Response to Pharmac proposal to extend childhood vaccinations to pharmacists

From the members and Board of General Practitioners Aotearoa

Dear Colleagues,

Thank you for asking for feedback on the proposal to extend vaccinations to pharmacists.

We acknowledge there is a serious shortfall in vaccination targets in New Zealand, some areas having rates as low as 60-70%. Internationally there are concerning cases of preventable diseases like polio now being reported in New York and London.

The contribution pharmacists made to the high rates of Covid vaccination in the pandemic was exemplary, and both acknowledged and valued. That was an appropriate response to a social emergency.

The journey of immunisation for a developing child as part of a growing whānau is very different.

We are increasingly concerned about the fragmentation of health care delivery in New Zealand. Instead of working together, provider is pitched against provider competing for an ever-shrinking health dollar.

General practice is being neglected more and more. General practice clinics still care for 90% of conditions, but this fragmentation is exponentially eroding the viability of hitherto functional teams.

Delivery of vaccinations is one example where the true value of an integrated general practice team can be realised.

When a child is vaccinated in their local general practice, we have an opportunity to talk to the parent, who may well have health concerns of their own, or additional concerns for their child or children. A nurse or a doctor sees the child being vaccinated. We check height, weight, skin and wellbeing, and add the results to the continuous records. We screen for serious issues like non-accidental injury, and intercept them. We may pick up signs of post-natal depression in the mother. The list goes on.

There is an argument that many patients do not have a GP, but this issue is made worse by diverting vaccinations away from general practice. It’s a missed opportunity to engage a whānau in the comprehensive primary care system.

The argument that general practices are too busy is a frustrating symptom of an under-funded GP system. Again, extending vaccinations to pharmacists makes this worse, not better.

We believe this initiative is naïve, and destructive to the fabric of general practice care.

We invite you to meet with us to seek solutions to the problems in general practice and child vaccine delivery.

We believe the important issue of unmet need for vaccinations can be thought through with a wider lens. Investment in general the practice system will be rewarded instead of lost. You have an opportunity to enhance the ethos of general practice health care delivery, improving vaccination rates and improving the health of New Zealanders.

Yours sincerely,

Dr Buzz Burrell MB BS MRCPI FRNZCGP FDRHMNZ

Interim Chair, General Practitioners Aotearoa

info@gpaotearoa.co.nz

For more coverage on this issue: https://www.newshub.co.nz/home/new-zealand/2024/01/gps-at-odds-with-pharmac-s-plan-to-extend-access-to-childhood-vaccines.html