On Monday a long overdue shift in ADHD care has been announced – one that may finally bring us closer to a system that is timely, accessible and grounded in ongoing relationships between patients and their trusted family doctors.
This new reform will allow specialist general practitioners, after additional training, to initiate stimulant medication for ADHD in kids that known to them and manage ongoing treatment – without requiring direct handover from the diagnosing paediatrician or psychiatrist. In practical terms, it means that instead of acting as a powerless middleman, I’ll finally be able to do what I know is right for my patients – and much sooner.
Currently, the system is buckling under the weight of long waitlists for paediatricians and psychiatrists. We’re talking 6 to 12 months – if the referral is even accepted – to access a diagnosis, let alone treatment. In that time, people fall through the cracks.
Children continue to struggle in classrooms where they are mislabeled as defiant rather than distracted; adults silently carry the burden of emotional dysregulation, disorganisation and burnout. Families suffer. Relationships unravel. Careers stall. And for what? Because we’ve artificially limited access to care and underestimated the ability of GPs to manage what is, in many cases, a chronic neurodevelopmental condition with clear diagnostic criteria and well-established treatment pathways.
As a GP, I see these patients daily. I know their histories. I know their families. And more often than not, I know exactly what a psychiatrist or paediatrician will say – but I’ve had to tell patients, “I know what needs to happen next, but I can’t legally do it.” That changes now.
This isn’t about GPs replacing specialists. It’s about filling the gaping chasm in care that exists between a diagnosis and effective treatment. It’s about recognising that in a stretched and fragmented system, GPs with the right training are best positioned to deliver timely and safe care, especially for conditions like ADHD.
But beyond my professional perspective, this reform touches something deeper for me. I was diagnosed with ADHD before the Covid-19 pandemic – well before the surge in public awareness and the influx of people seeking assessment in recent years. It was a long overdue recognition of a lifelong pattern.
I am also a parent of children with ADHD. I know the chaos of untreated symptoms and I know the clarity and calm that can follow the right treatment. I’ve seen lives transform – my own, my family’s, my patients’.
This is not just a policy win; it’s a personal one.
Some critics have suggested we are facing an epidemic of overdiagnosis. I disagree. What we are seeing is a long-needed correction – a better understanding of ADHD across the lifespan and among groups historically underdiagnosed. This isn’t a fad. It’s a reckoning with reality.
Critics may question whether GPs are “qualified enough” to manage stimulant medications. To that I say: we already manage far more dangerous drugs in complex scenarios – opioids, benzodiazepines, antipsychotics. We monitor, we adjust, we counsel. With appropriate guidelines and training, ADHD management is well within our wheelhouse.
This reform is about trust. Trust in patients to know when they need help. Trust in GPs to rise to the challenge with care and competence. And trust in a healthcare system that must evolve to meet growing demand with practical, people-centred solutions.
For every child who has waited too long, for every adult who has been misdiagnosed, misunderstood, or turned away, this change matters. For every GP who has felt helpless watching a patient deteriorate while stuck on a waitlist – this change matters. For families like mine, this is not an abstract policy. This is hope, made real.
We must get the implementation right. Training must be robust, support must be ongoing and collaboration with specialists must be preserved where complexity demands it. But let’s be clear: this is a gamechanger. And it’s about time.
• Dr Richard Nguyen is a GP in southern Sydney
