Pharmacists in NSW say they are being forced to pull out of paediatric COVID vaccinations and free rapid antigen test (RAT) programs because of a lack of government reimbursement.
With the recommended third dose interval reduced at the end of last year, pharmacists have juggled an influx of requests for boosters, vaccinations for five to 11-year-olds, and the rollout of free RATs for select concession cardholders.
The federal remuneration scheme offers $10 more per dose for administering a booster shot, compared with giving a first dose to a child in the youngest eligible age bracket.
As a result, Pharmacy Guild of Australia (PGA) figures show around half the state's pharmacy network has opted out of paediatric vaccinations, causing concern the rollout is lagging as kids return to school.
Judy Plunkett, a Port Macquarie pharmacist and a PGA vice-president, said it was "completely unviable" for her to offer appointments for children.
"People are really desperate to get their kids vaccinated but many pharmacies are not engaging in that rollout because of the level of remuneration," she said.
Chelsea Felkai, NSW branch president of the Pharmaceutical Society of Australia (PSA), who works in Newcastle, said "it just doesn't make sense".
"The fact we're getting $10 less is completely counterintuitive when it takes us so much longer and there's so much more involved in vaccinating a child," Ms Felkai said.
A Department of Health spokesperson said the booster incentive payment was "temporary" and the fee increase was a "recognition of the significant contribution of community pharmacies to the national COVID-19 vaccine rollout".
Vaccination wage gap
While pharmacy industry groups welcomed the recent increase in remuneration for booster doses, they are continuing to campaign for equal pay with GPs for all COVID vaccinations.
According to the PSA, if all three doses and a COVID-19 Vaccine Suitability Assessment are provided by the same practitioner in a major city, a pharmacist would receive $68 and a GP would receive $139.
"It just shows there's no understanding of what we do within community pharmacy and how much we provide to the community for the government to think we can provide these services at such a low rate and so much less than GPs," Ms Felkai said.
The president of the NSW branch of the Pharmacy Guild, David Heffernan, said pharmacists should be paid the same because "it's the same job".
"It's the same qualifications … that have to be completed by the vaccinator, whether that's the pharmacist, nurse or doctor," he said.
Pharmacists out of pocket
Pharmacists say they are also bearing the brunt of the RAT concession scheme for eligible cardholders to receive up to 10 free tests over three months.
Ms Felkai said pharmacies were reimbursed $10 per individual RAT, but many brands cost more.
"If the only stock we can get is $12 per RAT and it's a five pack, we're $10 under when we give it out as a concession package, so it's a really tricky environment," she said.
"Supply has started to become better but we still have no control over the type [of RATs] and the cost.
Mr Heffernan said the payment schedule for RATs was under negotiation as there was "no business case" for pharmacists to be giving them out for free.
Mr Heffernan said pressures on pharmacies were compounding as they also faced staffing shortages affecting the entire healthcare system.
"Pharmacists are overwhelmed … [and] it can get frustrating that we’re taken for granted,” he said.
“It has been a battle … we have been there with a mop and bucket trying to clean up 'policy by press release' announcements, whether that's supply chain issues, RATs and the vaccine … and we don’t really have a properly instituted health roundtable to nut out some of those problems."
