Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
You are listening to Mix one O four nine's three
sixteen eighties, twenty five minutes away from eleven o'clock. Earlier
in the week we spoke to the Pharmacy Guild about
the Northern Territory government expanding the role of community pharmacies,
allowing trained pharmacists, they say, to diagnose and treat twenty
one common health conditions from asthma to school saws, ear
(00:21):
infections and weight management. Now, the COLP governments say that
the move's going to improve access to care and reduce
pressure on gps and hospitals, but not everyone agrees. Now
the Australian Medical Association has raised concerns about patient safety
and that continuity of care. And joining us on the
show is the ama NT's president, Dr John Zorbis. You've
(00:44):
almost got a regular spot.
Speaker 2 (00:45):
Doctor zerbis.
Speaker 1 (00:48):
Hawning.
Speaker 3 (00:48):
I'll tell you what.
Speaker 1 (00:49):
It's been a busy week and the budget was dropped
earlier in the week we spoke quite extensively about that.
But this news now with the pharmacist changes, I know
the AMAS held some concerns around this for quite some time.
Just explain to our listeners what those concerns are for.
Speaker 2 (01:07):
Sure, Yeah, So look, what we're talking about here is
autonomous pharmacists prescribing. So let's be clear from the very start,
the AMA aren't against non doctors prescribing when it's safe
to do so. Right, We already support models where nurse
practitioners and nurses can prescribe. In fact, in the territory
we win one of the leaders in the country here
with remote area nurses and the CARPA manual. You know,
we really set the standard. What we're talking about, that's collaborative, right,
(01:29):
that's with doctors, nurses, pharmacists involved, the Chief Health Officer,
you know, proper governance, proper safety, proper guardrails. Ye, what
we're talking about here is a change to the legislation
that was done pretty sneakly, so an amendment to subordinate
legislation which bypasses all the debate we'd normally have in
Parliament and scrutiny in committees, et cetera single line change
to allow pharmacists to be prescribers. This is before we've
(01:50):
got a model of safety around it, guardrails and governance,
the exact same thing we've got around doctors, dentists, nurses,
other prescribers. In the current system. It's sold as you know,
twenty one conditions that are simple. And I completely sympathize
with every listener right now who is like, look, I
can't get into to see my GP. That's you know,
it is hard to see, especially your regular GP. And
(02:13):
we have been saying for yolks, Yeah, the reason for this,
like what is the root cause? The root cause is
that we haven't funded primary care in Australia properly, right
The root cause is we're not paying for it. And
this proposal, the way it's been written, what we're talking
about now is a team solution wrapped up in Amazon branding,
you know, like it's not the solution we need. When
Territorians deserve doctors. They deserve doctors.
Speaker 3 (02:34):
What do you say to people listening this morning?
Speaker 1 (02:36):
Because I know, even for myself, John, you know, without
going through you know, my medical history, but even for myself,
if I just need something simple like you know, your
birth control pill or something like you you know, a
puffer because you know you've run out of your preventer
for your asthma, it can be difficult to get into
a GP, but also quite costly, you know, for a
lot of our listeners. When you're adding up your cost
(02:56):
of living every day, If you've then got to pay
the extra eighty to one hundred bugs to go and
see your GP to get the same script that you've
been getting for the last however many years and never
had an issue with, you know, it does sound like
a really easy fix to just go to the pharmacist.
Speaker 2 (03:12):
Yeah, and look, there is a role for review. Right,
things are more expensive, it's harder to see your doctor.
But again this comes back to governments not doing what
they should be doing, which is maintaining our healthcare system.
We're putting a million dollars into training these pharmacists. That
million dollars could go into general practice, that could go
into seeing your GP. We're starting to see an uptick
in the rates of bulk billing in practices in the
(03:34):
territory and that's really exciting, right because that should lead
to less out of pocket for people to see their doctors.
And hopefully as we look at properly funding after ours consults,
we can start to see you know, better access to
your GPS. But in the meantime, cooking up a solution
like this that doesn't actually fix the problem when there's
no urgency, I might add, right like when this election
promise was made, right back then, we had models being
(03:54):
presented to and to health into the government saying hey, okay,
if this is what's been this is your mandate, well
let work out how we're going to do it. There's
been no progress on that, and yet all of a sudden,
in one week, buried in the middle of a couple
of budgets, we're just passing legislation like this. I don't
think it really stands up to the project.
Speaker 1 (04:09):
What do you reckon needs to happen here? Because it
sounds like it's all gone, like it's going to happen.
Speaker 2 (04:14):
Yeah, there is not. You know, the train hasn't completely
come off the rails, like we could talk about what
this could look and our emphasis is on collaborative care.
So you know, earlier the Pharmacy Guild were on here
saying I was spreading lies and misinformation. I mean, I'm
not sure what it was aut an issue with I
said pharmacy Guild members. For members have to be pharmacy owners.
That's true. I said, doctors aren't pharmacists, and pharmacists aren't doctors.
(04:36):
That's true as well. I'd make a terrible pharmacist. We
need a model that involves doctors and nurses, you know,
securely created through the Office of the Chief Health Officer, right,
the person responsible for all healthcare services in the territory,
not just doctors. We're not talking about, you know, single
representative groups here having carriage of the whole thing so
that that office can direct our limited resources as best
(04:59):
as they can be.
Speaker 3 (05:00):
So that's not happening at the moment.
Speaker 2 (05:02):
It doesn't. Well, we've got no model, right, We've got
a single line of legislation that just says trained pharmacists,
prescribers and then just blank space. It's wild west. And
we know the expert Advisory group that was put together
to form this has objections to what's happened. So they're
ignoring their own doctors and their own pharmacists. It's not
even me as a representative of the AMA.
Speaker 1 (05:21):
So tell me what happens if something goes wrong, Like
who's the person or the oversight body should something go
wrong throughout this process.
Speaker 2 (05:31):
So the safeguard here is the National Regulator. It's called APRA,
and APRO regulates about eighteen professions across the country. Doctors
and pharmacists included with nurses, midwives, everything, and if a
patient comes to harm it's their right to put in
a notification to Opera and Apera investigates that. The problem
with that, as you backstop, is if we know this
(05:53):
is not a good idea now, like we already know
that one in five patients who've done this in Queensland,
who've seen their pharmacist for an uncomplicated one in five
have then gone on to present to a GP with
complications from the treatment. Right, that's not a great that's
not a great result out of the gates. Why do
they have to come to harm if we know that
(06:13):
this is not the best idea and there's a better
way of doing it, Why do we have to put
patients and territorians in harm's way when there is absolutely
no urgency here. We've got time to do this properly.
The government has chosen to go ahead without doctors and
their own experts at the table, which is just a
real disappointment.
Speaker 3 (06:29):
John.
Speaker 1 (06:30):
Before I let you go, I want to ask you.
We've spoken about these maternity the Maternity ward and the
funding earlier in the week. Now no line item in
the budget for that ten million dollars for maternity services.
I caught up with Luke Gosling yesterday I think it
was he said that there is going to be ten
million dollars for maternity. I mean, like, we're pleased to
(06:50):
hear that, but I guess it's still a matter of
showing me the money.
Speaker 2 (06:52):
Yeah, I'm not pleased, Katie. I need to see it
on a piece of paper, signed, sealed, and delivered. The
number of promises we've around aged care, the number of
promises we've had maternity, the number of people we've spoken to,
both federal and local, who say that, oh, it's coming,
it's coming. I don't need your promises, I need your resources.
I cannot deliver the best health care and my member,
(07:15):
our members, our doctors, the people who live and brief you,
who are also patients in this system. Cannot remind everybody right,
we don't want promises. We're sick of promises. We want
the resourcing. And I'm also sick of hearing we don't
have any money. Yes, we don't have as much money
as other jurisdictions, and yes we are given a rough
deal by the Feds, and we've campaigned on this. We
agree with NT Health and our own government on this,
(07:35):
we're not giving you a fair shake of the source
model from the FEDS. That being said, we do have
a four point twenty five billion dollar infrastructure budget in
this most recent budget and only eight million has gone
to new infrastructure and healthcare. So yes, we don't have
a lot of money, but we do get to choose
where we spend what we've got. We think the balance
is wrong. We think healthcare has missed out. So you know,
(07:55):
let's see what we can do about funding maternity services
properly and all other services that are in I need a.
Speaker 3 (08:00):
Repair now before I let you go.
Speaker 1 (08:01):
How are things striking at the moment for our doctors
across the board, but particularly in emergency and across our hospitals.
Speaker 2 (08:08):
Really Yeah, tired, weary, battle worn. You know, it's the
same everywhere. You know, Let's take this example. We've talked
about pharacy prescribing. You know, we've got infectious disease consultants
who are the experts in anti microbial stewardship. Right, we
have some of the highest rates of antibiotic resistance in
the country. It's particularly dangerous up here in the territory,
and we have the experts in Australia. We have the
(08:30):
best infectious disease specialist in the country. They've done a
huge amount of work on what could be collaborative models
here and for this to just be outright rejected with
one line of legislation amendment, it's a real kick in
the teeth to people who are doing the hard work.
You know, every time that happens to a doctor or
a nurse or a paramedic, any healthcare work in the territory,
it's just one moment where they're just less likely to
(08:53):
come back to work the next day, you know. So
what does it look like on the front lines? Tired,
tired and underresourced and we want to do the job.
We all want to do what we have been trained
to do. Whild is take care of Territorians. It's getting
harder and harder.
Speaker 1 (09:06):
Well, doctor John's orbis. I always appreciate your time. Thank
you very much for joining us on the show, and
we'll talk to you again soon.
Speaker 2 (09:12):
Thanks Katie. I appreciate you talking about these things. I
think it's important for everybody listening.
Speaker 1 (09:15):
Yeah, I reckon it is to and I know that
our health, you know, at the moment, health is you
know it was a bit of an underlying issue for
a little while, but it's really come to the fore,
I think, over the last year, and it is really
important that you know that people understand the different sort
of you know, the different issues and the different things
happening behind the scenes.
Speaker 2 (09:33):
No healthcare system, no territory, Yeah.
Speaker 1 (09:35):
Spot on John's orbis good to speak to you. We'll
catch up with you soon.
Speaker 3 (09:39):
Thank you, thank you.
You are listening to Mix one O four nine's three
sixteen eighties, twenty five minutes away from eleven o'clock. Earlier
in the week we spoke to the Pharmacy Guild about
the Northern Territory government expanding the role of community pharmacies,
allowing trained pharmacists, they say, to diagnose and treat twenty
one common health conditions from asthma to school saws, ear
(00:21):
infections and weight management. Now, the COLP governments say that
the move's going to improve access to care and reduce
pressure on gps and hospitals, but not everyone agrees. Now
the Australian Medical Association has raised concerns about patient safety
and that continuity of care. And joining us on the
show is the ama NT's president, Dr John Zorbis. You've
(00:44):
almost got a regular spot.
Speaker 2 (00:45):
Doctor zerbis.
Speaker 1 (00:48):
Hawning.
Speaker 3 (00:48):
I'll tell you what.
Speaker 1 (00:49):
It's been a busy week and the budget was dropped
earlier in the week we spoke quite extensively about that.
But this news now with the pharmacist changes, I know
the AMAS held some concerns around this for quite some time.
Just explain to our listeners what those concerns are for.
Speaker 2 (01:07):
Sure, Yeah, So look, what we're talking about here is
autonomous pharmacists prescribing. So let's be clear from the very start,
the AMA aren't against non doctors prescribing when it's safe
to do so. Right, We already support models where nurse
practitioners and nurses can prescribe. In fact, in the territory
we win one of the leaders in the country here
with remote area nurses and the CARPA manual. You know,
we really set the standard. What we're talking about, that's collaborative, right,
(01:29):
that's with doctors, nurses, pharmacists involved, the Chief Health Officer,
you know, proper governance, proper safety, proper guardrails. Ye, what
we're talking about here is a change to the legislation
that was done pretty sneakly, so an amendment to subordinate
legislation which bypasses all the debate we'd normally have in
Parliament and scrutiny in committees, et cetera single line change
to allow pharmacists to be prescribers. This is before we've
(01:50):
got a model of safety around it, guardrails and governance,
the exact same thing we've got around doctors, dentists, nurses,
other prescribers. In the current system. It's sold as you know,
twenty one conditions that are simple. And I completely sympathize
with every listener right now who is like, look, I
can't get into to see my GP. That's you know,
it is hard to see, especially your regular GP. And
(02:13):
we have been saying for yolks, Yeah, the reason for this,
like what is the root cause? The root cause is
that we haven't funded primary care in Australia properly, right
The root cause is we're not paying for it. And
this proposal, the way it's been written, what we're talking
about now is a team solution wrapped up in Amazon branding,
you know, like it's not the solution we need. When
Territorians deserve doctors. They deserve doctors.
Speaker 3 (02:34):
What do you say to people listening this morning?
Speaker 1 (02:36):
Because I know, even for myself, John, you know, without
going through you know, my medical history, but even for myself,
if I just need something simple like you know, your
birth control pill or something like you you know, a
puffer because you know you've run out of your preventer
for your asthma, it can be difficult to get into
a GP, but also quite costly, you know, for a
lot of our listeners. When you're adding up your cost
(02:56):
of living every day, If you've then got to pay
the extra eighty to one hundred bugs to go and
see your GP to get the same script that you've
been getting for the last however many years and never
had an issue with, you know, it does sound like
a really easy fix to just go to the pharmacist.
Speaker 2 (03:12):
Yeah, and look, there is a role for review. Right,
things are more expensive, it's harder to see your doctor.
But again this comes back to governments not doing what
they should be doing, which is maintaining our healthcare system.
We're putting a million dollars into training these pharmacists. That
million dollars could go into general practice, that could go
into seeing your GP. We're starting to see an uptick
in the rates of bulk billing in practices in the
(03:34):
territory and that's really exciting, right because that should lead
to less out of pocket for people to see their doctors.
And hopefully as we look at properly funding after ours consults,
we can start to see you know, better access to
your GPS. But in the meantime, cooking up a solution
like this that doesn't actually fix the problem when there's
no urgency, I might add, right like when this election
promise was made, right back then, we had models being
(03:54):
presented to and to health into the government saying hey, okay,
if this is what's been this is your mandate, well
let work out how we're going to do it. There's
been no progress on that, and yet all of a sudden,
in one week, buried in the middle of a couple
of budgets, we're just passing legislation like this. I don't
think it really stands up to the project.
Speaker 1 (04:09):
What do you reckon needs to happen here? Because it
sounds like it's all gone, like it's going to happen.
Speaker 2 (04:14):
Yeah, there is not. You know, the train hasn't completely
come off the rails, like we could talk about what
this could look and our emphasis is on collaborative care.
So you know, earlier the Pharmacy Guild were on here
saying I was spreading lies and misinformation. I mean, I'm
not sure what it was aut an issue with I
said pharmacy Guild members. For members have to be pharmacy owners.
That's true. I said, doctors aren't pharmacists, and pharmacists aren't doctors.
(04:36):
That's true as well. I'd make a terrible pharmacist. We
need a model that involves doctors and nurses, you know,
securely created through the Office of the Chief Health Officer, right,
the person responsible for all healthcare services in the territory,
not just doctors. We're not talking about, you know, single
representative groups here having carriage of the whole thing so
that that office can direct our limited resources as best
(04:59):
as they can be.
Speaker 3 (05:00):
So that's not happening at the moment.
Speaker 2 (05:02):
It doesn't. Well, we've got no model, right, We've got
a single line of legislation that just says trained pharmacists,
prescribers and then just blank space. It's wild west. And
we know the expert Advisory group that was put together
to form this has objections to what's happened. So they're
ignoring their own doctors and their own pharmacists. It's not
even me as a representative of the AMA.
Speaker 1 (05:21):
So tell me what happens if something goes wrong, Like
who's the person or the oversight body should something go
wrong throughout this process.
Speaker 2 (05:31):
So the safeguard here is the National Regulator. It's called APRA,
and APRO regulates about eighteen professions across the country. Doctors
and pharmacists included with nurses, midwives, everything, and if a
patient comes to harm it's their right to put in
a notification to Opera and Apera investigates that. The problem
with that, as you backstop, is if we know this
(05:53):
is not a good idea now, like we already know
that one in five patients who've done this in Queensland,
who've seen their pharmacist for an uncomplicated one in five
have then gone on to present to a GP with
complications from the treatment. Right, that's not a great that's
not a great result out of the gates. Why do
they have to come to harm if we know that
(06:13):
this is not the best idea and there's a better
way of doing it, Why do we have to put
patients and territorians in harm's way when there is absolutely
no urgency here. We've got time to do this properly.
The government has chosen to go ahead without doctors and
their own experts at the table, which is just a
real disappointment.
Speaker 3 (06:29):
John.
Speaker 1 (06:30):
Before I let you go, I want to ask you.
We've spoken about these maternity the Maternity ward and the
funding earlier in the week. Now no line item in
the budget for that ten million dollars for maternity services.
I caught up with Luke Gosling yesterday I think it
was he said that there is going to be ten
million dollars for maternity. I mean, like, we're pleased to
(06:50):
hear that, but I guess it's still a matter of
showing me the money.
Speaker 2 (06:52):
Yeah, I'm not pleased, Katie. I need to see it
on a piece of paper, signed, sealed, and delivered. The
number of promises we've around aged care, the number of
promises we've had maternity, the number of people we've spoken to,
both federal and local, who say that, oh, it's coming,
it's coming. I don't need your promises, I need your resources.
I cannot deliver the best health care and my member,
(07:15):
our members, our doctors, the people who live and brief you,
who are also patients in this system. Cannot remind everybody right,
we don't want promises. We're sick of promises. We want
the resourcing. And I'm also sick of hearing we don't
have any money. Yes, we don't have as much money
as other jurisdictions, and yes we are given a rough
deal by the Feds, and we've campaigned on this. We
agree with NT Health and our own government on this,
(07:35):
we're not giving you a fair shake of the source
model from the FEDS. That being said, we do have
a four point twenty five billion dollar infrastructure budget in
this most recent budget and only eight million has gone
to new infrastructure and healthcare. So yes, we don't have
a lot of money, but we do get to choose
where we spend what we've got. We think the balance
is wrong. We think healthcare has missed out. So you know,
(07:55):
let's see what we can do about funding maternity services
properly and all other services that are in I need a.
Speaker 3 (08:00):
Repair now before I let you go.
Speaker 1 (08:01):
How are things striking at the moment for our doctors
across the board, but particularly in emergency and across our hospitals.
Speaker 2 (08:08):
Really Yeah, tired, weary, battle worn. You know, it's the
same everywhere. You know, Let's take this example. We've talked
about pharacy prescribing. You know, we've got infectious disease consultants
who are the experts in anti microbial stewardship. Right, we
have some of the highest rates of antibiotic resistance in
the country. It's particularly dangerous up here in the territory,
and we have the experts in Australia. We have the
(08:30):
best infectious disease specialist in the country. They've done a
huge amount of work on what could be collaborative models
here and for this to just be outright rejected with
one line of legislation amendment, it's a real kick in
the teeth to people who are doing the hard work.
You know, every time that happens to a doctor or
a nurse or a paramedic, any healthcare work in the territory,
it's just one moment where they're just less likely to
(08:53):
come back to work the next day, you know. So
what does it look like on the front lines? Tired,
tired and underresourced and we want to do the job.
We all want to do what we have been trained
to do. Whild is take care of Territorians. It's getting
harder and harder.
Speaker 1 (09:06):
Well, doctor John's orbis. I always appreciate your time. Thank
you very much for joining us on the show, and
we'll talk to you again soon.
Speaker 2 (09:12):
Thanks Katie. I appreciate you talking about these things. I
think it's important for everybody listening.
Speaker 1 (09:15):
Yeah, I reckon it is to and I know that
our health, you know, at the moment, health is you
know it was a bit of an underlying issue for
a little while, but it's really come to the fore,
I think, over the last year, and it is really
important that you know that people understand the different sort
of you know, the different issues and the different things
happening behind the scenes.
Speaker 2 (09:33):
No healthcare system, no territory, Yeah.
Speaker 1 (09:35):
Spot on John's orbis good to speak to you. We'll
catch up with you soon.
Speaker 3 (09:39):
Thank you, thank you.
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