Jerome Laxale (Bennelong, Australian Labor Party) Share this | Hansard source

When this government was elected in 2022 and then re-elected in 2025, Australians made it clear that they wanted Medicare—the entire system—to be strengthened, not just protected but made to work better in practice. Of course, they were responding to nine years of Liberal neglect of Medicare, where the Medicare rebate was frozen for six long years by the former leader of the opposition and the current Leader of the Opposition. Left alone, the cost of medicines at the pharmacy would have reached $50 without Labor's intervention. Bulk-billing clinics were harder and harder to find.

People elected us to reform Medicare and to reverse that neglect because Medicare is something that people rely on every single day. In my electorate of Bennelong, strengthening Medicare has meant real and measurable change. It has meant millions of dollars saved on cheaper medicines and visits to a bulk-billed doctor for local families and retirees, providing real cost-of-living relief. We hear a lot of that term and this is real progress in families' budgets, where they're not spending as much on pharmaceutical medicines, where they're not spending as much to go and see a doctor. It has meant more people being able to see their doctor, being able to look after their health without reaching for their credit card, without punching a hole in that weekly or fortnightly pay packet, and it's meant real cost-of-living relief delivered through a health system that people trust and that Australians expect to have their back.

Since coming to government, our cheaper medicines reforms alone have saved billions of dollars nationally and, as I said, millions in my electorate. The cost of PBS medicines on 1 January dropped to $25, the lowest it's been since 2004. As I said earlier, had we not come to government in 2022 and incrementally reduced that cost, medicine today without Labor's intervention would have been close to $50 in out-of-pocket costs. Today it's half of that—$25 for people to get the medicines they need. Pensioners and concession card holders continue to pay no more than $7.70. A few years ago we froze that for five years.

Ask any pharmacist about this, about what our investments in Medicare have meant. Katrina from Blenheim Road Pharmacy, Rebecca from Eastwood Pharmacy, and George from Boronia Park and Gladesville pharmacies have all told me that these changes delivered by a Labor government that cares about Medicare meant that families haven't had to pick and choose what medicines they need to provide for their kids or provide for themselves. People used to go up and say, 'Well, I can't afford $42 this week across three medicines. Can you tell me which one I can skip?' Or they would say, 'My kids need some more medicine this week. I'm going to go without for the next fortnight.' That's all but gone now, because Labor has halved the cost of prescription medicines at pharmacies.

But it's not just about cheaper medicine or more bulk-billing; we're committed to reforming this Labor creation—Medicare—created in 1984. It's about reforming the system so it's fit for purpose today and is ready for the future of health care. It's about how easily people can access care and how smoothly the system works when they need to access care. Even with these reforms, people still tell me there are moments where the system gets in its own way, where they're seeing a qualified health professional, receiving appropriate care but yet still facing unnecessary delays, unnecessary appointments or avoidable inconvenience. That's exactly the kind of friction that our long-term health reform agenda is designed to address, and this bill is designed to reduce that friction. It builds on the work we've been doing to make Medicare more accessible, more flexible and better aligned with how care is actually delivered in a community like mine in Bennelong.

The Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 is very important. It makes a targeted, practical change to the way medicines are accessed under the PBS. It amends the National Health Act of 1953 to allow designated registered nurses to prescribe certain medicines that are subsidised through the PBS. It also ensures that, when those medicines are prescribed, patients can access the same PBS subsidy that they would otherwise receive if those medicines were prescribed by a doctor. This isn't a broad rewrite of Medicare. It's not a change to who oversees primary care. It doesn't replace the role of doctors, particularly at initial prescription, but what it does is remove a barrier that no longer reflects how health care needs to be delivered on the ground. It gives easier access to medicines in a streamlined and more cost-effective way, not only for the system and the taxpayer but also for family budgets, meaning you don't need to go see a doctor to get a script for certain medicines. You'll be able to see a nurse to get that done—a huge change.

This change is needed because, in suburbs in Bennelong like mine, the demand for primary care continues to grow. Suburbs like Ryde, Lane Cove, Eastwood and Macquarie Park are all seeing general population growth because—let's face it—it's a great place to live, I've got to say, in Bennelong and some of those suburbs. We see a growth in population, and we also have an ageing population, so people need more access to primary care, when, as we've heard, there are constraints in the supply of qualified people to provide it.

Registered nurses are ready to serve more. They already play a critical role in access to primary care and aged care and in community health settings. In many cases, patients are already receiving appropriate care from these very highly trained nurses, but they still need an additional appointment or referral just to access a prescription. In 2026, I don't think that makes sense anymore. This bill will reduce that duplication. This reform will remove another friction point for people accessing primary care. It means that this care can be delivered more efficiently and without compromising safety standards. For older residents, it means fewer appointments at the doctor, less back and forth. Travelling to and from a doctor can be of concern for some of our older residents. This will help them with that. For working families, it means quicker access to treatment without having to take time off work, without eating into an already packed weekend. It means those families can get quicker access to the medicines they need.

This is a careful and deliberate reform. Only registered nurses who meet strict education, training and endorsement requirements will be authorised to prescribe. Prescribing will occur under a national registration standard, approved by health ministers, which is now in effect. Nurses will only prescribe within their scope of practice, clinical setting and level of competence. Prescribing services provided by nurse prescribers will be subject to existing professional oversight arrangements. These safeguards are important because they ensure prescribing is appropriate, evidence based and consistent with PBS requirements. The first nurse prescribers are expected to commence from July this year, following the completion of required education and training, because we understand that patient safety remains central to this reform, just as it is across every form of Medicare supported care. Australians should and can have confidence that the same standards will apply regardless of which health professional is providing this care and which health professional is prescribing these medicines.

This bill is not an isolated reform. This is a deliberate next step in the agenda that the government has to strengthen Medicare, things we've been doing progressively since we were elected in 2022. Rightly, we started by tackling affordability, cutting the cost of medicines and easing pressure on household budgets. We backed that up by expanding bulk-billed care, tripling the incentive for concession card holders and children under 16 and then making sure that tripled incentive was available to every Australian with a Medicare card. That's seen real results. Since 1 November last year, we've gone from nine bulk-billing practices in Bennelong to 14 bulk-billing practices in Bennelong, and we expect more to follow in 2026, meaning that more families, the elderly and other residents of Bennelong can access free bulk-billed care right across the community.

We've invested in Medicare urgent care clinics. Overdelivering on our promise to do 50, we have hit over 100 open right across the country—importantly, one in Top Ryde and one in Chatswood, promised and delivered by this government. We've expanded access to Medicare mental health centres so people can get the support they need without long waits or complex referrals through the mental health network. The Ryde mental health centre is now under construction and is expected to open in the first half of this year.

This is what strengthening Medicare is all about. It's about making sure that our system works, that it's fit for purpose in 2026 and that it's set up for the future. It's a system that should work for patients and for the clinicians delivering care. It's about getting people the right care in the right place at the right time. And in Bennelong, just like right across the country, those investments are making a huge difference, taking pressure off emergency departments with our urgent care clinics' open extended hours from 8 am to 10 pm in most cases; giving locals more options for free care through more bulk-billing; through the passage of this legislation, making it easier for people to get prescription medicine; and, of course, making that prescription medicine cheaper.

The future will put pressure on Medicare, and we need to make sure that our entire health system can respond to what will be challenges in our health system. Australians are living longer. More people are managing chronic and complex conditions, and demand on primary care will continue to rise. We can see that happening. Instead of cutting funding from Medicare, instead of neglecting Medicare, instead of freezing rebates like the Liberals and Nationals did for nine years with the same warnings we're getting now, we're setting up Medicare to ensure that it can deliver the care that Australians expect, just having that green and gold Medicare card. We'll continue to remove unnecessary barriers to help ensure that the system remains responsive and sustainable, particularly for growing communities like mine in Bennelong. And this will mean fewer delays. It'll mean better use of our health workforce, and it will give us a Medicare system that works the way people expect it to. The health legislation amendment bill is a practical continuation of the reforms that we've been putting in place since 2022, and I commend the bill to the House.

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