Furious GPs says pharmacy group out of control after ‘twits’ comment

The simmering war between doctors and pharmacists over who should be able to prescribe medicine has burst into the open after a speech by the Pharmacy Guild president.

Royal Australian College of General Practitioners president Dr Nicole Higgins. Picture: Supplied

The simmering war between doctors and pharmacists over who should be able to prescribe medicine has burst into the open after a speech by the Pharmacy Guild president who labelled GPs “twits”, said greater funding was not required for general practice, and claimed pharmacists should be able to prescribe, dispense and administer “all medicines for all people”.

In response Royal Australian College of General Practitioners president Nicole Higgins labelled Trent Twomey’s comments ­“astonishing” and “arrogant”.

“The Pharmacy Guild is out of control,” she said.

Mr Twomey made the comments at the National Australian Pharmacy Students Association Congress in Canberra as he railed against “bloody insulting” supervised and structured prescribing models that require pharmacists to be overseen by a doctor when prescribing medicines. He likened the protocol to “a plumber needing to look over the shoulder of an electrician”.

Pharmacists have been long demanding to be able to work within their full scope of practice but moves towards pharmacists prescribing and dispensing medicines has been bitterly opposed by doctors who say it fragments care and leads to poor patient results. The Queensland and NSW governments have recently introduced pilot and trial schemes to enable pharmacists to prescribe an array of medicines for common conditions.

Mr Twomey told the conference that pharmacists are permitted to dispense and review medicines but not prescribe or ­administer them. “I need to be able to do all four of those for all medicines for all people,” he said. The comments were reported in the Australian Journal of Pharmacy.

Mr Twomey told The Weekend Australian that pharmacists should be able to work to their full scope of practice in order to help the efficient functioning of the health system, which was under unprecedented pressure.

“It doesn’t mean that you’d be able to go to your local community pharmacy and get all medicines, it means that wherever medicines are, pharmacists should be,” he said.

“So if that is in a hospital, if that is in a community pharmacy, if that is in a residential aged-care ­facility, pharmacists are completely under-utilised in all settings.

“Every pharmacist has a unique scope of practice, like every nurse has a unique scope of practice and every medical practitioner has an unique scope of practice. So there are some things that I would have the requisite skills and knowledge to perform. And there are some things that I won’t.”

Pharmacy Guild president Trent Twomey. Picture: Stewart McLean

Doctors reacted with fury at being labelled “twits” for deregulating the ownerships of general practices in the 1990s, at which the guild president remarked “no wonder the system’s stuffed”.

Dr Higgins accused the guild of pushing a plan for pharmacists to operate as “quasi GPs” when they did not have the expertise or training to perform the function of prescribing medicines.

“Describing the idea of pharmacists only having extended powers if working in cohort with trained medical professionals as ‘bloody insulting’ shows the true mindset of the Pharmacy Guild. In this speech, there is no mention of patient safety, it is all about exerting power and extending the role of pharmacy to maximise pharmacy owner profits at any cost,” Dr Higgins said.

“The speech is nothing short of astonishing, it should send a shiver down the spine of politicians everywhere.

“The language used, the brazen way he addresses very serious healthcare issues and the underlying arrogance informing this speech demonstrates that the Pharmacy Guild should be ­approached warily.”