8 NOVEMBER 2024

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Backlash over pharmacy giant ’ s screening plan .

Rachel Fieldhouse PRICELINE says it will start offering HPV swabbing to women from this month , despite the corporate pharmacy chain failing to outline how it will follow-up patients with abnormal results .

It says its screening program will be done via self-collected swabs , with clinical support from doctors at telehealth company InstantScripts . Wesfarmers , which owns both companies , failed to respond to any detailed questions raised by Australian Doctor aside from saying the program had been developed in line with the National Cervical Screening Program ’ s ( NCSP ) quality framework .

But those running the national screening program are concerned , saying Priceline has yet to explain its care pathway .

“ How would Priceline ’ s systems allow for the timely notification , recall , retesting or referral of people who self-collect with its service ?” said Dr Lara Roeske , a GP and member of the NCSP ’ s self-collection implementation committee .

“ In general practice , we have tried and true systems of follow-up where women fail to attend , and those systems are part of why we are accredited .

“ The other question is how Priceline would determine whether a patient presenting for self-collection had symptoms associated with the likelihood of the development of cancer and offer investigation and management of those symptoms ?”

It was also unclear how pharmacies would assess eligibility and whether they would use the National Cancer Screening Register to confirm that women had not been screened for at least four years and nine months .

Dr Roeske said the planned program also failed to give women

choice — a key goal of the NCSP , which opened up self-collection eligibility in 2022 .

“ If an eligible woman presents and decides she does not want self-collection , in a general practice setting , there would be the opportunity to have a clinician-collected sample .

“ In a setting such as a chemist , that woman would not be able to participate in the program .

“ That is a problem because you are delaying access to screening as you are not supporting choice .”

‘ In general practice , we have tried and true systems of follow-up .’

— Dr Lara Roeske

A Department of Health and Aged Care spokesperson said health officials had “ contacted Priceline to determine if the proposed model meets the safety and quality requirements of Australia ’ s NCSP , including the provision of essential support and follow-up for patients ”.

Dr Roeske said that Wesfarmers — which also owns Kmart and Bunnings — had a role in health promotion , as did Priceline .

But anything beyond that was “ not within its scope ”.

“ Why not put up posters ? Why

not distribute pamphlets ? “ This should not be a case of ,

‘ Oh , it ’ s so convenient .’

“ We are in the business of detecting pre-cancerous change early and preventing cancer , so safety and quality must be paramount .

“ At this stage , what I have seen will increase the risk of inadequate follow-up ; it will actually miss opportunities for appropriate investigation of people with symptoms , and it will result in unintended charges for those who are not eligible .”

FAIRFAX

Rachel Fieldhouse A GP with a non-accredited solo practice says the MyMedicare patient enrolment scheme is fragmenting care and hurting special interest GPs .

Rebates for level C and D phone consultations are restricted to practices where patients are registered under MyMedicare , as are the tripled bulk-billing incentives on longer video consultations .

But to join MyMedicare , with a handful of time-limited exceptions , GP practices must be accredited .

GP Dr Naomi Rutten , president of the Australian Society for Psychological Medicine , runs an Adelaide clinic that provides mental health care exclusively . Because it does not offer “ predominantly ” general medical care , it is ineligible for accreditation — and therefore MyMedicare .

‘ The therapeutic connection will be lost .’

Even if eligible , Dr Rutten says that morally she would not enrol patients under MyMedicare “ knowing I do not do all the general GP stuff ”.

However , she recalls a patient with complex PTSD who was imprisoned when longer phone consults were available to all under Medicare .

When he was released after two years , the rebates had been scrapped and only brought back for MyMedicare patients .

“ This patient has no internet access and is living 90 PAGE 4