The last few weeks have been extremely challenging for general practice.
The COVID-19 vaccine rollout in general practice commenced, with a number of missteps by the Commonwealth that made it harder than it should have been. The launch of the national booking service was poorly communicated and the Department of Health is learning on the run just how difficult it is to distribute vaccines in a timely way, something that is outside its normal expertise.
That said, the Commonwealth’s decision to position general practice at the centre of its roll out plans was the correct one. The AMA, along with other GP bodies, continues to try and work with the Government to address problems as they arise, maintain public confidence, and ensure that GPs get the support and recognition they deserve.
Last week’s decision, based on advice from the Australian Technical Advisory Group on Immunisation (ATAGI), to preference Pfizer over Astra Zeneca for people under 50 years also left GPs in a very difficult position.
While the AMA supported the decision as it was based on independent medical advice, it significantly changed the landscape overnight. Advising patients on the Astra Zeneca vaccine immediately become far more complicated and, for now, the supply of Pfizer remains extremely limited.
Otherwise straightforward consultations with some patients about COVID-19 vaccination have become more complex and will require more time. The current COVID-19 MBS vaccine assessment items were never designed to deal with the situation GPs now find themselves in and I have already raised with the Minister for Health the need to give more latitude to allow co-claiming with standard consultation items or for the creation of specific longer assessment items.
Following the initial confusion over the ATAGI decision, the Commonwealth quickly provided updated advice to help GPs and patients in making decisions about vaccination along with new consent forms. The AMA also moved to quickly reassure the community that the Astra Zeneca vaccine is safe and recommended for anyone 50 years and over and that GPs were best placed to advise patients of any eligible age on the merits or otherwise of the Astra Zeneca vaccine.
However, I know some GPs remain worried about medical indemnity coverage for providing advice to patients about Astra Zeneca as well as for its administration. The AMA has been repeatedly and categorically assured by Medical Defence Organisations (MDOs) that doctors are covered by their policies and MDOs are providing this same advice to their members in the strongest terms. Vaccine manufacturers have also been indemnified by the Commonwealth.
While medical indemnity coverage is not an issue of itself, we have been in ongoing discussions with the Commonwealth about the potential long term implications of the vaccine roll out. While the available vaccines appear incredibly safe based on trial and real world data, we do not know what impact future claims might have on reinsurance arrangements and indemnity premiums. This uncertainty needs to be removed.
In recognition of our concerns, the Commonwealth has given me written assurance that it will take further steps to protect and support health professionals if the vaccination rollout gives rise to an unusual number of claims from patients.
While this guarantee is welcome, we still do not have enough detail about what mechanisms it would use and the exact circumstances that would see the Commonwealth act on this. I told the Minister for Health over the weekend that more clarity is needed and we continue to call for measures to ensure that, as far as possible, GPs are not drawn into future vaccine related litigation.
There is no doubt that the roll out of COVID-19 vaccines is going more slowly than the community would have hoped, largely due to supply constraints, and planning is now having to adapt to the increased reliance on Pfizer. While the public debate is intense, I will continue to provide measured public commentary that acknowledges and seeks to support the role of general practice, is based on the available science, promotes greater transparency, and emphasises the need for collaboration at all levels to ensure that the community is vaccinated as quickly as possible.