It’s Time to Free the Pill

Cross-posted from The Hand Mirror.

By Alison McCulloch

Back in the 1960s, when the Pill became available in Aotearoa New Zealand, the New Zealand Branch of the British Medical Association (the precursor to today’s NZMA) decided it would be unethical for doctors to let unmarried women get their hands on it. Doing so, it was argued, would be akin to doctors giving extra-marital relationships a stamp of approval, and the NZMA wasn’t about to do that.

If you thought doctors keeping us from the Pill for our own good was a thing of the past, think again. Sure, it’s no longer under the guise of protecting our moral purity – (most) doctors have (mostly) given up on that argument. Now, it’s all about protecting our health.

As recently as 1996, both the Royal College of General Practitioners and the NZMA opposed the reclassification of the Emergency Contraceptive Pill. “We have concerns that in a pharmacy the patient may be disadvantaged from receiving the greater advice that would occur in a general practice consultation,” the college’s chairman, Professor Gregor Coster, was quoted as saying in an article in the British Medical Journal.

Fast forward to 2016, and a new front in this seemingly endless struggle is focused on efforts to get the Pill, aka oral contraception, liberated from doctors’ prescription pads and made available over the counter. The most recent round began in 2014, when Pharmacybrands Ltd (now Green Cross Health, which represents 300 community pharmacies and has an equity interest in 80) and Pharma Projects Ltd, now Natalie Gauld Ltd., made an application to Medsafe’s Medicines Classifications Committee to reclassify the Pill so it could be sold in pharmacies without prescription, though only by specially trained pharmacists, following the model that’s now used for the Emergency Contraceptive Pill.

That application was turned down in the face of stiff opposition from general practitioners and the NZMA: the latter said they didn’t think prescription only access was a barrier to the Pill and wanted to make sure doctors continued to provide “the advice and counselling about its use and about sexual health in general”, while the College of GPs, apparently felt “as if they are being excluded from an important part of primary health care”. (Never mind that the actual users of this “important part of primary health care” were – and continue to be – excluded.)

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