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Autonomous Prescribing Risks Safety


All Health Reporters/Chief Executives/Press Officers

FROM: Dr Pippa MacKay, NZMA Chairman

DATE: October 6, 1999

SUBJECT: Autonomous Prescribing Risks Safety

The Medicines Amendment Act, which opens the way for autonomous prescribing by nurses and other health professionals, has serious implications for patient safety, says the New Zealand Medical Association.

Doctors receive years of training in all the skill areas of health care - history taking, examination, diagnosis and treatment (which includes prescribing medicines). Other health professional groups have different roles in the health sector and do not receive such extensive training.

The NZMA has consistently pointed out the safety risks in separating prescribing from diagnosis and other forms of treatment.

"Prescribing cannot be carried out in isolation from history taking, examination and diagnosis of the patient," says NZMA Chairman Dr Pippa MacKay.

"What is needed is a co-ordinated approach to primary health care, building on its existing strengths.

"The NZMA strongly supports the concept of collaborative prescribing, where nurses would work closely with doctors, which will foster the improvements in access to services that the Government is hoping to achieve.

"Of great concern is the fact that independent nurse prescribing will initially be in the areas of child and elderly persons health -- two of the most vulnerable groups in society," Dr MacKay says.

The NZMA challenges Health Minister Wyatt Creech to explain how autonomous nurse prescribing will improve community access to health care, especially in areas of greatest need such as rural areas.

"Nurses will have to undertake masters level training to qualify to prescribe. It is unlikely that such highly educated nurses will work at the coal-face in remote rural areas or community clinics," Dr MacKay concluded.


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