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Speaker 1: Now, towards the end of last week, we spoke on

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Speaker 1: the show to the CLP spokesperson for Health, Billyan, about

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Speaker 1: their plans to expand the scope for practice of practice.

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Speaker 1: I should say for pharmacies to provide twenty one extra

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Speaker 1: services for things like school saws, shingles, travel vaccinations. UTIs

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Speaker 1: that is if they are elected to come August. Now.

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Speaker 1: Bill said it's not about replacing the work of our GPS,

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Speaker 1: but it aims to take some of the pressure off

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Speaker 1: them in dealing with low level health concerns while speeding

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Speaker 1: up treatment for patients. He also said that GPS had

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Speaker 1: been consultant, but that doesn't appear to be the case

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Speaker 1: because the Royal Australian College of GPS has raised concerns

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Speaker 1: that the CLP's plan risks the health of Territorians due

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Speaker 1: to misdiagnosis and incorrect treatment. Now, the College's NT chair,

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Speaker 1: doctor Sam Heard, joins me on the line. Good morning,

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Speaker 1: doctor Herd, good morning, thanks, thanks so much for your

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Speaker 1: time this morning. Now, what was the I mean, we'll stuff,

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Speaker 1: I guess were you guys consulted about these plants? No, no,

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Speaker 1: no discussions at all. No, So what is what's the

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Speaker 1: problem with somebody, but not with.

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Speaker 2: College, And obviously that's a concern. You know, the first

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Speaker 2: thing I would just like to was, you know, I

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Speaker 2: don't want to be a kill joy or stop people

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Speaker 2: getting treatment quickly for things where that makes a difference.

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Speaker 2: You know, that's where everybody would like that. And pharmacist

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Speaker 2: has a lot of things that they give to people

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Speaker 2: obviously already in that ye being a standard development. Hasn't

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Speaker 2: it over the years become available. I mean, I don't

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Speaker 2: know if you've had a metrosol or one of the

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Speaker 2: projecin pump inhibitors for gastric refluts and things. There used

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Speaker 2: to be authority scripts for GPS and now they're over

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Speaker 2: the counter in small quantities. You know, there's a lot

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Speaker 2: of progress that generally takes place in this direction when

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Speaker 2: it's appropriate.

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Speaker 1: And so, but at this point in time, it doesn't

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Speaker 1: sound as though you guys have been consulted. I mean,

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Speaker 1: have you has the college been been contacted by GPS

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Speaker 1: who've raised concerns about this proposal?

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Speaker 2: Yeah, I think there's universe Yes, there's universal concern about it.

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Speaker 2: I mean, when you had school saws in there, you're

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Speaker 2: kind of starting to talk about you've got uti school

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Speaker 2: saws particularly, you're talking about over the counter antibiotics really,

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Speaker 2: so that's you know, that's a very serious change, and

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Speaker 2: that takes us into the territory of countries where there's

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Speaker 2: massive resistance to antibiotics. And there's already so nurses and

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Speaker 2: average health practitioners as you know in outside Darwin can

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Speaker 2: dispense antibiotics. There's already an increased resistance. We've got the

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Speaker 2: issues with it, but we have to face the fact

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Speaker 2: that when you've got less diagnostic capability, people are going

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Speaker 2: to use more antibiotics. And in this situation, I think

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Speaker 2: if you come in, say I've got a SAW and

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Speaker 2: abum or whatever over the counter, nobody's going to check

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Speaker 2: out what's going on. Ah, They're just going to give

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Speaker 2: you the antibiotics.

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Speaker 1: Really and look, yes, so from your perspective, what are

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Speaker 1: the main concerns that things may go undiagnosed or you know,

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Speaker 1: you may be diagnosed with the wrong seat.

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Speaker 2: Yeah, I think you know. Take So We've had one

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Speaker 2: experience in North Queensland where it was sort of monitored

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Speaker 2: a bit, not not in any major way, but seven

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Speaker 2: thousand people went to their chemists with the urini trapped infection.

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Speaker 2: So about one in six of those the dim mass

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Speaker 2: one seven of those women, mostly all women, I believes

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Speaker 2: we weren't any better. About two hundred of them had

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Speaker 2: a major diagnosis turned up later and nine of them

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Speaker 2: went to hospital. So you know, that's a fairly sounds

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Speaker 2: a bit dramatic, but it's a fairly safe kind of outcome.

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Speaker 2: I guess. I think, you know, we've diagnostic kind of

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Speaker 2: approach that we could have done a lot better, and

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Speaker 2: that'll be the question for people. It just I'm sure

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Speaker 2: many people listening. If your women, you've had burning passing yeurine,

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Speaker 2: you've been to GP and sometimes there's nothing wrong, and

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Speaker 2: that's where we have to consider what would antibiotics do

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Speaker 2: for that person, which is nothing really And then there's

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Speaker 2: the thirteen percent who didn't get any better. So it's

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Speaker 2: a significant and you retech confection, for example, does get

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Speaker 2: better with time, You know it doesn't. It's a bit uncomfortable,

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Speaker 2: and we have been talking with the current government about

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Speaker 2: that particular area, and most states now have an emergency

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Speaker 2: treatment for UTI, the infectious disease, but Parry is in

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Speaker 2: favor of a single dose of nitrofern tone. So very

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Speaker 2: safe medication has good effect, so available from chemists for examples, consultation,

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Speaker 2: you can come up with a sensible solution, I think

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Speaker 2: very safe one.

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Speaker 1: So doctor Hurd to play Devil's advocate here. I mean,

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Speaker 1: for some people, if you're not able to get in

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Speaker 1: to see your GP, and you know you may be

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Speaker 1: having an issue, you know, with a UTI or with

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Speaker 1: er asthma or something like that, and you're not able

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Speaker 1: to get in to see the GP and it falls

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Speaker 1: under these twenty one conditions or that the COLP is proposing,

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Speaker 1: I mean, what do you say to those people who

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Speaker 1: feel like it's really expensive for them to see the

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Speaker 1: GP and they might not be able to get in.

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Speaker 2: Ye, so that you know, and I absolutely understand that,

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Speaker 2: and we've seen you know, BOLT building is now quite

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Speaker 2: well supported for kids, so you know, for kids, money

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Speaker 2: isn't a barrier. And for people on healthcare cards, so

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Speaker 2: for people without finance resource that's you know, BOLT billing

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Speaker 2: is still available, but there's less bulk billing for people

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Speaker 2: who haven't got a healthcare card. So we have to

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Speaker 2: face you know, the government's saying whether they want us

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Speaker 2: to say so or not. But they're seeing that people

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Speaker 2: who are inning income should pay something when they go

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Speaker 2: to their GP. That's what they're expecting. There's some gps

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Speaker 2: who will accept forty dollars for seeing people, but I

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Speaker 2: think if you add up reception, treatment, dressings, everything else,

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Speaker 2: GPS use that's not going to be very much money

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Speaker 2: in an hour, so it's not really sustainable. Well, I

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Speaker 2: would like to see things like, you know, nurse that

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Speaker 2: the nurse getting a bolt building thing for to say

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Speaker 2: that is those twenty if they have a twenty one

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Speaker 2: that we all agree need very quick treatment, that you

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Speaker 2: could go into your GP, see a nurse quickly and

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Speaker 2: get still get your diagnostic things, still have a GP

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Speaker 2: available if it's complicated, and walk out again. You know

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Speaker 2: what about that? Why do we need to go in

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Speaker 2: a completely different direction, which is over the counter, which

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Speaker 2: I think has all sorts of issues, and you know,

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Speaker 2: it should be driven by patients and us and not

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Speaker 2: the pharmacy deal. That's my point of view. Politically, it's

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Speaker 2: probably expedient. You know, it sounds good. You can get

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Speaker 2: all these things over the counter, but you know, let's

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Speaker 2: talk about each one and see what's good. I think

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Speaker 2: travel vaccines is great for example, Yeah, right, and problem

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Speaker 2: with that at all?

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Speaker 1: And so is this something though that is happening in

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Speaker 1: other states? I mean, are we going to be left

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Speaker 1: behind if we don't go down this path?

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Speaker 2: So only UTI? And as I said, the current government

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Speaker 2: is I think quite close to making a statement about

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Speaker 2: that with consultation the others. You know, that's the pharmacy.

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Speaker 2: You brought this up some time ago and it's been going,

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Speaker 2: you know, for a while on the conversation. It's suspensable

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Speaker 2: conversation to be having all times about all drugs, but

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Speaker 2: you know it needs it needs to be thought about

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Speaker 2: as each one because this involves training, right, that's the pharmacy.

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Speaker 2: If they're going to train pharmacists to diagnose these conditions, well,

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Speaker 2: you know it's it takes quite a long while to

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Speaker 2: learn about diagnosis, and that's a medical thing, right, it's

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Speaker 2: can you diagnose UTI in isolation? You know, UTI in

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Speaker 2: a healthy young woman quittly trivial, but there's a lot

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Speaker 2: of people at UTI is a very serious consideration.

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Speaker 1: Yeah right, Well, it does sound as though there needs

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Speaker 1: to be some work gone through here. I really appreciate

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Speaker 1: your time this morning, doctor Sam heard. Thank you so

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Speaker 1: much for joining us.

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Speaker 2: Thank you very much, thank you