One of the most important lessons from the COVID pandemic had very little to do with viruses.
It was a lesson about decision-making, specifically:
What happens when political leaders begin making clinical decisions that sit outside established medical, scientific and regulatory frameworks?
The Australian Human Rights Commission’s recent Collateral Damage report documented many of the unintended consequences of pandemic policy, finding that human rights impacts were not always adequately considered or protected.
For many Australians, those consequences remain deeply personal.
For healthcare professionals, they should also serve as a reminder of why clinical governance matters.
The cost of getting it wrong
Throughout the pandemic, Australia witnessed a series of decisions that continue to be debated today.
- The hotel quarantine failures that contributed to Victoria’s second wave.
- The North Melbourne and Flemington tower lockdowns, later found by the Victorian Ombudsman to be incompatible with human rights protections.
- Border closures that separated families and, in some cases, had devastating personal consequences.
- Extended lockdowns that left vulnerable people isolated from support networks, healthcare and community connection.
Reasonable people may disagree about the decisions themselves, but these examples highlight an important truth:
When decisions affect health, liberty and wellbeing, robust governance matters.
Why this matters today
That is why I become concerned when governments increasingly override established clinical and regulatory advice in favour of political solutions.
The latest example is the expansion of pharmacist-initiated prescribing of the oral contraceptive pill in Victoria.
This is not a debate about pharmacists, nor is it a debate about access. It is a debate about clinical governance.
In 2021, the Therapeutic Goods Administration reviewed the oral contraceptive pill and maintained the requirement for medical practitioner initiation based on considerations of safety, assessment and ongoing clinical care.
When governments choose a different path, Australians should reasonably ask:
- What evidence has changed?
- Who is accountable if harm occurs?
Healthcare is more than a transaction
Access to medication is important and so is convenience, but healthcare is rarely as simple as treating a symptom or supplying a medicine.
A consultation about contraception may also involve:
- Cancer screening.
- Sexual health assessment.
- Screening for contraindications.
- Discussion of long-acting reversible contraception.
- Continuity of care.
- Preventive healthcare.
These are not administrative tasks–they are important elements of quality clinical care.
The question is not whether pharmacists are capable professionals. They are.
The question is whether healthcare reforms strengthen or fragment the systems that help identify risk, coordinate care and keep patients safe.
The ADHD example
Only weeks before the pharmacy prescribing announcement, the Victorian Government announced changes allowing stimulant medications for ADHD to be accessed through the Victorian Virtual Emergency Department.
Again, the issue is not access, the issue is governance.
Stimulants are medications with significant risks, including misuse, diversion and dependency.
Changes involving medicines of this nature should be accompanied by clear evidence, strong clinical oversight and careful evaluation. That is how public confidence is maintained.
The principle that matters
Medicine should never become a political football, nor should healthcare policy be driven primarily by convenience, popularity or election cycles.
The role of governments is important, the role of regulators is important and the role of healthcare professionals is important.
The strongest healthcare systems emerge when those groups work together, respecting both evidence and expertise.
As Australians continue to debate healthcare reform, perhaps the most important question is not whether a proposal is popular.
It is whether it improves patient outcomes while maintaining the standards of safety, accountability and clinical governance that patients deserve.
Because once trust in those systems is lost, it can be very difficult to rebuild.
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