Helen Haines (Indi, Independent) Share this | Hansard source

I rise to make a brief contribution on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. I acknowledge the member for Moreton, who's given us such an elegant explanation of what this bill is about, what this bill aims to do and what I feel very confident this bill will achieve. I thank her for her acknowledgement of nurses right across Australia, many of whom are old former colleagues of mine, and I thank her for her very clear recognition and understanding of the work that nurses do.

This bill amends the National Health Act 1953 and the Health Insurance Act 1973 to allow authorised registered nurses to prescribe medications under the Pharmaceutical Benefits Scheme. In doing so, it adds the final piece to an important reform that's been under development for almost a decade. This isn't a flash in the pan. This isn't something that someone's just come up with. This has been a long time in development, and that's because it's important to get these things right.

I highlight that this is about authorised registered nurses. This is about nurses who have undertaken significant further education and training to enable them to expand their scope of practice now to prescribe a formulary of medications. The introduction of registered nurse prescribing is the result of extensive coordination and collaboration between the Nursing and Midwifery Board of Australia, the Australian Health Practitioner Regulation Agency, the Australian and New Zealand Council of Chief Nursing and Midwifery Officers and the health ministers across all Australian jurisdictions.

The member for Moreton laid out the extensive training that's required in order for authorised nurses to prescribe schedule 3 and 4 medications, and made it quite clear that this is part of a bigger suite of reforms to strengthen Medicare. I was involved many years ago, in Australia, in the very beginning of nurse practitioner education and training. It was part of my role, leading the education of a cohort of 14 aspirant nurse practitioners in a rural and regional health service to assist them with their education and training in pharmacology and other elements of the higher training they required in order to meet the scope of practice that was critical to becoming an endorsed nurse practitioner. I've spent more than three decades working in health care, and one of the most extraordinary evolutions I've seen is how nurses' scope of practice, and, indeed, other health professionals—allied health, too—has grown over the last decade to respond to the growing requirements of our population, particularly our ageing population.

This initiative, just like the nurse practitioner pioneers, is especially important to me as a regional MP and as a former nurse and midwife. I know, because I've seen it and lived it, that regional, rural and remote Australians—and you know it, Deputy Speaker Scrymgour—have a higher burden of disease than our metropolitan counterparts. We know that our health care is dictated by our postcode, and in my electorate of Indi—which is a regional electorate, but it has some remote areas too—we experience conditions such as asthma, arthritis and heart disease at rates way above the national average. This piece of legislation enables fully authorised and educated nurses to prescribe medications in categories that will absolutely make a difference to timely care in these chronic diseases.

This bill is really important to me because I can give confidence to anybody in this House that this will make a difference to people who suffer from chronic disease, most particularly in rural and regional Australia. When I talk about chronic diseases being above the national rate and rural, regional and remote Australians dying earlier than their metropolitan counterparts, I do that knowing many of the people who have, in fact, died prematurely because they simply had not had access to the care that they needed. To make matters worse, we have healthcare workforce shortages in the regions that make it practically harder to effectively manage chronic health conditions and illnesses.

Now, while this bill doesn't directly address the issue of healthcare workforce supply, I do want to spend a little moment talking about this, because it is part of the broader picture. It's really important that we situate this legislation in the broader reality of health care in the regions. Of course, this legislation isn't restricted to nurses who work in the regions—it's across Australia—but I'm highlighting why it matters to communities like mine in particular. Regional communities absolutely struggle to access healthcare, including the prescribing of medications. To be clear, I want to say that the healthcare workforce in regional Australia is absolutely fantastic, filled with highly competent professionals, of whom the biggest group are nurses, and so many of them had not been able until more recent times to work to their full scope of practice. These problems aren't their doing. There's simply not enough workforce to meet our healthcare demands. So, with the workforce that we have, we need to ensure absolutely that we're providing the opportunities to access the training and education they need to expand their scope of practice and work closely with the people who need them most.

Further to that, when I think about health workforce in rural and regional Australia, it's not just a matter of attracting workforce; it's also a matter of retaining them. One of the challenges for many nurses is job satisfaction—the frustration of seeing a patient who needs further care and the restrictions on nurses in being able to provide that care. That's why this bill, again, is really important in a sense of expanding scope of practice and really building on job satisfaction for a nurse.

The reasons for workforce shortages in rural health are many and complex. Certainly there is inadequate resourcing of regional health systems. Training pathways make getting regional experience difficult or unaffordable. Housing and childcare shortages prevent talented professionals from moving to regional Australia. We really do have a wicked problem, and there isn't just one policy to solve it, but this piece of legislation is part of that puzzle, and I really welcome it. The truth is that, if we're going to address workforce challenges, we do need to come at it from all angles, and that includes making sure that every single healthcare professional is supported to work at their full scope of practice. This bill supports a reform that does precisely this.

In Victoria, the number of nurses is actually relatively consistent in proportion to population across major cities, inner and outer regions and remote communities. In fact, as I said before, nurses make up the highest number of healthcare professionals in the bush, and, where we do have the workforce in rural and regional Australia, we need to make sure that we're not putting unnecessary handbrakes on the care that they can provide their communities. I've been in that situation many times in my long distant past, working in a bush nursing hospital where I have waited on the phone, trying to get on to a medical practitioner to come and prescribe what is a pretty basic repeat medication for a patient who's driven for several hours to come to the hospital to get that medication. It all could have been sorted in a very short time if a nurse had this additional capacity. Enabling registered nurses to expand their scope of practice through additional training endorsement—really, it's a commonsense national solution and one I hope will materially improve access to health care in the regions. We've heard this evening that this isn't Robinson Crusoe; this is happening in many other parts of the world, most recognisably in the United Kingdom.

Right now there are people in my electorate of Indi who spend half a day travelling or wait weeks for GP appointments just to get that repeat prescription, and I'm hoping this legislation is going to be a godsend for them. It'll make a real difference to their lives if they can get their medications a little sooner and a little closer to home. I'm absolutely alive to concerns from some other members of the health team about fragmented care. I'm the first to say that we really must make sure that our communication and digital tools are sufficient to enable us to ensure that we do not have fragmentation.

Debate interrupted.

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