The government is planning to rob New Zealanders of essential healthcare, says General Practitioners Aotearoa (GPA).
Health Minister Simeon Brown on Wednesday announced he planned to give pharmacists more power to assess, diagnose and treat certain conditions.
“As a GP, this terrifies me,” says GPA chair Dr Buzz Burrell. “And I suspect it terrifies a lot of pharmacists too.”
Four of the five proposed conditions have very serious consequences if misdiagnosed or mistreated.
“The Minister is suggesting that children’s pain and fever can be dealt with by a quick chat over the counter. I’m telling you there are few things more important than correctly assessing a child’s fever,” Burrell says.
While fevers are often an indication of a low-level illness, they can also signify serious conditions like meningitis or pneumonia.
“You could have two children turn up with the exact same symptoms, but one of them is on death’s door,” Burrell says.
“I’m not going to disparage the amazing work pharmacists do, but it’s genuinely difficult for a trained GP to diagnose these conditions in a 15-minute appointment.”
GPs are trained diagnosticians, who assess symptoms and cross-reference information about living situation, family history and more to make complex diagnoses.
“I could rattle off all day the things that can go wrong with the conditions the government is suggesting be treated with a quick stroll down to the pharmacy,” Burrell says.
“There’s no simple test for how dehydrated a child is, and you always have to know why it’s happening. If we miss the opportunity to diagnose a time-critical illness, then that kid is going to hospital and sending a big fat bill to the government.
“Conjunctivitis could be bacterial or viral; I’m expecting to see a lot of inappropriate prescriptions for antibiotics that do nothing to treat the virus in your eye.
“Then there’s scabies, you can’t diagnose scabies by eye because it’s microscopic. And then even assuming the correct diagnosis is made, treatment for this disease isn’t as simple as handing over a tube of skin cream. You’ve got to educate the patient about cleaning their house, sheets and clothes, identify any other reinfection risks, and make a follow-up plan.”
Simeon Brown suggested the new pharmacist powers would let patients skip the long wait for a GP appointment.
“Hey, I’ve got a really good idea to improve access to healthcare,” Burrell says. “Fund general practice so we can do our jobs.
“Why is the government diverting essential work away from GPs? Everybody has a right to see their doctor for these illnesses. They can be serious problems, and they require careful plans.
“Speaking of plans, I’m also really worried about the fact pharmacies are not set up to handle the logistics of follow-up appointments and escalating plans. GP clinics are set up with the systems and software to organise nurse checkups, follow-up appointments, patient notes and treatment plans.
“This reeks of a poorly-thought-through, slap-dash plan to pinch pennies and make the next Government Budget look better at the cost of every future Budget.”
Research has shown that for every $1 of taxpayer money spent in general practice, it can save the health system $10 to $13 down the line.
Many New Zealand GPs work part-time, are retiring early from the profession, or switching to other medical specialties in hospitals or overseas.
The GP workforce could be rapidly expanded if properly funded.
“By under-funding general practice, the government is looting Kiwis of their family doctor,” Burrell says.
“Diverting this work to pharmacy is robbing Peter to give a pittance to Paul, and it’s the patients who are going to suffer.”
