Ash Ambihaipahar (Barton, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This is a bill that goes to the heart of how we deliver health care in this country, who we trust, how we use our workforce, and whether Australians can access the medicines they need when they need them without unnecessary delay or cost. This bill is more than a legislative amendment; it is absolutely about modernising our health system in a way that reflects reality on the ground. It is about recognising the skill, training and professionalism of nurses, and it is also about ensuring Medicare continues to serve Australians not just for today but into the future.

This reform matters because Australia's health system is facing pressures that are both known and deeply felt by communities across the country. We have an ageing population. We are seeing higher rates of chronic and complex disease. Demand for primary and acute care continues to rise while workforce shortages—particularly in general practice, aged care and rural and remote services—place real strain on patients and providers alike. For too many Australians, accessing health care has become more difficult than it should be. We know people are waiting longer for appointments. Emergency departments are under pressure, and in some communities people are travelling long distances or delaying care altogether. If we are serious about strengthening Medicare then we must look honestly at how our health system operates and how it can operate better. That means using the skills we already have in our workforce more effectively.

Before coming into this place, I worked closely with the New South Wales Nurses & Midwives' Association. In that role, I had the privilege of listening to nurses from every corner of our health system, whether it was in the public or private system, in metro hospitals or regional clinics, or in aged-care facilities or community health services. I witnessed their pride in their professionalism, their commitment to patient care and their willingness to step up, often in incredibly challenging times. But I also heard their frustration. I heard from nurses who knew exactly what their patients needed but were constantly constrained by systems that no longer made sense. I heard from nurses who were trusted to manage complex clinical situations but could not take the final step of prescribing a medicine—even when it was safe, appropriate and well within their competence.

I had the opportunity to listen last night to the contribution of the member of Indi on this piece of legislation. I, too, heard about nurses who spent hours chasing signatures, making phone calls and sending patients elsewhere for tasks that they could have easily resolved, quickly and safely, in the same consultation. I heard from patients, particularly older Australians and people living with chronic illnesses, who bore the cost of that inefficiency in delays, inconvenience and sometimes worsening health conditions. This bill responds directly to those experiences. It reflects what nurses have been saying for many years, that with the right training, safeguards and collaboration they can do more and patients would be better off for it.

Registered nurses make up about half of the Australian health workforce. They are the pillar of our health system, delivering care across hospitals, general practice, aged care, disability services, community health and beyond. They are also the most geographically dispersed health professionals in the country. In many rural, regional and remote communities, nurses are not just part of the health system; they are literally the health system. Nurses are highly educated and highly regulated but also deeply trusted by the public of Australia. Yet, despite this, their scope of practice has not always kept pace with their training or the needs of patients. This bill takes a sensible step towards addressing that imbalance.

The Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 makes targeted amendments to two key pieces of legislation. First, it amends the National Health Act 1953 to allow registered nurses who are endorsed under the relevant registration standard to become authorised prescribers of certain medicines under the Pharmaceutical Benefits Scheme. This means that when those nurses prescribe approved medicines, patients can access them at PBS subsidised prices, ensuring affordability and equity.

Second, the bill amends the Health Insurance Act 1973 to ensure that prescribing services provided by designated registered nurse prescribers are subject to the Professional Services Review scheme. This ensures that strong oversight, accountability and safeguards remain in place, protecting patients, taxpayers and the integrity of Medicare. This is not a radical change; it is a carefully designed reform that modernises our legislation to reflect contemporary healthcare practice.

It is also important to be clear about what this reform is and what it is not. This bill does not create unsupervised prescribing. It does not lower standards. And it does not compromise patient safety. I had the opportunity to also listen to the contribution made by the member for Mallee, who was making rather bold assertions about this particular policy. She referred to it as being 'lazy', that it doesn't have enough evidence. Assigned registered nurse prescribing is the result of years of extensive research, consultation and policy development led by the Nursing and Midwifery Board of Australia in collaboration with the Australian Chief Nursing and Midwifery Officer.

In December 2024, all Commonwealth, state and territory health ministers approved a new national registration standard endorsement for scheduled medicines designated registered nurse prescriber. That standard came into effect in September 2025. Under the standard, registered nurses must meet strict education, experience and competency requirements to gain and maintain endorsement. Prescribing must occur within an agreed scope and under a formal prescribing agreement with another authorised health practitioner. This is collaboration. This is team based care. This is the gold standard of modern health delivery.

The first cohort of designated registered nurse prescribers is expected to complete their education, receive endorsement and commence prescribing from July 2026. This phased approach ensures the workforce is well-prepared, systems are ready and patient safety remains paramount.

For patients, the benefits of this reform are real and immediate. It means quicker access to medicines for common and ongoing conditions. It means fewer unnecessary appointments simply to obtain a prescription. It means less pressure on overstretched general practices and emergency departments. It also means care that is delivered closer to home.

For the people living in rural, regional and remote areas this reform is very important. In many communities, access to a GP can involve long travel times and extended waits. Enabling appropriately endorsed nurses to prescribe certain medicines allows people to receive care locally, safely and affordably. This is about fairness. Where you live should not determine how easily you can access essential medicines.

This reform aligns directly with the work of the Strengthening Medicare Taskforce and the Unleashing the potential of our health workforce: scopeofpracticereview. It recognises that workforce reform is essential to the long-term sustainability of Medicare. By allowing nurses to work to their full scope of practice, we improve efficiency across the system, reduce duplication and ensure that all health professionals can focus on the areas where they add the most value. This is not about replacing doctors or diminishing any other profession. It is about using the full health team efficiently and effectively so patients receive the right care from the right professional at the right time.

The bill ensures that medicines prescribed by designated registered nurse prescribers under the PBS remain subject to the same rigorous processes that apply to other prescribers. The Pharmaceutical Benefits Advisory Committee will continue to assess which medicines are appropriate for prescribing under this model, ensuring decisions remain evidence based and cost effective. This protects the integrity of the PBS while expanding access for patients.

For nurses, this bill represents recognition: recognition of their education, recognition of their clinical judgement and recognition of the role they play in our society by delivering high care to all Australians every day. Having worked alongside nurses through the New South Wales Nurses and Midwives' Association, I know how deeply this recognition matters. It's not about status. It is about being trusted to do the job they are trained to do—in partnership with others and in the best interests of the Australian people.

This bill delivers on the Albanese government's commitment to strengthen Medicare, support our health workforce and improve access to affordable medicines. It empowers nurses, it supports patients and it builds a health system that is more responsive, more equitable and more sustainable. This is sensible reform, it is patient focused reform, and it is reform that reflects the realities of modern healthcare in Australia. I commend the bill to the House.

See this speech in context