Justine Elliot (Richmond, Australian Labor Party) Share this | Hansard source

I too rise to speak in support of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This bill is about making sure Australians can get the medicines they need when they need them without unnecessary barriers standing in their way. It really builds on our government's investment in health care and Medicare over the past few years. Of course, as we've heard from many of the speakers, we did have a decade of neglect under the Liberal and National parties when they were in government. It's taken a long time to build back and invest in Medicare and in health services. This bill today is part of our reforms to make sure that people can access health care when they do require it, particularly those in rural and regional areas. Our reforms have made a huge difference, and I'll go through some of the details later on about that.

This bill proposes amendments to the National Health Act 1953 and the Health Insurance Act 1973 to enable authorised nurse prescribers to prescribe certain medicines under the PBS. Under existing law, prescribing rights are confined largely to medical practitioners, dentists, optometrists, endorsed nurse practitioners and midwives. The reforms in this bill will mean that nurses are empowered to provide this care directly to the community, reducing the need to visit a GP or attend a hospital emergency department. It'll make a huge difference.

The reforms in this bill support the broader health workforce reform agenda of ensuring that health professionals are enabled to work to their full scope of practice. For a health professional, 'scope of practice' means the activities which they are competent and authorised to perform. As identified in the Strengthening Medicare taskforce report and the subsequent Unleashing the potential of our health workforce review, removing barriers and increasing incentives for all professionals to work to their full scope of practice is necessary in delivering better health outcomes. These reforms recognise that, while our registered nurses are highly educated and skilled, their skills have been underutilised in the primary health care system. The reforms also recognise that empowering nurses to work to their full scope of practice will strengthen our healthcare system by removing barriers, easing pressures on the workforce and building long-term capacity and sustainability.

Under state and territory legislation, some nurses are already prescribing medicines, particularly in primary care, community health and regional settings. But, without PBS prescriber status, their patients are forced to pay full price for their medicines. Two patients with the same condition, seeing two different qualified health professionals, should not face different out-of-pocket costs simply because one prescriber is recognised under the PBS and the other one is not. This bill closes that gap by creating a new category of prescriber under the PBS. The bill also contains very important safeguards to ensure that only nurses with appropriate training and professional qualifications are in fact authorised to prescribe.

Improving access to health care has been a key priority of the Albanese Labor government. We know the demands on our health system continue to increase. We have an ageing population and a growing number of people living with complex and chronic conditions. It has been at the heart of so much that our government has done in reforming health care and providing more services. The changes that I refer to today in this bill build on the work that we've done to deliver cheaper medicines, a stronger Medicare and just greater access to health care across the board. In fact, just recently we increased hospital funding. Record funding is another initiative of our government that's making a huge difference.

Of course, in 2022, we reduced the eligibility threshold for the PBS safety net to ensure that even more Australians had access to cheaper medicines and lower out-of-pocket costs. This included a 25 per cent reduction in the number of scripts a concessional patient must fill before the PBS safety net actually kicks in. We further slashed the cost of medicines in 2023, making the largest cut to the cost of medicines in the entire history of the PBS. This was the first time in 75 years that the general patient co-payment was reduced, and it saw the maximum cost of a general script falling about 30 per cent from $42.50 to $30.

We also introduced 60-day prescriptions to enable Australians with chronic or ongoing health conditions to get twice the medication on a single prescription. This means a reduction in the amount that people pay for medicines, fewer trips to the doctor and fewer trips to the pharmacist as well. And we froze the cost of PBS medicines for pension and concession card holders so that prices will stay at a maximum of $7.70 until the end of the decade. For areas like mine—we are very fortunate to have a high proportion of seniors in northern New South Wales—it makes a huge difference to have the certainty that it is $7.70 they will be paying. So many locals have told me the difference that makes to them and to their health care. Starting from 1 January this year, we delivered even cheaper medicines for all Australians by reducing the PBS general patient co-payments from $31.60 to $25. It's so low.

In my electorate of Richmond on the north coast of New South Wales, I'm very proud to have delivered on my 2025 election commitment, which was that a re-elected Albanese Labor government would deliver a Medicare urgent care clinic in the Tweed region. When I was campaigning, people were very keen to have this in place, knowing how well the urgent care clinics provide support and the difference that makes. When we talk about the urgent care clinics, we say that all you need is your Medicare card, not your credit card. That's the reality—just walk in there with your Medicare card. The one we have, the Tweed Heads Medicare Urgent Care Clinic, is based at the Tweed Health for Everyone superclinic. Our superclinic was delivered by a previous Labor government and provides wonderful services for the community. The urgent care clinic provides locals with the free, urgent care they need fully bulk billed, and it's open seven days a week from 7.30 am to 7.30 pm.

We officially opened the urgent care clinic last December. Since then, so many locals have told me that it's really filled a very crucial gap in the provision of healthcare services in our community. I've been told that since it's opened, there's been a daily average of 38 presentations. They have been incredibly busy providing that service, and it is making a massive difference. Nearly 60 per cent of patients who visit the Tweed Heads urgent care clinic would have otherwise gone to the emergency department of the Tweed Valley Hospital to access the care they need. So this shows this clinic in Tweed is easing the pressure on our local hospital. That is the feedback that I'm getting from health professionals and locals. It is making a massive difference for so many people—locals, seniors and families.

We're also delivering access to free walk-in mental health care for locals, with planning underway for a Medicare mental health centre in Tweed. The centre will be open for extended hours with no appointment or referral needed to access those services. A number of years ago, we opened the new headspace in Ballina. That's providing important support for younger people. We have an existing one in Tweed Heads, which does a remarkable job as well, but it's important that we have all these services here. As I said, that planning is underway for the Medicare mental health centre. It will make a huge difference in the community to have that operating.

We're also delivering on our election commitment to expand bulk-billing, and this has been an absolute game changer in my electorate and across the country. It's part of the single largest investment in Medicare since its creation 40 years ago. For the first time, Labor has expanded bulk-billing incentives to all Australians and created an additional new incentive payment for practices that bulk bill every patient. We've tripled the bulk-billing incentive for people who need to see their GP most often—pensioners, concession card holders and families with children. From 1 November 2025, we expanded those incentives to all Australians. It has been a huge success in my area and, I know, right across the country. We also introduced a new incentive payment for practices that bulk bill every patient. Since 25 November, a new bulk-billing practice incentive program is supporting practices that bulk bill all their patients. This is on top of the bulk-billing incentive, so fully bulk-billed practices receive an additional 12.5 per cent loading on their Medicare rebates.

Towards the end of last year, I visited the Wollumbin Medical Centre in Murwillumbah, where GPs informed me they were universally bulk billing, and that was due to two reasons. First of all, there were our increases to the bulk-billing incentives, but another major change that our government made was reclassifying the town of Murwillumbah from metropolitan to regional for healthcare services. I want to again acknowledge all of the community that worked so hard to make this happen. The fact that the previous Liberal-National government had classified it in that way, as a city, really inhibited a lot of people's capacity to access healthcare, so we changed that. I give special thanks to the health minister for that. Having that change is so important. That, combined with our bulk-billing incentives, means that places like Wollumbin Medical Centre fully bulk-bill everyone. I also invited the Minister for Health and Ageing back to the North Coast in October to visit the Tweed Banora Medical Centre in Tweed Heads South and speak to GPs who also started bulk-billing all their patients on 1 November.

Thanks to all these changes that our government's made, we now see right throughout the North Coast these wonderful signs in front of GP practices. They say, 'Medicare bulk-billing practice'. How great is it to see that sign? People know it's there. They know they can go in. They know they'll be bulk-billed. Those signs are now in the front windows of more than 20 bulk-billing practices, so it has expanded very quickly. That's going from Tweed Heads to Byron to Ballina, right throughout my electorate. We're seeing more and more practices that are fully bulk-billing.

Of course, on 1 January this year we also launched 1800MEDICARE, a free, nationwide, 24/7 health advice line and after-hours GP telehealth service. And now, of course, we're seeking to make health care more accessible through all the measures that we have in this bill. The reforms that are contained within this bill will also make a huge difference, and it's important because registered nurses are the most geographically dispersed health profession in Australia and comprise around half of the entire Australian health workforce. By enabling authorised nurse prescribers to prescribe certain medicines under the PBS, people will get better access to medicines closer to home. They won't have those associated costs with travelling further to see a doctor, and the delays in waiting for an available appointment will all be reduced. Again, this will also be another game changer when it comes to delivering health care. Of course, preventable hospitalisations that result in delayed access to medicine will also be reduced as well, and these reforms are the result of work already undertaken to improve access to timely, affordable and safe medicines and alleviate pressure on our health workforce as well.

Of course, there's been extensive research and the consultation that's been led by the Nursing and Midwifery Board of Australia and the Australian Nursing and Midwifery Offices. This work led to the development of new standards for designated registered nurse practitioners, and in December 2020 for Commonwealth, state and territory health ministers approved the new registration standard to enable nurses to become authorised prescribers. From July 2026, it's expected the first cohort of nurse prescribers will complete their additional education and receive endorsement. That's just great news, particularly, as I say, for those of us in regional and rural areas. The reforms in this bill help align our health legislation with modern clinical practice. They strengthen patient access to subsidised medicines and support the evolution of the health workforce. And, of course, the bill complements existing practice by enabling a broader range of health providers to contribute effectively to patient care. And this is very important in context where medical workforce shortages can lead to delays or inefficiencies.

Ultimately, this whole bill is about putting patients first, and that has been our whole agenda with all of our healthcare reforms making sure we are putting patients first. It also, very importantly, recognises the skills of our nurses. And I do want to compliment all of our nurses in my region and across the country—both nurses and health professionals—for the remarkable work that they continue to do all of the time. This is a recognition of that. So it recognises the skills of our nurses, trusts the evidence and removes barriers that, quite frankly, don't make sense. It doesn't make sense that this had not been in place before. It's about ensuring that where a person lives or which qualified health professionals they see doesn't determine whether they can afford the medicines that they need, that they need then and there. By modernising our laws to reflect contemporary practice, we're strengthening Medicare; supporting the health workforce; and making our health system more responsive, more equitable and more sustainable into the future, because we do have that ageing population and we do have increasing clinical and complex care needs that are there. These investments right across the board are vitally important. I commend the bill to the House.

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