Johannesburg – Healthcare practitioners’ organisations are up in arms after the Department of Health approved a proposal by the South African Pharmacy Council (SAPC) to allow pharmacists to practise as mini-doctors and nurses.
The department has gazetted SAPC’s proposal that pharmacists can provide primary healthcare such as treating patients with HIV and TB without being seen by a qualified medical doctor, in what is called Pharmacy Initiated Management of Antiretroviral Treatment (Pimart).
Organisations such as the National Health Care Professionals Association (NHCPA) and African Viral Care Society (AVCS) said it would disadvantage qualified medical practitioners to do their work and lead to loss of income.
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NHCPA secretary-general, Dr Prudence Buthelezi, sent a scathing letter to Health Minister Joe Phaahla last week in which the association is objecting to the approval of Pimart.
The association said Pimart would harm the standards of healthcare and expose the public to unscrupulous pharmacists whose interest was to make profit.
In the complaint seen by Sunday World, Buthelezi wrote: “We see this as mismanagement of patients and an act of pushing big pharmacies to make money through [the] poor health of vulnerable patients. We must strengthen the primary healthcare system in our country by ensuring all healthcare workers complement each other for the benefit of the patient, not for profit.”
“The clinical examination is noble for medical doctors who spend time throughout their medical career to execute their jobs properly. Are pharmacists able to perform a clinical examination and where would this clinical examination be conducted?”
According to Buthelezi, the SAPC trains its pharmacists in a two-week course, while medical doctors and other health professionals spent almost seven years to learn and understand the dynamics involved in the medical field. In the letter to Finance Minister Enoch Godongwana lask week Monday, AVCS managing director Dr Muhangwi Ben Mulaudzi expressed his objection to the proposed Pimart.
SAPC CEO Vincent Tlala said the initiation and management of the antiretroviral therapy at the primary healthcare level is not a new phenomenon in South Africa and globally. “The Pimart intervention was developed with input from all stakeholders, including Southern African HIV Clinicians Society.
Pharmacists are part of a healthcare team that ensures therapeutic outcomes for patients,” said Tlala. “We also wish to stress that the treatment of HIV/Aids is not an exclusive area or competence of one or the other of the healthcare professionals. It is a collective multidisciplinary service in the interest of humanity.
“As such, not all patients who are initiated on antiretroviral therapy at a pharmacy or clinic will remain patients at the pharmacy.”
Tlala added: “Certain patients, due to comorbidities or unique health conditions, will be referred to doctors/medical practitioners for treatment. Similarly, stabilised patients may be referred to the primary level of care where their treatment will be managed by nurses or pharmacists.”
Health Department spokesperson Popo Maja said the introduction of pharmacists in the primary testing and treatment of HIV expands the accessibility to ensure universal access to HIV testing, referral and treatment across the healthcare system in line with the Primary Healthcare Standard Treatment Guidelines.
Maja said: “Pimart does not seek to encroach on the scope of practice of any other practitioner and does not give pharmacists any specialist rights to what medical practitioners are currently exclusively responsible for in the treatment of HIV/Aids”.
He said stakeholders had the opportunity to make their input into the Pimart policy documents.
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