in line with an agreed treatment protocol.

“This is not about stopping someone from going to the GP. It’s not about pharmacists. What it is about is women being able to get appropriate treatment and relieving her symptoms,” Professor Carroll said.

Labor health spokesman Walt Secord described the plan as “common sense” and said similar measures were already in place in New Zealand, the United Kingdom and in some Canadian provinces.

“It would be an interim measure and could also reduce the number of young women presenting at emergency departments as they cannot get access to a GP outside normal business hours,” Mr Secord said.

Mr Secord said Labor also supported a similar trial allowing women to access a once-off supply for the contraceptive pill from a pharmacy based on the woman’s existing script.

RACGP President Dr Harry Nespolon argued the plan, if implemented, would displace the role of professional medical advice and could lead to the over prescription of antibiotics and incorrect diagnoses.

“It is more complicated than just giving a woman a script for the pill or some antibiotics,” Dr Nespolon said. “You need to take a history, you need to talk to the patient, and you need to follow up on those patients to check the antibiotics has actually worked.”

Dr Nespolon said the over-prescription of antibiotics was a “serious medical problem” and had prompted the World Health Organisation to repeatedly warn about the threat of antibiotic resistance and “super bugs”.

Family Planning NSW medical director Dr Deborah Bateson said the organisation was “broadly supportive” of the proposal to allow women to access repeats of the contraceptive pill over-the-counter.

“We know that women can run out their contraceptive pill and that can put them at risk of an unintended pregnancy. Any implementation would need robust training of pharmacists and robust guidelines,” Dr Bateson said.

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