source : the age
Tension is brewing between Premier Jacinta Allan and Health Minister Mary-Anne Thomas over two contentious health policies that will expand the prescribing powers of pharmacists and GPs.
The internal friction spilled into the public eye this week when Thomas liked a scathing social media post by Dr Anita Munoz, Victorian chair of the Royal Australian College of General Practitioners (RACGP).
The situation has also ignited ructions between state and federal Labor, with federal Bruce MP Julian Hill labelling the Allan government’s move to allow pharmacists to supply the contraceptive pill to women without a doctor’s script as “terribly risky”.
In Munoz’s LinkedIn post – titled “What happens when a politician with no medical training self-appoints as the highest medical authority in the land” – she slammed Allan for making “captain’s calls” to allow pharmacists to initiate the supply of oral contraceptives against the advice of Australia’s medical watchdog.
Munoz’s post also criticised the Premier’s “reckless” decision to allow Victorian Virtual Emergency Department doctors to prescribe top-ups of stimulant medication for patients with ADHD who have run out.
The premier said last month the change would enable stimulant drugs to be available “from the convenience and comfort of your couch, anywhere, anytime”. However, GPs and psychiatrists have said the move bypasses proper clinical care and is unsafe and untested.
Thomas unliked the post after being contacted by this masthead for comment.
Two Labor sources, speaking anonymously to detail internal discussions, said they understood Thomas had not been supportive of the initial ADHD announcement, which will also allow upskilled GPs to diagnose the condition and prescribe stimulants.
They said this contributed to it being spearheaded by Mental Health Minister Ingrid Stitt.
On the day of the announcement, Stitt stood in the upper house of parliament and gave a ministerial statement promoting the policy.
In the lower house, where Thomas serves as leader of the house, it was the premier who rose to give a ministerial statement spruiking the policy.
Hansard records show Thomas has yet to mention the policy in parliament, although she did spruik it on social media.
Thomas told The Age the policies had her full support but did not publicly address why she liked Munoz’s post.
“These policies are making it easier and more affordable for Victorians to access the healthcare they need – and they have my full support,” she said.
“Contraception shouldn’t be a burden on women and by making it available at the pharmacy, we are giving Victorian women more choice. GPs diagnosing ADHD and prescribing medication makes sense, and we have been working closely with the RACGP as we roll this out across Victoria.”
Allan has spruiked both her ADHD and contraceptive pill announcements as “new solutions” to modern challenges.
The “new solutions” slogan, initially unveiled at a Labor caucus meeting, has been central to the Allan government’s early election pitch to voters.
At that meeting, Allan pledged her government’s purpose was to “make systems catch up to the complex reality of modern family life, where hopes are big, responsibilities are many, and time and money are tight”.
In an email to a Victorian GP, federal Bruce MP Julian Hill also criticised the contraceptive pill announcement.
“I was also surprised, to say the least, to see this announcement by a state government, against the advice of the relevant medical colleges,” the Labor MP said.
Hill said he had extensively researched the issue after his daughter had a close call with deep vein thrombosis linked to an off-label prescription of a contraceptive pill.
“Going to a pharmacy for a first prescription for a contraceptive pill seems a terribly risky thing to do and I’d strongly suggest to anyone in my life who asked – woman or man – to go and see a doctor for contraceptive advice and an initial prescription of the pill if that is the preferred option,” he said.
Hill was contacted for comment.
Munoz said GPs were blindsided by the announcement as the government had recently told the college that allowing pharmacists to initiate the pill was not a policy it would pursue.
“This comes as a bolt out of the blue, because I was led to believe that that was not a policy that would be endorsed by people in health,” she said.
The RACGP, Royal Australian and New Zealand College of Obstetricians and Gynaecologists and Australian Medical Association (AMA) have criticised the policy, saying pharmacists are not trained to undertake all the complex medical checks that are required to safely prescribe the pill.
This includes checking blood pressure, ruling out migraine disorders, and considering histories of hormone-dependent cancers or liver disease.
AMA Victoria president Dr Simon Judkins said pharmacists were not set up to have complex and sensitive conversations with patients who were starting on the pill.
“Initiating contraception is not just about, ‘what pill do you want?’, it is about sexual health, education and all sorts of other complex things,” he said.
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Henrietta Cook is a senior reporter covering health for The Age. Henrietta joined The Age in 2012 and has previously covered state politics, education and consumer affairs.Connect via X, Facebook or email.
