Julie-Ann Campbell (Moreton, Australian Labor Party) Share this | Hansard source

There is a certain irony in the member for Lindsay's raising the track record of the former coalition on the matter of health. What we know about the coalition, and what we know about those opposite, is that the Liberals, the Nationals—despite the fact that there is no current coalition, they were the coalition at the time—tried to introduce a co-payment for GPs when it came to health care. This co-payment would have destroyed bulk-billing—a system that is the bedrock of ensuring that every Australian has the ability to access affordable health care—in this country.

When it comes to this bill, I want to start by talking about my family. My daughter, Margaret, the apple of both her parents' eyes, is 2½ years old now—just a touch over that. Like many babies, toddlers, children across this country, Margaret suffers from reactive airways. Basically, it means that sometimes she finds it difficult to breathe; she has issues with her respiratory system. On more than a few occasions we have taken Margaret to the hospital. And when you go to the hospital as a parent, a few things become clear: your heart starts pounding, your brow has sweat on it and your mind is racing. And when those things happen, whether you're going in an ambulance to that hospital or whether you're driving in the car up to emergency, those things are constantly on your mind.

The thing for me, when I walk into the room and a nurse comes into that room, is the relief that hits me. Nurses are the beacon of care in our community. They are the people who make sure that Australians are okay every day. Nurses are absolutely at the core of our health system with the care that they give out every single day to make sure Australians get better.

I want to acknowledge the former nurses in this place. I acknowledge the member for Cooper, Ged Kearney, for her extraordinary work not only as a nurse on the ground but also for her work in advocacy for nurses across this nation. I acknowledge the member for Bullwinkle, Trish Cook, and her fantastic work as a nurse. And I acknowledge the member for Indi, Helen Haines. We are lucky to have those nurses here with us in this place. They bring the experience of nursing onto the national stage.

In my short time giving speeches in this place, I've had the great opportunity to speak on health legislation and health related issues numerous times. The reason for this is simple: the Albanese Labor government are committed to universal health care, and we are committed to Medicare. We are committed to strengthening it. We are committed to making medicines cheaper. We are committed to expanding bulk-billing. And we are committed to making access to timely health care easier for Australians every day. Urgent care clinics—I'm delighted to say I got to visit one just last week in Oxley in my local area—and Medicare mental health centres across the country enable this seven days a week.

Today we're acting on our commitment to health with the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill. This bill builds on a strong Labor foundation of healthcare support by providing easier access to medicines. In December 2024, state and territory health ministers approved a new registration standard, which enables suitably qualified registered nurses, or RNs, to become designated RN prescribers. The Endorsement for Scheduled Medicines—Designated Registered Nurse Prescriberstandard enables this group of RNs to prescribe medicines. The standard outlines the required qualifications that an RN must have when applying to the Nursing and Midwifery Board of Australia to attain and retain the endorsement for prescribing scheduled medicines.

This bill is important because reforming the scope of practice for health practitioners means real, tangible benefits for Australians, Australians who would be able to access the affordable medicines they need when they need them. That's what this bill is all about. This bill is about affordability and accessibility, and it builds on what we, the Albanese Labor government, have already done. We've already put in place urgent care clinics, and, as we heard from ministers earlier today, there are more and more rolling out every single day. We've put in place a $25 cap on PBS medicine prices so that, when you go to the pharmacy, you will never pay more than a $20 and a $5. And we've been investing in women's health, to make sure that women's health is front and centre, with the biggest investment in women's health in the history of this country.

As the Australian College of Nursing's chief nursing officer Frances Rice said:

This increases access to care, and boosts healthcare efficiency by allowing a registered nurse to work to the top of their scope. Further, it takes pressure off nurse practitioners and medical practitioners and allows them to focus on more complex cases.

This legislation is not just about increasing access to healthcare; it's also about freeing up time and giving more efficient healthcare options across the system.

The bill amends two acts. It amends the National Health Act 1953 to enable a suitably qualified RN to be an authorised medicines prescriber. Such RNs will be able to prescribe certain medicines that are available under the Pharmaceutical Benefits Scheme. And it also amends the Health Insurance Act 1973 to enable RNs to review their prescribing services under the Professional Services Review Scheme.

Most of us might think that we have a fair idea of what registered nurses do. I assure you we don't. Unless you have been a nurse, unless you have walked those halls, whether they be in aged care or in a hospital, you don't know the demands of nursing every single day. But, if you've been to a hospital, you know that they take your vitals and that they administer your medications. You'll also find them working in residential aged-care centres, at GP clinics, in the urgent care clinics that we've been rolling out across the country, at schools and at community health centres, to name just a few locations. If you look at the scope of workplaces, it's no surprise that the job description to plan and oversee the management of people in their care includes performing treatments and complex care, and starting, administering and monitoring medication and intravenous therapy. RNs also interpret test results and reports. They participate in medical and surgical procedures and they supervise nursing students. Crucially, and perhaps much harder to quantify, patients rely on RNs to provide emotional and psychological support as they are treated. This can include advocating for those patients.

With this scope of practice—and the intense patient contact and support—it makes sense for appropriately qualified RNs to be enabled to prescribe certain medications. This will allow safe and timely and efficient prescription for patients, especially in primary-care and aged-care settings. This system has been in place in the UK since the 1990s. Nurse Charlotte Coulson, who has worked there and in Victoria in palliative care, says that RNs being enabled to prescribe medicines in palliative care cases is particularly impactful and prevents suffering, noting that 'GPs have limited time and multiple priorities'.

To qualify, RNs are required to hold current general registration, have at least three years of full-time equivalent clinical experience after becoming registered and complete a board approved postgraduate course or equivalent study in registered nurse prescribing. This comprehensive program generally takes four to six months part time and covers topics like conducting physical health assessments and the principles of safe and appropriate medical use. RNs are also trained in pharmacodynamics, which is how medications affect the body, and pharmacokinetics, which focuses on how medicines on how medicines are absorbed, distributed, metabolised and eliminated. Registration also requires six months of supervised clinical mentorship with a medical practitioner or nurse practitioner. The level of supervision is similar to nurse practitioner training and evolves from monitoring of the RN's prescribing decisions to a collaborative working relationship. One endorsed, RNs will be able to prescribe specific types of medicines. This includes schedule 3 medicines which usually require pharmacist advice but not a prescription, such as an emergency contraception. They will also be able to prescribe schedule 4 prescription only medicines such as antibiotics and medicines for high blood pressure and high cholesterol.

The reform in this bill aligns with the intent of the Strengthening Medicare Taskforce and the October 2024 Unleashing the potential of our health workforcescope of practice review. The aim of that review was to, 'reform our primary care workforce to deliver high quality, equitable, integrated and sustainable healthcare for Australian communities'. This built on the extensive work of and consultations by the Nursing and Midwifery Board of Australia and Australian Chief Nursing and Midwifery Officer since 2017 around the potential for RNs to increase their scope of practice. The registration standard was developed after comprehensive consultation with numerous peak bodies, including the Royal Australian College of General Practitioners, the AMA, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives and the Australian Primary Healthcare Nurses Association.

The reforms in this bill are part of a bigger picture for the Albanese government. It is a picture of the Albanese Labor government's investment in public health. In 2023 Labor increased the bulk-billing incentive threefold for groups who rely on their GP the most. The Albanese Labor government increased that bulk-billing incentive for pensioners, for concession card holders and for families with children, and this change reversed the decline in bulk-billing and resulted in an extra 6.5 million bulk-billed GP appointments across the country.

A major milestone for Medicare then took effect on 1 November last year. From that date, for the first time, GPs received the bulk-billing incentive for every patient they bulk-billed, not just the groups I just mentioned. This is the largest single investment ever made in Medicare and is expected to support around 18 million additional bulk-billed visits every single year. In my electorate of Moreton, there are now 20 bulk-billed GP clinics, with 10 clinics moving from a mixed model to a full bulk-billing model. This is a 50 per cent increase, and it means that people on the south side of Brisbane have more access than ever before to bulk-billed GP clinics. With these reforms, projections show that by 2030 around 90 per cent of GP visits nationwide will be bulk-billed, and it also means that the number of fully bulk-billing practices is set to grow to roughly 4,800 clinics. That's more than three times the current figure, which is a significant improvement for communities across Australia.

Urgent care clinics are also easing demand on hospital emergency departments. In Oxley in my own electorate of Moreton the local clinic is already making a difference. It's the health professionals there who are treating over 12,200 patients as of mid-January, and it's the same with expanding networks across the country. I note the member for Griffith is in the chamber tonight. We have one right on our border which also helps so many people in Annerley. In the 2025 budget the government committed nearly $645 million over three years to expand the number of urgent care clinics from 87 to 137, and as a result four out five Australians live within a 20-minute drive of free, high quality, urgent medical care, something that could only be achieved under this Labor government. And from 1 January, as I said before, the maximum co-payment for a standard PBS subscription fell from $31.60 to $25.

Labor's commitment to health care is underpinned by our fundamental values. It's part of who we are. It's part of what runs through our blood. It's part of our DNA. We haven't held these values for a minute; we've held them for a very long time. The Australian Labor Party believes that everyone deserves access to health care, regardless of your income, regardless of your employment and regardless of where you live.

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