What should ACT families do if their child was removed from the allergy waitlist?

Contact your GP. CHS has said that if a GP reviews the case and believes the child should be seen by the clinic, a referral back retains the family's place in the queue. ACT Health Minister Dr Marisa Paterson has also urged families whose referrals were closed to contact CHS directly to request a review. For a child with a known anaphylaxis history, that conversation should happen urgently.

What is the difference between anaphylaxis management a GP can provide and specialist allergy care?

GPs can prescribe and review adrenaline auto-injectors, provide emergency management plans, and counsel families on avoidance. What specialist allergy clinics offer beyond that includes oral immunotherapy (desensitisation), formal allergy testing under controlled conditions, complex multi-allergy management, and management of conditions where standard approaches have failed. The removal of children from the list does not change what the GP can safely offer — it changes who carries responsibility for ongoing management.

ACT allergy waitlist clears 1,000 children — GPs left to fill gap

Canberra Health Services sent letters this month to approximately 1,000 families telling them their child had been removed from the Paediatric Allergy Clinic waitlist and should seek care through their GP or paediatrician instead. Some of the children on that list have a confirmed history of anaphylaxis. RACGP President Dr Michael Wright called the situation “totally unacceptable.”

That description is not hyperbole. The parents of children with anaphylaxis have been managing an escalating level of risk — regular emergency department presentations, EpiPen use, and the ongoing anxiety of knowing their child is reactive to something in the environment — while waiting, in some cases for years, for specialist guidance that could change the clinical picture. Being told to see your GP instead is not the same as being told your child has been assessed and doesn’t need specialist care.

It also puts GPs in an invidious position: holding responsibility for complex allergy management without the training, equipment, funding, or escalation pathways that specialist care provides.

What CHS did and why

Canberra Health Services undertook a comprehensive review of outpatient services against a backdrop of about 65,000 people currently waiting for an outpatient appointment. Some Paediatric Allergy Clinic patients had been waiting more than six years. The review updated referral criteria and triage protocols, and a cohort of referrals was closed because they were deemed manageable in general practice or by another allergy specialist or paediatrician.

On that basis, the review has a logic. Specialist time is scarce. Some patients on long waitlists will have had their condition resolve, stabilise, or shift to a profile that doesn’t require tertiary specialist input. Clearing those cases creates more accessible appointments for people who genuinely need the specialist tier.

The problem is the implementation. Dr Rebekah Hoffman, RACGP NSW&ACT Chair, said families deserve transparency and a clear care pathway, and that it is unacceptable to shift responsibility to GPs without consulting the profession or ensuring services are in place. GPs in the ACT were notified of updated criteria, but notification is not consultation, and notification does not come with additional funding, training, or infrastructure.

The Medical Republic reported that no GP consultation was required before children were removed from the list. The triage was done by the clinic, based on the original referral information, without the GP who knows the child’s current clinical picture being part of that decision.

The anaphylaxis problem

Anaphylaxis is the detail that makes this story different from a routine waitlist management dispute. One parent quoted in newsGP described her nine-year-old daughter, who was removed from the list after three years — despite having had an anaphylactic reaction in January 2024 and several emergency department visits since. CHS subsequently confirmed that her daughter’s history did meet the new eligibility criteria.

That correction matters. It means the review was not infallible, and families who believe their child’s referral was closed in error are right to request a review. It also means the letters — sent to 1,000 families — were not individually calibrated. Some children with clear specialist-level need were caught in a batch process that wasn’t designed to catch them.

Anaphylaxis management in general practice is not outside scope. GPs prescribe and review adrenaline auto-injectors, provide emergency action plans, and manage ongoing allergen avoidance. What general practice cannot do is oral immunotherapy (OIT), formal provocation testing under controlled conditions, or complex multi-allergen assessment for children where simple avoidance is not sufficient or not working.

Both-and: system logic versus clinical safety

The both-and here is real. An outpatient waitlist where some patients have been waiting six years is not working well for anyone — not for the patients waiting appropriately long, and not for the system trying to allocate finite specialist time. A review that updates criteria and reroutes some lower-acuity patients to general practice is not unreasonable in principle.

The execution, done without GP input, without financial support, and without adequate checking against current clinical presentations, created exactly the situation the RACGP is describing: general practice asked to absorb risk it wasn’t consulted about and isn’t resourced to carry.

Dr Wright’s call for “financial and other support” is the clinically important ask. GPs need practical support to deliver allergy care safely — not as an optional extra, but as a precondition for the shift in care to work. That support is not yet confirmed.

2 cents: what to do now

For ACT GPs: expect families from the waitlist to present in the coming weeks. The updated CHS referral criteria will tell you what the clinic considers specialist-appropriate under the new triage. If you review a child and believe they meet those criteria, refer back — the family retains their queue position.

For families in the ACT: contact your GP. If your child has anaphylaxis, an EpiPen prescription and a written emergency action plan are the minimum. If you believe the removal was in error, both CHS and the ACT Health Minister have explicitly invited review requests.

For GPs outside the ACT: this is not a Canberra-specific problem in its underlying logic. The pressure on specialist outpatient waitlists is national. The pattern of redirecting patients to general practice without additional resourcing is familiar. The RACGP’s response here — consulting the college before shifting care, and providing financial and clinical support when that shift happens — is the standard that should apply everywhere.

Verdict: yes — the allergy waitlist story is a local event with a national pattern: the gap between specialist capacity and demand is being quietly shifted onto general practice, one waitlist at a time.