'This isn't health, it's just politics': RACGP slams NSW Govt's risky approach to women's health

he Royal Australian College of GPs (RACGP) has expressed its disappointment the NSW Government has failed to prioritise women’s health and safety in its reckless expansion of pharmacy oral contraceptive prescribing.  

The move follows strong lobbying and significant donations from the pharmacy business owner's lobby. 

It also disregards expert advice against down-scheduling that would have permitted pharmacists to supply oral contraceptives in 2021, and significantly exceeds the NSW pharmacist practice standards for the continuation of hormonal contraception, including by:  

• Not requiring an initial prescription and appropriate assessment by a qualified medical or nurse practitioner 

• Not requiring a GP or other doctor to review how a contraceptive is affecting a patient.  

While the previous NSW Government implemented a clinical trial for its pharmacy prescribing expansion – the only state to do so, and one the RACGP supported for its independence and rigour – the findings from that trial have not been published to inform this decision. 

“That should concern every Australian,” RACGP Vice President Dr Ramya Raman said. 

“The approach here indicates this isn’t evidence-based health policy, it’s lobbyist-led health policy. This sends a troubling message to women that expert medical advice can be ignored if it benefits donors to cut corners with our patients’ health. 

“Medical and health policy should be based on evidence, not donations – and the previous NSW Government did the right thing by being the only state to actually run a clinical trial.  

“Where is the evidence from that to support this change? Does the trial support it? Or is this just politics?” 

When pharmacy prescribing of hormonal contraception was considered by the TGA in 2021, the independent regulator declined to allow pharmacists to independently provide oral contraceptives by down scheduling the medications.  

The health regulator cited the risk of serious adverse health outcomes and concluding that pharmacist-only consultations were not sufficient to ensure patient safety over time. 

The RACGP has previously raised concerns about the influence of pharmacy business lobby donations on policy, and with the Stroke Foundation, the potential risks of using oral contraceptives without the supervision of a qualified practitioner.   

Election donations disclosures show the Pharmacy Guild has donated $99,600 to the NSW branch of the Australian Labor Party since the 2023 election.  

“Hormonal contraception is safe for many women, but GPs take their use and risks seriously,” Dr Raman said. 

“They carry well established risks, including increased risk of stroke and blood clots, particularly during periods of hormonal change, the very times when women need comprehensive medical assessment, not fragmented care. 

“A new headache, visual changes, ‘auras’ – that’s a red flag, not a refill. Allowing pharmacists to prescribe the pill sends a dangerous public health message to Australian women, that this is a simple, risk-free medication when it is not. 

“For many young women, contraception is not just about preventing pregnancy, it’s about managing serious medical conditions like endometriosis and PCOS, and making informed choices about their health, education and careers. Allowing non‑medical professionals to provide this care risks delayed diagnosis and exposes women to potentially life‑threatening complications such as stroke or pulmonary embolism. GPs are specifically trained to assess these risks and offer the safest, most appropriate options, which are not always the oral contraceptive pill.”