Dan Repacholi (Hunter, Australian Labor Party) Share this | Hansard source

I rise today to speak in support of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. I do so as the member for Hunter but also in my role as the Special Envoy for Men's Health. And I want to be very clear from the outset: this bill is not just about workforce reform, it's not just about scope of practice and it's not just about legislation. This bill is about access, it's about prevention and it's about saving lives—particularly the lives of men who too often fall through the cracks of our health system.

When we talk about men's health in this place, we have to start with the uncomfortable truth: men are less likely to seek help. Men are more likely to delay care. Men are more likely to put things off until something becomes serious or, sometimes, until it's, unfortunately, too late. We see it in all the statistics. Men die younger than women. Men have higher rates of suicide. Men are more likely to present late with chronic diseases. And men in regional and outer metropolitan areas like the Hunter face even greater barriers to timely care.

That is the context in which this bill matters. The legislation enables appropriately trained and endorsed registered nurses to prescribe certain medications under the Pharmaceutical Benefits Scheme, or the PBS. It allows those prescriptions to attract a Commonwealth subsidy and it ensures appropriate oversight through the Professional Services Review scheme. That might sound technical, but, in the real world, the impacts are very simple. It means people can get the medicines they need when they need them and without unnecessary delays. From a men's health perspective, this is critical. I cannot tell you how many blokes I've spoken to that say the same thing to me. They know something is wrong, they know they need help but they can't get in to see a GP for a couple of weeks. Or they live in a town where there is no access to a GP and they're not taking new patients. Or they're juggling shift work, caring responsibilities and cost pressures, and they, unfortunately, are putting themselves last. So they wait and they wait, and their condition gets worse.

This bill helps break that cycle. By allowing designated registered nurse prescribers to work their full scope of practice, we expand the front door to the health system. We reduce the bottlenecks. We get people treated earlier and we keep them out of hospital. This is good health policy and it's good for men's health policy as well. Men are more likely to present to a health service in crisis rather than earlier. That is true for mental health, cardiovascular disease, diabetes and many other conditions. Early access to treatment and medication can be the difference between management and emergency. In communities like mine, nurses are often the first point of contact in primary care clinics, in aged care, in mental health settings, in Aboriginal community controlled health services and in hospitals supporting discharge and following up with care. Giving those nurses the ability to prescribe within a structured, regulated and collaborative framework means patients are not left waiting. It means continual care of these patients and it means better outcomes.

This bill gives and delivers on an election commitment by the Albanese Labor government to implement scope-of-practice reforms for nurses and midwives. It aligns with unleashing the potential of our health workforce review, and it reflects years of consultation and careful planning. This certainly is not rushed reform; this is considered reform. Health ministers approved a new national registration standard in December 2024. The Nursing and Midwifery Board of Australia has set clear education and endorsement requirements. The first cohort of designated registered nurse prescribers is expected to begin prescribing from July 2026—only a few months away.

This is a staged, safe and sensible approach, and I want to be very clear about something else: this reform does not replace doctors, it does not undermine GPs and it does not compromise anybody's safety. Designated registered nurse prescribers will practice in partnership with authorised health practitioners under active prescribing arrangements. There is oversight, there is accountability and there are clear boundaries around what medicines can be prescribed. This is about team based care, and it's exactly where modern health systems need to go.

From a men's health perspective, multidisciplinary care is essential. Men often present with complex needs; physical health, mental health, work related injuries, substance use and chronic disease all intersect. Having nurses able to prescribe within their scope means fewer handovers, fewer appointments and fewer opportunities for men to disengage from care altogether. That matters because every extra barrier is a chance for someone to walk away.

I want to speak specifically about regional and outer metropolitan Australia. In the Hunter, access to care can vary dramatically depending on where you live. Some towns have very good coverage, and others struggle. GP shortages are real, wait times are real and pressures on emergency departments are constant. This bill helps relieve that pressure. By enabling nurses to prescribe PBS subsidised medicines in primary care, aged care, disability services, mental health settings and hospitals, we make better use of the workforce we already have. This is just common sense.

This bill also supports continual care for men leaving hospital. Too often, men are discharged with instructions to see their GP and follow up with prescriptions and follow-up care. Unfortunately, that follow-up care doesn't always happen—or it happens too late. Allowing nurse prescribers to support discharge planning and outpatient management reduces readmissions and improves adherence to treatment. From a men's health perspective, this is crucial and definitely needed. Men are less likely to follow up, less likely to attend multiple appointments and, unfortunately, more likely to fall out of the system. This bill helps close that gap.

I also want to speak about prevention. Prevention sits at the very heart of men's health. Too often, our health system is built to respond when something has already gone wrong—when a bloke turns up in the emergency department with chest pain, when diabetes has progressed too far or when mental health distress has reached its crisis point. That is not a failure of individuals; it's a failure of access. If we want to improve men's health outcomes, we have to intervene earlier. We have to make it easier to have that first conversation, easier to get that first prescription and easier to start treatment before the problem becomes an absolute catastrophe.

This bill is going to do exactly that. This bill helps that the whole way along. When a man walks into a clinic, an aged-care service, a mental health service or a community health setting and speaks to a nurse, that interaction should not end with them needing to come back later, needing to book somewhere else or needing to have a conversation with three or four other people. Every extra step increases the risk that nothing is going to happen at all.

Designated registered nurse prescribers mean that, when a man finally reaches out, the system can respond in real time. That matters more often than we would like to admit. In men's health, timing is absolutely everything. We know men are more likely to delay care. We know men are more likely to minimise their symptoms and not actually tell the GP or the nurse practitioner exactly what's wrong with them. We know that men are more likely to disengage if the system feels too complicated or too slow. This bill reduces friction in the system.

It also supports better management of chronic disease, which disproportionately affects men. Conditions like heart disease, diabetes, respiratory illness and musculoskeletal injuries—it's a tough word to say, that one—are more common in men, particularly in men who have worked in physically demanding industries. These are often not one-off issues. They require ongoing care, medication management and regular follow-ups. Nurses already play a crucial role in that care. Allowing them to prescribe within their scope strengthens community and also strengthens the consistency of males seeing and reaching out for this help. From a men's health perspective, having continual care matters because men are less likely to attend multiple providers. They want clear advice, clear plans and clear next steps. This reform supports that.

I also want to speak directly about men working shift work and non-standard hours. In industries like mining, manufacturing, transport and construction, shift work is the norm. Accessing a GP during business hours is quite often difficult, and men are left choosing between their health and their pay. Nurses are often available outside traditional GP hours, particularly in community clinics, hospitals and residential care settings. Giving them prescribing authority ensures that working men are not disadvantaged by the hours they keep. This is an equity issue.

This bill also supports older men, particularly those transitioning into aged care or receiving community based support. Older men often have complex medical needs. They may struggle with mobility or transport or have cognitive decline. Delays in prescribing or renewing medications can have serious consequences to all of these people. Designated registered nurse prescribers working in aged care and community settings will help ensure continuity, reduce medication errors and improve quality of life. From a men's health lens, dignity in ageing matters. Access to timely care matters. This reform supports both.

I also want to acknowledge Aboriginal and Torres Strait Islander men, who experience significantly poorer health outcomes and lower life expectancies. Nurses play a crucial role in Aboriginal community controlled health services. Enabling nurse prescribing within culturally safe, community led models of care supports better access and much better trust. Men are more likely to engage in health services they trust. This reform strengthens those services.

Mental health must also remain front of mind. As the Special Envoy for Men's Health, I cannot speak about access or care without speaking about suicide prevention. Men make up the overwhelming majority of suicide deaths in this country. We know that many of those men had contact with the health system in the months before they died. The problem was not that they did not seek help. The problem was that the help did not always move quickly enough for them. Designated registered nurse prescribers in mental health settings can support timely intervention, medication continuity and follow-up. They can help keep men engaged during critical periods of their lives. This saves lives.

I want to be very clear. This reform is not about lowering standards. It is about modernising them. The nurses who prescribe under this framework will be highly trained, endorsed against national standards and subject to oversight and review. This is safe, evidence based reform that aligns with international best practice. Other health systems have successfully implemented similar models. The evidence shows improved access, high patient satisfaction and no compromise to safety. Australia should not lag behind.

This bill is also about valuing our healthcare workforce. Nurses are highly skilled professionals. Allowing them to work their full scope is not only efficient but also respectful. From a men's health perspective, a confident, empowered workforce means better care. It means clinicians who can act decisively when a man finally asks for help. I often say that we cannot fix men's health outcomes by telling men to do better alone. We must fix the system. This bill is system reform. It recognises how men actually use health services and reduces barriers. It improves access, and it supports early intervention. It strengthens Medicare, it strengthens primary care and it strengthens outcomes for men all across this country, especially in regional and outer metropolitan communities like the Hunter. This is why reform matters, and that's why I'm proud to support this bill. I commend this bill to the House.

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