Doctors wary as pharmacists given authority to diagnose asthma, skin issues, ear infections in bid to fill gap

Pharmacists will soon be able to diagnose and treat common conditions like asthma, skin issues and ear infections — but patients will have to pay because bulk-billing will not apply. Up to 80 community pharmacists will undergo training to begin diagnosing more ailments from late 2026 in a bid to ease pressure on GPs. It is an expansion of a trial that currently allows pharmacists to manage contraceptive pills and diagnose and treat urinary tract infections. “It’s all about making sure we’re giving people access to the health care that they need,” Health Minister Meredith Hammat said on Monday. “We’re giving people more choice about how they access that health care.” But doctors’ lobby groups lined up to raise concerns about the $1.2 million pilot program within hours of its announcement. Australian Medical Association WA president Kyle Hoath questioned whether the initiative was “prioritising quick treatment over quality treatment”. “If we widen the scope too much in what pharmacists can manage, we will inevitably have cases where we miss things and things fall through the cracks, because people are complex,” he said. The Royal Australian College of General Practitioners WA chair Ramya Raman said pharmacists should not be a substitute for the familiarity of GP care. “What may seem like a smaller condition can mean that there may be a delay in the actual diagnosis, or perhaps a delay in referring to the GP,” she said. “Ultimately, it may not actually reduce hospitalisations or improve outcomes for the patients.” The Government said both the AMA and RACGP are involved in ongoing consultations, as training and oversight of the program is fine tuned. GPs are taking on extra duties too, with a trial underway for family doctors to prescribe ADHD medications that previously required a specialist’s diagnosis. “We’re listening to the concerns that they’re raising, but I think they recognise that we do need to approach access to health care differently, right across the board,” Ms Hammat said. “That’s why we’ll have a trial and an evaluation of the trial period as well.” In 2024 pharmacists were given the power to diagnose and treat urinary tract infections, with 14,000 people having taken up pharmacy consultations for UTIs since the pilot program launched last August. Such consultations have ranged in price across the State, with it typically costing between $30-$40. Ms Hammat said it would be up to pharmacies to set fees for consultations on the new treatments available, with the pilot program starting in 2026. In Queensland, pharmacists charge $19.50 for a 10-minute check, or $70.15 for a 20 minute consult on similar conditions. Dr Hoath denied doctors’ concerns were about protecting the current GP profit model. “This is not about a turf war, this is about making sure we have quality access to care,” he said. “If done right, the pilot program will improve access to care. The devil’s in the detail for us.” Pharmacy Guild of WA president Andrew Ngeow called the overhaul the “most significant reform” ever of pharmacy participation in primary health care. “The increased access that this is going to provide can only have the effect of an increased health outcome for all West Australians, no matter where they live,” he said. “There is a process of diagnosis, as well as the treatment and prescribing medication. “That’s the only way we can get the health outcomes we need to relieve the pressures on the system.” Pharmacists in rural and regional WA, where GP rates are even lower, will be offered a higher subsidy to take on the expanded role. “There are multiple towns across WA where their sole basis of medical care is in their community pharmacy,” Mr Ngeow said. But the scheme will not be covered by Medicare. Ms Hammat conceded that some families might not be able to afford to pay and could still have to wait longer to see a GP. “We’re always keen to have discussions with the Federal Government about how they apply Medicare,” she said. “What we’re focusing on is how we can improve access. “Medicare is obviously a matter for the Federal Government, we’re focusing on what we can do as a State.” The latest Productivity Commission report on health found the number of full-time equivalent GP’s in Perth has fallen 10 per cent from 110 per 100,000 people in 2019 to 98 in 2023. Bulk-billing rates in WA have fallen from 83.5 per cent in 2022 to 70.5 per cent in 2024, according to the Australian Institute of Health and Welfare. Ms Hammat, the RACGP and the AMA were all in agreement that more Federal funding is needed to boost GP numbers. “The bigger problem is a failure to plan for the fact that we knew we had a dwindling workforce and we didn’t do anything about it,” Dr Hoath said. “We left it too late and saying now we need more medical students, we need more doctors, we’ve been saying that for a very long time.”