AMA SA Council News - May

Pharmacy prescribing for UTIs – access benefits, safety and stewardship concerns

A significant focus was the new healthcare pathway enabling some female patients to access treatment for urinary tract infections (UTIs) directly through pharmacists, without urine investigation or formal medical review. While Council acknowledged the accessibility and convenience this may provide for patients, members raised strong concerns about diagnostic accuracy, clinical governance and antibiotic stewardship.

Council noted that UTI-like symptoms can reflect a range of non-infectious or more serious conditions, including bladder cancer, interstitial cystitis, atrophic vaginitis, sexually transmitted infections, or presentations complicated by antibiotic resistance. There was concern that easier access to empiric antibiotics – without appropriate assessment, investigation and follow-up – risks contributing to antimicrobial resistance and may delay diagnosis of serious pathology.

Questions were also raised about the level of clinical training, supervision standards, escalation pathways and overall accountability available to pharmacists managing these presentations. In response, Council is progressing a position paper calling for clear training frameworks, comprehensive audit mechanisms, and transparent accountability arrangements to support consistent standards of care and patient safety as pharmacy prescribing expands.

General practice pressures, digital systems and workforce sustainability

The broader issue of GP shortages remained central, with concern that governments are increasingly shifting primary care responsibilities without adequately strengthening the medical workforce and supporting practice viability. Dr John Williams, Immediate Past President and Chair of the General Practice Committee, reported active engagement with the Commonwealth on digital health systems. Council reiterated ongoing concerns about inefficient platforms and workflows that can extend consultation times and increase administrative burden, and reaffirmed the importance of improving usability and performance through closer collaboration with federal stakeholders.

Workforce sustainability was a key theme, particularly the challenges facing International Medical Graduates (IMGs), who were viewed as an underutilised workforce. Council discussed the substantial financial and training barriers currently faced by IMGs, including the requirement for significant personal investment in training pathways and limited Medicare billing access during supervised training. These settings were seen as limiting recruitment and retention – especially in rural areas. Council reaffirmed its advocacy for reform to IMG funding and regulatory arrangements to better support workforce growth and improve access to care.

Primary care integration, aged care and avoidable hospital demand

Council discussed broader primary care system pressures, including data indicating strong GP engagement in aged care while highlighting service gaps that contribute to avoidable hospital demand. Strengthening primary care capacity and improving integration across services remains a strategic priority, particularly as system pressures continue to shift demand toward emergency departments and inpatient care.

Palliative care capacity – bottlenecks and workforce needs

Significant concern was expressed regarding palliative care capacity. Council noted limited bed availability and insufficient community-based services are creating bottlenecks across the system, with flow-on impacts for acute care and patient outcomes. Council endorsed continued advocacy for increased infrastructure and a sustainable workforce model to support timely access to palliative care in both inpatient and community settings.

Rising ASD and ADHD diagnoses – drivers, impacts and system strain

A second major discussion point was the increasing diagnosis rates of Autism Spectrum Disorder (ASD) and ADHD. Members considered whether the rise reflects improved recognition and help-seeking, changing social and behavioural factors, environmental influences, broader diagnostic criteria, or the risk of overdiagnosis. Concerns were also raised about the potential influence of NDIS funding structures on diagnostic trends and service pathways.

Council noted that increasing neurodevelopmental diagnoses may further strain an already underfunded mental health system, including pressure on paediatric services and outpatient capacity. Discussion also touched on flow-on impacts in women’s health, particularly the increasing complexity of managing chronic pelvic pain and functional disorders, alongside rising numbers of laparoscopic procedures. A broader question was raised about when diagnostic labelling supports patients through access to appropriate care – and when it may inadvertently contribute to overmedicalisation, dependency, or fragmented management.

In this context, Council also considered a proposed paediatric service redesign, expressing strong preliminary support for an integrated model of care aimed at addressing rising neurodevelopmental demand and reducing pressure on outpatient services. This reform area will be progressed through further discussion and refinement, with ongoing input from Council members and the broader membership.

Public health policy – e-bikes and road safety

In public health policy, Council endorsed a road safety position on e-bikes, supporting balanced regulation, improved enforcement and investment in safer infrastructure. Discussion also recognised the role e-bikes can play in promoting physical activity by enabling more people to exercise and travel outdoors, rather than relying on car use.