David Moncrieff (Hughes, Australian Labor Party) Share this | Hansard source

Last year this government was re-elected with a clear commitment to strengthen Medicare, expand access to affordable medicines and ensure our health workforce can work to its full scope of practice. The Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 is part of that commitment of the Albanese Labor government. It delivers on the government's commitment to ensure our health workforce operates at full scope, enhancing safe and timely access to medicines. It's a win for nurses and a win for all Australians.

At its core, this bill is about supporting and promoting access—access to care, access to medicines and access to a health system that works when people need it, not weeks later and only if they can afford to wait or travel. It recognises the truth that communities across Australia, including my electorate of Hughes, understand too well: as demand for primary health care grows, workforce pressures are becoming more acute and our system needs to make better use of the skilled professionals we already have. It was a truth not recognised by those opposite during their near-decade in office—a period during which the Leader of the Opposition, as health minister, distinguished herself as the only health minister in the history of Medicare never to increase the rebate for Medicare once—a goose egg! The health minister who went out for a duck on Medicare and extended Peter Dutton's Medicare freeze from two years to six years now leads the opposition. That shows Australians that what those opposite value: when you cut access to health in the Liberal Party, you get promoted. We are still cleaning up the mess that those opposite left in health and medication.

This bill represents part of those efforts to restore trust in affordable and accessible health care in Australia. It supplements our commitment to cheaper medicines. Since 1 January, medicines on the Pharmaceutical Benefits Scheme have cost no more than $25, a price they haven't been since 2004. It was action on our commitment to cheaper medicines, and this bill adds to that commitment.

This bill introduces historic reforms that empower nurses to work to their full scope of practice and improve access to medicines for people across Australia. Specifically, the bill amends the National Health Act 1953 to allow registered nurses who are endorsed under the new registration standard for scheduled medicines to become authorised prescribers for certain medicines under the Pharmaceutical Benefits Scheme. This means prescriptions written by designated registered nurse prescribers can attract a Commonwealth subsidy through the PBS, ensuring medicines remain affordable for patients.

The bill also amends the Health Insurance Act 1973 to ensure that prescribing services provided by designated registered nurse prescribers fall within the Professional Services Review Scheme. This ensures oversight, accountability and integrity within the system. These are sensible, measured reforms. They are firmly grounded in years of research, consultation and agreement across government and the health sector.

Since 2017, extensive research and consultation has been undertaken on how registered nurses can safely and effectively contribute to prescribing within their scope of practice. That work culminated in December 2024, when Commonwealth, state and territory health ministers approved a new registration standard, 'endorsement for scheduled medicines—designated registered nurse prescriber', under the Health Practitioner Regulation National Law Act 2009. That standard came into effect in September 2025. It sets out clear, rigorous education and qualification requirements that a registered nurse must meet to obtain and retain an endorsement.

The first cohort of designated registered nurse prescribers is expected to complete their education, receive endorsement and begin prescribing from July 2026. This is a reform that hasn't been rushed. It's not an experiment; it's a carefully designed, nationally agreed framework. Importantly, it has been developed with extensive stakeholder consultation. The Nursing and Midwifery Board of Australia consulted with the Royal Australian College of General Practitioners, the Australian Medical Association, palliative care services, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives and the Australian Primary Health Care Nurses Association.

Medical professionals have expressed support for designated registered nurse prescribing on the basis that it occurs in partnership with an authorised health practitioner under an active prescribing agreement. That partnership model remains central to this reform. Designated registered nurse prescribers will not operate in isolation. They will practice within clearly defined clinical governance arrangements that support patient safety and quality care. Primary care stakeholders expect that designated registered nurse prescribers will be able to prescribe PBS subsidised medicines in primary care, aged care, disability services, mental health settings and in acute hospital environments, particularly to support discharge processes and outpatient management.

For the people of Hughes, this means more timely care in the places they already access. It means community health clinics, aged-care facilities and hospital outpatient services can operate more efficiently. It means fewer unnecessary delays, fewer repeat appointments for administrative reasons and better coordination across the system. Currently, many registered nurses in primary care are highly skilled, highly educated and deeply experienced yet remain underutilised. Allowing them to prescribe certain medicines under the PBS boosts efficiency and allows GPs and nurse practitioners to focus on patients with more complex needs. That is good for patients. It's good for clinicians, and it's good for the sustainability of Medicare.

Designated registered nurse prescribing strengthens the health system by easing workforce pressures and building long-term capacity. It helps ensure the right professional is providing the right care at the right time. This is especially important in areas facing workforce shortages, including outer metropolitan, regional, rural and remote communities. The community at the southern tip of Sydney in Hughes is not immune to these pressures. Older Australians managing chronic conditions often need timely access to medicines. Carers and families balancing work and care responsibilities need health services that are responsive and accessible. As a result of a decade of neglect of Medicare, residents face long waits for appointments, particularly bulk-billed services, but bulk-billed services are coming back in Hughes. I've been visiting bulk-billing practices across my electorate that are seeing the value in Labor's investment in bulk-billing for patients and for doctors and healthcare professionals. There's more work to do, but it's work that this government is committed to doing, and this bill is part of that commitment.

Improved access to primary health care reduces avoidable hospital visits and preventable hospitalisations. When people receive timely treatment in the community, it reduces pressure on emergency departments and inpatient services. This bill supports that outcome. It also aligns with the Albanese government's commitment to cheaper medicines and the objectives of the National Medicines Policy. By enabling PBS subsidised prescribing by designated registered nurse prescribers, we ensure that medicines remain affordable and accessible. The list of medicines that designated registered nurse prescribers will be able to prescribe under the PBS will be determined through the independent Pharmaceutical Benefits Advisory Committee. This ensures decisions are evidence based, clinically appropriate and subject to rigorous assessment.

Affordability matters in health care. For families in Hughes, the cost-of-living pressures are real. Health costs are not abstract. They are felt at the pharmacy counter, at the GP clinic and when people delay health care because they're worried about cost. This government is doing something about it, and we're doing it despite those opposite opposing every cost-of-living measure put forward by this government in the last term. Ensuring PBS subsidies apply to medicines prescribed by designated registered nurse prescribers removes unnecessary financial barriers.

This reform also supports continuity of care. In aged care and disability settings, designated registered nurse prescribers can respond more quickly to changes in a person's condition. In hospital settings, they support timely discharge and follow-up care, reducing the risk of re-admission. In mental health services, they can improve access to treatment and reduce delays that exacerbate distress. These are real, practical benefits that flow directly to patients.

The bill also ensures integrity and safety through appropriate oversight by amending the Health Insurance Act 1973 to include registered nurses under the Professional Services Review Scheme. This bill ensures that prescribing services are subject to peer review and accountability. This protects the integrity of the PBS and maintains public confidence in the system. Targeted consultation has occurred between the Department of Health, Disability and Ageing, Services Australia, the Professional Services Review and the Department of Veterans' Affairs to ensure alignment and smooth implementation.

States and territories are also doing their part. All jurisdictions are currently amending their drugs and poisons legislation to enable designated registered nurse prescribing by July 2026. This national alignment makes delivery of health care more streamlined right across this continent. It ensures consistency, clarity and safety across Australia.

This bill is not about replacing doctors; it's about supporting the entire health workforce to work together more effectively. It recognises the expertise of nurses and the vital role that they play across every part of the health system. It reflects the reality that modern health care is delivered by multidisciplinary teams, not in silos.

For the people of Hughes, this reform means a stronger, more responsive health system in southern Sydney. It means care that is closer to home, delivered sooner and more affordably. It means nurses who already provide trusted care in our community will be empowered to do more within a safe and regulated framework.

This bill is another example of the Albanese government delivering on its commitments to strengthen Medicare, support the health workforce and put patients first. It's a win for nurses, it's a win for patients and it's a win for the sustainability of our health system. I commend this bill to the House.

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