Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Link to this | Hansard source

by leave—Members may be aware that one of the government’s election commitments in health was to establish the position of Commonwealth Chief Nursing and Midwifery Officer. I am delighted to congratulate Ms Rosemary Bryant on the announcement today of her appointment to this role within the Department of Health and Ageing. Nurses are a critically important part of Australia’s health workforce. There are some 150,000 nurses working in our hospitals, both public and private, and around 245,000 nurses working in the health system more generally. Yet until today nurses have not had a proper voice within policy making at the Commonwealth level. With Ms Bryant’s appointment to the role of Commonwealth Chief Nursing and Midwifery Officer, from now on nurses will have a strong voice within the Commonwealth government, not just on nursing workforce issues but on the issues facing the health system more generally in which nurses play such a vital part.

In her role as Commonwealth Chief Nursing and Midwifery Officer, Ms Bryant will undertake a range of important roles:

• As the government’s most senior adviser on nursing workforce issues, she will help shape policies which will strengthen the nursing profession as a career of choice.
• She will play a key role in developing a strategic and collaborative approach to nursing policy across both the Commonwealth and the state and territory governments.
• She will also advise the government on implementation of existing commitments, including our plan to bring thousands of extra nurses back into the hospital workforce.
• She will help lead the maternity services review.
• She will play a key role in the health reform debates and new policy formation that are so central to the Rudd government’s long-term view of the need to reshape our health system, from prevention right through to hospitals—at every step of the way, nurses of one form or other play a central role.

Rosemary Bryant comes to the role of Commonwealth Chief Nursing and Midwifery Officer with a wealth of knowledge and experience. She is currently Executive Director of the Royal College of Nursing and has worked in a wide range of hospitals and community settings. She was previously the director of nursing policy and planning in the Victorian government and the director of nursing at Royal Adelaide Hospital. Ms Bryant was elected as a member of the board of the International Council of Nurses, the ICN, in 2001 and was elected as its second vice-president in 2005. She has also provided advice to the World Health Organisation on nursing in Nepal.

One of the first tasks I will be asking Ms Bryant as Commonwealth Chief Nursing and Midwifery Officer to undertake is to lead the government’s maternity services review. This review, which was another of the government’s election commitments that are being delivered upon, is a first step towards developing a comprehensive plan for maternity services into the future. This piece of work will canvass a wide range of issues relevant to maternity services, including pregnancy, birthing and postnatal care, as well as care for parents who have lost babies. The government want to ensure we have the best system possible in place to provide high-quality care for mothers and newborns because we recognise that early care is the key to giving children the best start in life. I will be asking Ms Bryant as Commonwealth Chief Nursing and Midwifery Officer to lead this review because one of the things the government would like to see come out of the review is the potential for a greater role for midwives in the provision of maternity services. Midwives are highly skilled, highly qualified health professionals, and we believe there is scope for them to be playing a greater role in the provision of maternity services around the country.

The government has also announced recently a number of other very important policy initiatives, in which the Commonwealth Chief Nursing and Midwifery Officer will play a leading role, which are part of the government’s agenda to shape a health system designed to tackle the challenges of the future. Key among these is the development of a National Primary Care Strategy. The strategy will look at how to deliver better coordinated, more efficient, more accessible frontline care to families across Australia. Practice nurses, community nurses, district nurses, diabetic educators—the list could go on and on—are already part of that front line, but we want to consider if all health professionals’ skills are being properly utilised and supported to provide access to top quality care at all times. In particular the development of the Primary Care Strategy will focus on:

• better rewarding prevention in primary care;
• promoting evidence based management of chronic disease;
• better supporting patients with chronic diseases like diabetes, heart disease and asthma to manage their conditions;
• supporting the role GPs play in the health care team;
• addressing the growing need for access to other health professionals, including practice nurses and allied health professionals like physiotherapists and dieticians; and
• encouraging a greater focus on multidisciplinary, team based care in primary care settings.

Dr Tony Hobbs, a rural GP from Cootamundra in New South Wales and the current Chair of the Australian General Practice Network, is leading an external reference group to advise the Department of Health and Ageing on the development of the Primary Care Strategy. I will be asking the Chief Nursing and Midwifery Officer to be involved in the development of the Primary Care Strategy, given the important role that practice nurses play in primary care settings and the scope, amongst other things, for looking at how the roles of practice nurses as well as nurse practitioners might be expanded. The development of the Primary Care Strategy will of course also examine critical questions of workforce more generally. Alongside this work is a review of the Medicare Benefits Schedule primary care items with a focus on reducing red tape for doctors, simplifying the Medicare schedule and giving more support to prevention.

Just as importantly, we are undergoing extensive reform in the hospital sector as well, investing more heavily than the past government did in public hospitals and working through COAG and the National Health and Hospitals Reform Commission to see how we can mould our health system and workforce to meet the needs of the Australian community into the next decades. The voice of doctors and specialists in this debate is critical, but so too is the expertise of others, notably the large nursing workforce in our hospitals and the increasingly specialised role they play in everything from aged care to child and maternal health, to dialysis and critical care.

The position of Chief Medical Officer has existed since 1985 to provide clinical medical advice to the Commonwealth government, and I might note that prior to that the secretary of the department of health was always a medical doctor. The Chief Nursing and Midwifery Officer will play a complementary role on nursing issues. We will continue to work with and engage with professional and stakeholder organisations across the spectrum, especially in allied health, but we welcome the source of ready advice to government from a dedicated nursing adviser during this busy reform era.

These policy initiatives, including the announcement of the appointment of the Commonwealth Chief Nursing and Midwifery Officer, are about planning for a health system which is designed to tackle the challenges of the future. This government wants to take a strategic approach to health workforce issues, in particular as they relate to nurses, the largest single group in the health workforce, and to take a strategic, long-term approach to the provision of services, including maternity services and primary health care, the latter being of fundamental importance if we are to keep Australians healthy and out of hospital.

I am delighted once again to congratulate Ms Rosemary Bryant on her appointment to the position of Commonwealth Chief Nursing and Midwifery Officer. She is the first person to hold that position, it having just been created by the government. I look forward to working with her, on behalf of all nurses and the broader community, and welcome the important role she will play in the government’s health reform agenda into the future.

I ask leave of the House to move a motion to enable the member for North Sydney to speak for eight minutes

Leave granted.

I move:

That so much of the standing orders be suspended as would prevent Mr Hockey speaking for a period not exceeding 8 minutes.

Question agreed to.

Joe Hockey (North Sydney, Liberal Party, Manager of Opposition Business in the House) Share this | Link to this | Hansard source

I join with the Minister for Health and Ageing in congratulating Ms Rosemary Bryant on her appointment as the first Commonwealth Chief Nursing and Midwifery Officer, and recognise that Rosemary Bryant is very well qualified to hold this position. She is currently Executive Director of the Royal College of Nursing, a position which she has held since 2000. She is also currently the second Vice-President of the Board of the International Council of Nurses, the international body for nursing, comprising 129 member nations and representing 13 million nurses. I note that Ms Bryant was previously director of nursing policy and planning in the Victorian government and had hands-on experience at the Royal Adelaide Hospital. She has also been involved in policy development with the World Health Organisation. Obviously, Ms Bryant is very well qualified.

I welcome the creation of this position. Nursing has not received the recognition that some would say it has most properly deserved, over many years, including under previous Labor governments. But the matter is being addressed and I congratulate the minister for that. I recognise that we do have workforce challenges not just in nursing but right across the health spectrum. The health workforce understandably demands more flexible work hours primarily as a result of the pressures on families with both parents working but also as a result of the fact that there are more and more women in the overall workforce, particularly in relation to doctors. They naturally enough bring common sense to the workplace in one way above that of men and that is to bring greater flexibility in the workplace. The challenge you face in relation to doctors flows through to the provision of primary health care. The challenge you find in relation to nursing is that it is an extremely challenging job and nurses more generally have had overall rather poor remuneration in relation to the tasks they have been asked to perform. That is probably one of the reasons that, for example, in New South Wales there are far more nurses not practising as nurses than there are actual nurses working in the profession. I think these workforce challenges are significant not just in the public hospital system run by the states but also as a general issue. There are significant challenges that need to be met head-on by all governments.

One of the reasons the previous Liberal-National government under John Howard introduced 25 Australian hospital nursing schools, costing $170 million, was to provide hospital based training rather than exclusively university based training for nurses. We wanted them to have real experience. The new government came in and abolished those training schools—they have abolished 25 Australian hospital nursing schools. The chief nurse might have said to the minister, ‘This is a bad idea’, as everybody else did, but the minister proceeded with it and is instead giving $39 million to nurses who return to the workforce and an extra $99 million to extra nursing places in the university and TAFE system. The net impact is that those nurses who have done all the hard yards, who have stayed in the system doing the difficult tasks, are in no way rewarded for their efforts. I think the government’s policy is heading in the wrong direction, and Ms Bryant has a considerable job ahead of her in trying to convince the government to get back on track and reinstate Australian hospital nursing schools and focus on retention of nurses rather than just bringing back nurses who were previously in the profession but who are no longer in it. There are also basic workforce issues like how to get greater flexibility into the workplace in relation to nursing.

I also particularly welcome the appointment of a midwifery officer. Midwifery is a hugely important job and it has been around for many years. In fact, my grandmother, who is now deceased but I am sure she is listening to me at this very moment, was a midwife in Jerusalem. In those days of course doctors were very hard to find, particularly in the 1930s. My father recounts to me how he used to carry my grandmother’s bag around to the various births. That was a hard thing for a seven- or eight-year-old to do at the time, I am sure. But in those days the midwife picked up the challenges of birth. In those days, through no fault of the midwives, there was a much higher infant mortality rate than there is today. Thank God for the advent of better health care. The infant mortality rate generally has improved, although it is still horrendous in Third World countries and still way too high in Indigenous communities. We should never underestimate the significance of the role of midwives and how they often provide the services that cannot be provided by doctors. I imagine that over 95 per cent—I do not know the exact figure—of midwives are women and therefore provide a very important role at key moments during the birthing process when it might be best to have not only a woman there but also someone who has experienced childbirth—which no man will obviously go through, at least not in our lifetime.

In terms of the maternity services review, I also welcome this. I think that it is an important initiative. Providing the best system for pregnancy, birthing and postnatal care is vitally important. It is also important for families who lose a child. Again, we underestimate sometimes the psychological impact of that. I note that the coalition promised $800,000 for Bonnie Babes for counselling services for families who have lost a child pre or post birth. I am very disappointed that the government failed to put that in their budget. It was a commitment we made at the last election, the important point being that it is a phone service. From my own ministerial experience I know that phone services are often used particularly at distressing moments, rather than face-to-face services, which are not always available particularly for people who are in remote and regional areas.

The ministerial statement does refer to other health reforms. I want to very generously congratulate the minister on having a policy in health that is generated by the health department or by her, and not by the Department of Treasury. The alcopops tax came out of Treasury, as we found out during estimates, and the Medicare levy surcharge, which is taking a baseball bat to private health insurance, came out of Treasury as well. So it is a welcome change and all Australians should applaud when we get health policy from the health minister and not from Treasury, and I join in supporting this wonderful new initiative.