26 March 2026
As more states and territories allow general practitioners (GPs) to diagnose and treat attention deficit hyperactivity disorder (ADHD), paediatricians are proposing a national plan to ensure easier access does not inadvertently lead to misdiagnosis, inappropriate treatment or harm for children and adolescents.
Royal Australasian College of Physicians (RACP), which represents 33 physician specialties including paediatrics, adolescent and young adult medicine, clinical pharmacology, cardiology and addiction medicine, has put the proposal to the nation’s Health Minister and Chief Medical Officer.
President of the RACP Paediatrics and Child Health Division, Dr Niroshini Kennedy, said reducing wait times for ADHD diagnosis and treatment was extremely important, but it had to go hand-in-hand with proper GP training and guardrails to protect patients from potential harm.
“ADHD in children is complex and rarely exists as a single condition. Proper diagnosis and management involves screening and treatment for medical issues and other conditions including ear disease, sleep disorders, learning difficulties, dyslexia, screen addictions, anxiety and developmental trauma,” Dr Kennedy said.
“Many of these conditions present with similar symptoms and this can result in over- and under-diagnosis. A screening and treatment approach that focusses only on ADHD can oversimplify complex problems, which is why it’s important that whoever is diagnosing and treating ADHD in children is skilled in identifying and managing all the conditions that often exist alongside it.
“Treatment for ADHD – especially when the patient has other conditions – cannot be a ‘set-and-forget’ process, and it is much more than the prescription of stimulant medication. Ideally it would involve a team of specialist doctors and allied health professionals providing targeted and individualised treatments and wrap-around care for the child and family.
“Stimulant medication can be highly effective and has its place, but it requires careful monitoring, especially given it is a controlled medication with high risk of addiction and misuse. In addition, stimulant medications can exacerbate other conditions that may exist alongside ADHD.”
Up until recently the diagnosis and management of ADHD in children in Australia has mostly been the remit of paediatricians, as is the case in similar health systems like the US and UK.
ADHD and other neurodevelopmental conditions make up a substantial part of the six years of specialist medical training required to become a paediatrician in Australia, with some undertaking a further three years of training specifically in neurodevelopmental paediatrics.
Dr Kennedy said GPs could play an important role in ADHD care but appropriately credentialled training and shared care would be key.
“As ADHD care is expanded, it’s important there is nationally consistent, appropriately credentialled training available to GPs who want to practise in this space, and clear regulation and referral pathways so GPs have support from paediatricians and others with more complex cases.”
Dr Kennedy said the RACP – along with the colleges representing psychiatrists and rural and remote medicine – must be involved in developing training for GPs.
“Any doctor assessing or treating somebody who has, or may have, ADHD needs to have a thorough understanding of medication side effects, the potential for misuse, the risk of growth suppression and the non-pharmacological treatments available. They also need the skills to identify and manage learning difficulties and other conditions that children may have alongside.”
Dr Kennedy said there were also equity issues that governments must consider in expanding access to ADHD treatment.
“The public health system must set the standard, so children can get timely, safe and affordable ADHD assessments and care no matter where they live and no matter how much money their parents have,” she said.
“There’s no guarantee recent changes will bring the cost down, as most GPs work in private practice and Medicare rebates do not cover the long consultations necessary to diagnose and manage ADHD. As it stands, there will still be significant gap fees.
“Paediatricians, psychiatrists and GPs all have in important role to play in ADHD care. But this must be underpinned by properly-funded public health systems and long-term planning and investment in training the paediatricians, psychiatrists and GPs needed to provide safe ADHD care into the future.”
At a recent meeting, federal, state and territory Health Ministers’ agreed on the need for a national consistent approach to ADHD diagnosis and prescribing practices, and Dr Kennedy said the RACP would continue to work with them.
“The goal is to ensure children and families get accurate diagnoses and safe, affordable and timely care in a way that is consistent across the country. A patchwork system will only confuse both families and medical practitioners.”
Read the RACP Proposal for a National Model for ADHD Care