27 October 2026

Mr GAFFNEY (Mersey) - Mr President, the Royal Australian College of General Practitioners (RACGP) highlighted with me some of their concerns. My Special Interest Matter today will reflect issues raised with me by that organisation.

Their primary concern is one of profound structural consequence to the safety of every person in Tasmania from the proposed expansion of autonomous pharmacists' prescribing and diagnostic authority. As our state looks at changes to whom can diagnose illness and prescribe high-risk and clinical medicines, the RACGP believe that this parliament must unite behind one unshakable principle, patient safety must always come first. The RACGP contend that this is not a debate about individual professional capability, dedication or intentions of our hardworking community pharmacists, rather, it speaks directly to a cold systemic reality, the specific conditions required for the safe exercise of medical diagnostic authority, particularly in environments where clinical uncertainty is inherent and patient harm may only emerge long after initial consultation.

We should agree that expanding access to our care across Tasmania is an urgent priority, especially for our regional, rural and isolated communities, however, safe prescribing is never just a single transactional moment of care, nor is it simply about providing fast relief to symptoms. It relies entirely on structural systems that support continuity, oversight and deep accountability over time, not solely on the skill or goodwill of an individual practitioner working in isolation. The RACGP recognises that most health conditions are not straightforward. Symptoms are frequently unclear during an initial presentation, shared across a vast web of entirely different medical conditions, and change unpredictably over time. A correct, safe diagnosis often cannot be achieved in a single episodic visit. It only becomes clear through time, rigorous follow-up and ongoing connected care.

The RACGP believes that current pharmacy education, training pathways and business structures within retail pharmacies simply do not align with the complex clinical competencies required to safely manage these undifferentiated raw medical presentations. What initially appears to be a straightforward UTI or ear infection, skin condition or episode of reflux may be a symptom of a different or more serious underlying condition. The RACGP believe if we expand diagnosing and prescribing to episodic isolated retail settings without robust system level safeguards it fears that we might introduce severe predictable failure points into Tasmanian healthcare.

First, the RACGP believes care will become heavily fragmented. Safe medicine depends completely on continuity of care and displacing these decisions into a transactional over-the-counter environment breaks the longitudinal patient-doctor relationship that keeps chronic and vulnerable patients alive.

Second, the RACGP contends important warning signs will be missed in complex care contexts. Clinical diagnosis is a process that evolves. Patient harm is frequently delayed, diffused or completely undetected during a brief first consultation. Without deeply connected information networks, universal access to shared patient histories and formal pathways to immediately refer or escalate care to a medical team, serious complications will slip through the cracks.

Third, the RACGP explain that antimicrobial stewardship may be severely threatened. Distributing prescribing authority for acute conditions like ear, skin or respiratory infections into retail settings runs completely counter to decades of public health advocacy. Splitting the health system increases the risk of inappropriate antibiotic use, directly accelerating the dangerous global threat of antimicrobial resistance.

Finally, the RACGP vocalised that clinical accountability will be eroded. When prescribing is decoupled from comprehensive diagnostic oversight, it becomes entirely unclear who is ultimately responsible for the long-term patient outcome. Tasmanians deserve a health system where clinical accountability is transparent, permanent and designed strictly around the patient.

Most concerningly, the RACGP states that the Tasmanian government's accelerated path towards unilateral pharmacy prescribing is entirely at odds with intergovernmental commitments made only a few weeks ago. At the national Health ministers' meeting on 4 September 2026, every federal, state and territory minister explicitly agreed to update the Australian Health Ministers' Advisory Council's guidance for national boards on scheduled medicines. They pledged to collectively develop a unified national decision making framework to deliberately promote national consistency in prescribing scope of practice. For our state to forge ahead with isolated, fragmented changes right now directly violates that joint ministerial consensus and undermines the very national framework meant to protect patient safety.

The RACGP contends systems, not just individuals, keep patients safe. This principle is particularly vital for older Tasmanians and those with complex multilayered healthcare needs who are highly vulnerable to the dangers of polypharmacy. We must not permit convenience to be substituted for clinical safety, nor national agreements to be cast aside for political expediency. The RACGP implores the Tasmanian government and our state regulators to honour their September commitment. We must immediately halt any independent expansions and ensure that strong, system level safety protections are legally locked in place through the agreed national decision making framework before any prescribing roles are altered. The RACGP's closing comment to me was along the lines of, 'Let us choose a future for Tasmania that is safe, connected, accountable and designed entirely around the safety of the patient.'