Susan Templeman (Macquarie, Australian Labor Party) Share this | Hansard source

We made a promise that we would expand the scope of practice for health professionals so we could deliver real benefits to Australians. We all know it's tough to get to a GP exactly when you need to, and this is one of many tools we're using to try and address issues that have been building up for a long time in our health system, particularly at that first interaction in primary health care.

This bill, the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025, is an important step to ensure that Australians have better access to the health care they need and specifically to the medicines they need—now more affordable medicines, thanks to our capping of medicines under the PBS at $25 a script and the ability to get 60-day scripts. This is all part of a much bigger picture and shouldn't be seen in isolation.

The sense of this bill is that it will allow designated registered nurses to prescribe safe, timely and effective medication. It's extending what we call their scope of practice, the stuff they're allowed to do, particularly in primary care and aged care. I know for my community it's worth noting that we've got more than 1,300 registered nurses in Macquarie, and that's on top of about 1,700 midwives and nursing professionals. So there's a really large cohort of people who are highly qualified, very experienced and may well choose to take the next steps involved so that they can expand the things that they're allowed to do.

It may not sound like a big change. The legislation allows registered nurses who are endorsed against the registration standard to be an authorised prescriber to enable them to prescribe certain medicines that can be supplied under the Pharmaceutical Benefits Scheme and attract Commonwealth subsidy. It changes the Health Insurance Act 1973 to include registered nurses with certain provisions. But it's been described by nurses and people working in the sector as a huge change to the health system. When you think about the implications of it, who you can go to in order to get a script and have a healthcare professional talk to you, we've already made it possible for more things to be done at pharmacies because we want pharmacists working at the top of their scope, but this is now expanding it even beyond that realm. We're talking about tens of thousands of nurses around the country who are now eligible to take that pathway towards prescribing medicines to patients.

It's worth remembering what the situation we're changing is. Until now, the only health practitioners allowed to prescribe were medical doctors, dentists, optometrists, some pharmacists and, with some restrictions, nurse practitioners and endorsed midwives, all of whom have done the appropriate training to be able to make these really critical decisions for patients when they see them. For nurse practitioners and endorsed midwives, they have additional postgraduate training that expands their scope of practice. Registered nurses may only have a bachelor's degree as well as registration with a regulatory agency, and that has not allowed them to be prescribers.

So how is it going to work? Health ministers got together, and that is one of the strengths of our government. We have the capacity to work with the states and health ministers around the country, because you do need things to be worked out, usually, at the Commonwealth and state level. And health ministers last year approved the plan to expand the role of registered nurses. I want to be really clear. This is a lot about ensuring the time of GPs is freed up, but it is not necessarily about nurses working in isolation. The idea is that they work as part of a multidisciplinary team so that we have each member of that team being as effective and efficient for patients as they can be.

An example of what might fall under this came from Frances Rice, who's the chief nursing officer at the Australian College of Nursing. She said that a good example would be a person who is stable on medication that they've been for some period of time and may need a repeat script. Depending on the medication, the registered nurse could be the one to do the prescribing, instead of needing to make an appointment to see the GP. So there is one example of where this might work.

There are extra requirements that registered nurses will need to do. It's a major expansion of their scope of practice, and they have to meet stringent requirements to apply for an endorsement to prescribe. They have to do postgraduate qualifications. They have to be able to demonstrate adequate clinical experience, and then they need to participate in a six-month clinical mentorship with an authorised health practitioner. They then need to establish a formal partnership with an authorised health practitioner, like a GP, and that will involve a prescribing agreement detailing the circumstances in which the nurse can prescribe drugs.

It's a huge change. It has a lot of safeguards around it. It is probably worth noting that the last time new prescribers were endorsed in a similar way was when midwives and nurse practitioners were endorsed, and that was about 20 years ago. These things are done with a lot of care, a lot of planning and a lot of safeguards around them. The registration standard for endorsement has been published by the Nursing and Midwifery Board of Australia. It paves the way for prescribing of schedule 2, 3, 4 and 8 medicines—each of those is a different type of medication—but only in partnership with an authorised health practitioner who's an independent prescriber, such as a nurse practitioner or a doctor.

The way this changes things is one part of many things that we're doing. I should point out that this legislation that we are discussing today will result in the first cohort of designated registered nurse prescribers likely to complete their education, receive endorsement and begin prescribing medicines from sometime around the middle of the year. So this is something that will take a little bit of time, but we're going to see it in 2026. We are really committed to supporting our health workforce, our valuable, highly skilled and hardworking health workforce, to deliver quality care to Australians. We've done it in a number of ways.

We've been talking a lot today about bulk-billing practices. In Macquarie, to make it easier to access your GP, we've ensured that we already have 18 fully bulk-billing practices, and they are practices not just in one area. Remember that my electorate is 4,000 square kilometres. So they are not just in one part but from the top of the Blue Mountains all the way down to the plains where the Nepean River defines it and then up north, across through the Hawkesbury. These practices are fully bulk-billing practices. For every patient, every time, bulk-billing is available. There are 18 of them to date.

I'm also very proud that our Hawkesbury Medicare urgent care clinic opened this week. It's fantastic! I got a sneak peek through it last week, and I look forward to the official opening, but it is up and operating from eight in the morning until 10 at night. Again, you just need your Medicare card, and it's at 2 Kable Street in Windsor, co-located with the Cable Street GP Myhealth practice. I'm very grateful to the doctors, nurses and staff at that facility, who have stepped up in quite a short space of time to create a place where I know on Monday morning at eight o'clock there was a queue because it's a much-needed service and will take a lot of pressure off our Hawkesbury hospital emergency department.

The practice will work closely with other GPS and feed back the circumstances in which they've seen patients. There's still more to come. We still need to see radiology on site. We will continue to work on all the things as we get feedback from people as they use it. That's another example of the Albanese government doing something really practical to make access to health care not just affordable but free when and where you need it. I'm told by my local sporting groups that they don't want to have to send any of their players there, but when the season starts, they have every expectation that there will be a steady trail of limbs being examined from basketball, soccer, football—you name it.

I've mentioned that this piece of legislation also plays in to our cheaper medicines. It is hard for people to remember back to the early 2000s. It is hard for any of us to remember, and there are a whole lot of people who weren't even born then who will have no idea why we hark back to it. But the last time that medicines were $25 when you went to get a script was in the early 2000s. It's really significant to see the price reduction. Not many things go down in price in this world, and it's great that we have been able to use that lever to help ease cost-of-living pressures for people.

We've also made a really big effort to ensure that these new nurses who are coming on and are able to prescribe things have even more things that they may be equipped to provide. The one that we announced just this weekend was the medication for Australians with an aggressive form of prostate cancer. They now have access to a really key medicine that had not previously been available on the PBS and cost about $930 a script, and, now, it's $25 a script and even less for people with a concession card. It's just $7.70 with a concession card—a price that will remain for the next few years, because we've frozen that concession card price. The medication has a really long name and goes by the brand name Andriga-10, and those who are relying on it will absolutely appreciate the benefit that it has. It's for the treatment of castration-resistant metastatic carcinoma of the prostate—not something that's good to have—but this can absolutely slow the disease, ease the symptoms and help patients feel better for longer.

These are just some of the ways in which the Albanese Labor government is looking at availability and affordability of health care. We don't pretend that it's done and dusted. There is always more to do, and I have many parts of my electorate where I want to see more fully bulk-billing GPs and where I want to see greater access to support. I think the thing I'm probably most proud of and have fought hard for for well on 15 years is the access to free and available mental health support. Not only do we now have our online service that began on 1 January, but locally we have headspace for our young people at the top of the mountains in the Hawkesbury and in Penrith. We also have Medicare mental health centres where you can just walk in and say, 'Things are not great,' and you can talk to somebody and find a pathway—all of these things. It's about your Medicare card, not your credit card. That is life changing for mums, for elderly people—all of us have competing pressures, and it's really hard to tackle all the other challenges of life if your health is letting you down. What we're focused on is making sure that health is the thing that you can get on top of.

I really encourage people to support this legislation so that we can have more of our amazing Macquarie registered nurses ready, able and legally allowed to prescribe medications to help take pressure off our GPs and to help support a community that most of them not only work in but live in. I commend this bill to the House.

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