Melissa McIntosh (Lindsay, Liberal Party, Shadow Minister for Women) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This bill enables eligible registered nurses to prescribe certain medicines under the Pharmaceutical Benefits Scheme. It establishes a framework for approving authorised nurse prescribers, including safeguards that allow approvals to be suspended or revoked where necessary. It also formally recognises authorised nurse prescribers as a new category of PBS prescriber, ensuring that patients receiving care from authorised nurses can access medicines under the PBS.

Registered nurses make up around half of Australia's health workforce. They serve communities right across the country, including in rural, regional and remote areas, where access to doctors can be limited and where healthcare workforce shortages are most acute. Expanding scope of practice in a safe and regulated way has the potential to improve access to medicines, particularly for Australians living outside metropolitan centres.

The introduction of nurse prescribing follows extensive consultation and regulatory development through the Nursing and Midwifery Board of Australia. An agreement among health ministers and the first cohort of nurses is expected to begin prescribing from mid-2026.

The opposition won't stand in the way of this bill passing the House. On its face, the bill is broadly consistent with the objective of ensuring Australians have timely and affordable access to essential health care, particularly in rural and remote communities. However, as always, the details matter. We will be carefully examining the implementation of these arrangements through the upcoming Senate Community Affairs Legislation Committee process and considering any issues or amendments that arise once the committee reports later this month.

While this bill deals with prescribing arrangements, it sits within a broader challenge facing Australians—the rising costs and challenge of accessing healthcare. Australians relying on prescription medicines are facing increasing healthcare costs under this government, including the highest out-of-pocket GP fees on record. Patients are now paying, on average, more than $50 out of pocket simply to visit a GP. For many Australians, especially families and those managing chronic conditions, healthcare costs are becoming harder to absorb, particularly amongst the broader cost-of-living challenges impacting household budgets right across this country. Labor's mismanagement is forcing Australians to make difficult decisions about their health—decisions no Australian should ever have to make. We're seeing more Australians delaying doctor visits or putting off refilling their scripts because they simply cannot afford it.

The coalition and, of course, the opposition have always supported affordable access to medicines through a strong and sustainable PBS. Our record shows consistent investment and reform to ensure Australians have access to the medicines they need at prices they can afford. Supporting appropriately qualified registered nurses to prescribe PBS medicines is consistent with that commitment to improving access and affordability. But access is not just about who can write the prescription; it is also about whether medicines are available to Australians on the PBS in the first place, and, on this measure, Australia is falling behind.

Despite growing healthcare needs, investment in the PBS fell in real terms in the 2024-25 financial year under the Albanese government—a decline of almost $200 million compared to the previous year. This stands in contrast to the record of the former Liberal-National government, which approved more than 2,900 new or amended PBS listings, with investment totalling around $16.5 billion. Meanwhile, Australians are waiting longer than ever for new medicines to become available under the PBS. On average, it now takes around 466 days after registration for a medicine to be listed. That is more than a year's delay. Behind those numbers are real people waiting for treatments that could change or even save lives. Patients, clinicians and industry stakeholders consistently tell us that Australia's system for approving and funding medicines is slow, outdated and overly complex. The health technology assessment review was commissioned to fix precisely this problem, yet, more than 600 days later, many of its recommendations are still sitting unanswered. This review represents a critical opportunity to modernise our processes so they remain world class, responsive to innovation and genuinely patient centred. That opportunity must not be wasted.

While we support enabling nurse prescribers to prescribe PBS medicines, we also condemn the government's broader failure to ensure Australians can have timely and affordable access to life-saving and life-changing medicines. This bill also intersects with a broader discussion across the health sector regarding scope of practice reform. There is significant interest in the government's response to the scope of practice review and what it means for workforce reform across the healthcare system. We view this process as an opportunity for the government to provide a clear roadmap for reform. When health professionals are enabled to work to the full extent of their training and capability, patients benefit through improved access and more efficient care. Empowering the workforce is one of the most practical ways to relieve pressure on the health system. But reviews alone do not deliver reform; action does.

The government must now respond to the final report as a matter of priority. This review must not join others commissioned by the health minister that ultimately result in delay—we know this; it's a fact—inaction or simply more reviews instead of real reform. Healthcare workers and patients alike deserve clarity and progress. In closing, the opposition supports measures that responsibly improve access to health care for all Australians, particularly in rural and regional Australia, where this remains a significant challenge. We recognise the important role nurses play in our healthcare system, and the potential benefits of sensibly expanding scope of practice. At the same time, we will continue to scrutinise implementation details carefully to ensure patient safety, system efficiency and workforce sustainability are maintained.

We look forward to further clarity arising through the committee process, and to ensuring that reforms genuinely improve access to health care for Australians wherever they live. The opposition will not oppose the passage of this bill, and we will continue working to ensure Australia's healthcare system delivers timely, affordable access to health care for all Australians.

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