Tom French (Moore, Australian Labor Party) Share this | Hansard source

I rise to speak in support of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This bill represents a careful and deliberate reform to Australia's health system. It strengthens Medicare, improves access to affordable medicines and ensures that our health workforce is better supported to meet rising demand by enabling professionals to work to their full and appropriate scope of practice. It is a reform grounded in evidence, consultation and an understanding of how health care is delivered on the ground in communities across Australia.

At its core, this legislation amends the National Health Act 1953 and the Insurance Act 1973 to allow appropriately qualified and endorsed registered nurses to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme. Importantly, it does so within a clearly defined regulatory framework that includes professional oversight, prescribing agreements and established accountability mechanisms. This legislative change reflects a broader shift in how health care is delivered in Australia.

Contemporary care increasingly relies on multidisciplinary teams, continuity across settings and the effective coordination of skills, and yet our legislative and funding frameworks have not always kept pace with these changes. In the many parts of the health system, professionals are trained to undertake responsibilities that existing settings prevent them from exercising fully. This creates inefficiency, duplication and frustration both for patients and for providers. Addressing these barriers is essential if Medicare is to remain responsive and sustainable.

This bill takes a targeted approach to reform. Rather than restructuring the system wholesale, it removes a specific constraint that has been well identified through policy review and professional consultation. It enables appropriately qualified registered nurses to contribute more fully within defined clinical and governance arrangements. By doing so, it supports a health system that is better aligned with how health care is delivered in practice, particularly in primary and community settings where demand continues to grow.

Australia's health system is under sustained and increasing strain. In my electorate, the Joondalup Health Campus serves a large and growing population across Perth's northern corridor and highlights the importance of strong primary and community care in supporting timely treatment and safe transitions for patients. Nurses at the Joondalup Health Campus already play a critical role in assessment, care coordination, chronic disease management and discharge planning. What this bill recognises is that in appropriate circumstances and within defined governance arrangements those nurses should be able to complete an episode of care rather than fragment it. Enabling appropriately endorsed registered nurses to prescribe under the Pharmaceutical Benefits Scheme supports safer transitions from hospital to community care, reduces unnecessary delays in treatment and helps prevent avoidable readmissions. For a health campus operating at scale, and for a community that relies on it every day, these efficiencies matter. They improve patient flow, reduce pressure on emergency departments and support better continuity of care once a patient leaves hospital.

Demand for care continues to grow as our population ages and as more Australians live with chronic and complex conditions. These pressures are compounded by workforce shortages, particularly in primary care and general practice. Too often, these challenges manifest as long wait times, fragmented care pathways and avoidable escalation of care that could have been better managed earlier in community settings. Enabling appropriately endorsed nurses to prescribe under the PBS allows care to be delivered more seamlessly within existing service models. It reduces the need for multiple appointments and supports continuity, particularly for patients with ongoing care needs. For constituents, this can translate into more timely access to treatment, fewer delays and a better experience of the health system. For providers, it supports more efficient use of clinical time and skills.

This reform recognises how care is delivered on the ground in growing outer metropolitan communities and ensures Medicare settings better reflect those realities. Enabling registered nurses to prescribe under the PBS within defined parameters directly supports that goal. It allows care to be delivered more efficiently and reduces unnecessary duplication while preserving clinical governance and patient safety. For patients, this can mean faster access to treatment and fewer barriers to care. This bill responds to those realities by making better use of the skilled health workforce already embedded in our communities.

Registered nurses comprise approximately half of Australia's health workforce and play a central role across the health system. Yet, despite their expertise, regulatory and funding arrangements have often limited their ability to operate at the top of their scope, particularly in the primary and community based care areas. The reforms in this bill allow endorsed registered nurses who meet rigorous education, experience and accreditation requirements to prescribe specified medicines under the PBS. This enables patients to receive timely and affordable treatment from the health professional who is already providing their care, without unnecessary duplication, delay or additional appointments.

It is important to be clear that this reform is not about replacing doctors or diminishing the role of general practitioners. Rather, it is about strengthening multidisciplinary, team based care. Modern health systems function best when each professional is supported to contribute their skills within a coordinated and collaborative framework.

The policy foundations for this reform are well established. The Strengthening Medicare Taskforce identified scope-of-practice reform as essential to improving access, affordability and sustainability in primary care. That work was reinforced by the scope-of-practice review, which found that unnecessary regulatory barriers were preventing health professionals from contributing fully to patient care and system efficiency. Alongside this work, the Nursing and Midwifery Board of Australia, working with the Australian Chief Nursing and Midwifery Officer, undertook extensive research and consultation on nurse prescribing. This process commenced several years ago and involved engagement with governments, nursing and medical organisations, medical organisations, clinicians and consumers. It culminated in the endorsement of a new registration standard for designated registered nurse prescribers by all health ministers, which came into effect in 2025. This bill provides the necessary Commonwealth legislative framework to support that standard by enabling access to the Pharmaceutical Benefits Scheme.

It is worth setting out how this legislation operates in practice, because its safeguards are central to its integrity. The safeguards contained in this bill are comprehensive and deliberate. Eligibility, approval and prescribing arrangements operate together to ensure that nurse prescribing under the PBS occurs within a framework that prioritises safety, accountability and professional standards. Approval as an authorised nurse prescriber is not automatic. Applications must be assessed by the secretary, and approvals may be subject to conditions. Chief among these requirements are prescribing agreements with other authorised PBS prescribers. These arrangements embed nurse prescribing within collaborative, team based models of care. The inclusion of authorised nurse prescribers within the Professional Services Review scheme further strengthens accountability. It ensures consistency and oversight across the PBS and provides mechanisms for peer review and sanction where appropriate. These measures collectively demonstrate that the reform balances improved access with strong governance and public confidence.

The bill also makes clear that authorised nurse prescribers may only prescribe pharmaceutical benefits determined by the minister for the purposes of the PBS. In making those determinations, the minister must have regard to the advice of the Pharmaceutical Benefits Advisory Committee. This preserves the independence, rigour and evidence-based nature of PBS decision-making. Further, authorised nurse prescribers will be subject to the Professional Services Review scheme under the Health Insurance Act. This ensures that their PBS prescribing is subject to the same peer review and accountability mechanisms that apply to other PBS prescribers, maintaining the integrity of the system. This bill includes provisions allowing the secretary to suspend or revoke approvals where conditions are breached, along with clear notification and review rights. These measures ensure that participation in nurse prescribing is contingent on ongoing compliance with professional and legislative requirements.

From the perspective of the electorate I represent, the benefits of this reform are practical and tangible. Across Moore, nurses already play a central role in managing chronic disease, supporting older Australians, delivering preventive care and coordinating services for people with complex needs. Allowing appropriately endorsed nurses to prescribe under the PBS enables more complete and efficient episodes of care. For older residents managing multiple medications, this can mean fewer appointments and better continuity. For families balancing work and care responsibilities, it can mean less time navigating fragmented services. For people living with chronic illness, it can mean earlier intervention and reduced risk of avoidable deterioration.

This reform is also significant for equity of access. Workforce shortages are not evenly distributed. Regional and remote communities and some outer metropolitan areas have greater difficulty attracting and retaining health professionals compared with metropolitan centres. By expanding the capacity of nurses to deliver care within their scope, this bill helps ensure that access to affordable medicines is not constrained by geography or workforce bottlenecks. It also supports the sustainability of general practice. By enabling nurses to manage appropriate prescribing within collaborative arrangements, general practitioners are better able to focus on patients with complex diagnostic needs, multimorbidity and care coordination requirements. This strengthens rather than undermines the role of general practice.

International experience supports this approach. Nurse prescribing models operate safely and effectively in countries such as the United Kingdom, Norway, Ireland and the Netherlands. Evidence from those systems demonstrates that non-medical prescribing, when governed properly, improves access to care, supports workforce retention and maintains high standards of patient safety.

The bill makes clear that prescribing by authorised nurse prescribers will commence only after the relevant delegated legislation is in place. The use of legislative instruments to determine the prescribing scope ensures flexibility while maintaining parliamentary scrutiny. It allows adjustments to be made in response to evidence and experience without undermining the integrity of the framework. It recognises that modernising health regulation requires both ambition and caution, particularly where patient safety and public confidence are concerned. By embedding oversight, review and accountability mechanisms, the bill ensures that implementation proceeds in a way that is transparent and adaptable.

This reform is focused on improving how care is delivered within the existing health system rather than changing infrastructure or hospital planning settings. The financial impact of this bill indicates there is no expected additional cost to the PBS. That reflects the fact that this reform changes who can prescribe, not who is eligible to receive, the subsidised medicines. It improves access and efficiency without expanding entitlement.

Taken together, the measures in this bill modernise Australia's health legislation to reflect contemporary practice and patient needs. They strengthen Medicare's capacity to respond to demand and support a workforce that is better equipped to deliver timely, high-quality care. For the people I represent in Moore, this matters. It means a health system that works more effectively in practice, recognises the professionalism of nurses and delivers care when and where it is needed. For those reasons, I support the bill and commend it to the House.

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