Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This bill enables eligible registered nurses to prescribe certain medicines under the Pharmaceutical Benefits Scheme. It establishes a framework for approving authorised nurse prescribers, including important safeguards that allow approvals to be suspended or revoked where necessary. It also formally recognises authorised nurse prescribers as a new category of PBS prescribers, ensuring that patients receiving care from authorised nurses can access medicines under the PBS. Registered nurses make up around half of Australia's healthcare workforce. They serve communities right across the country, including rural, regional and remote areas, where access to doctors can be limited.

Expanding the scope of practice in a safe and regulated way has the potential to improve access to medicines, particularly for Australians living outside metropolitan centres. The introduction of nurse prescribing follows consultation and regulatory development through the Nursing and Midwifery Board of Australia and with health ministers, with the first cohort of nurses expected to begin prescribing from mid-2026. The details of these measures have now been carefully examined through the Senate Community Affairs Legislation Committee process. The opposition will support the changes in this bill to recognise the important role nurses play in our healthcare system and the potential benefits of sensibly expanding the scope of practice. These measures are consistent with our focus on ensuring Australians have timely and affordable access to essential health care, particularly in rural and remote communities.

It is also important to acknowledge the broader context in which this reform is introduced. It is critical to ensure that Australians have affordable access to medicines at a time when health care has never been more expensive to access. Australians relying on prescription medicines are facing rising healthcare costs under Labor, including the highest out-of-pocket costs for GP fees on record. Patients are now paying, on average, more than $50 out of their own pocket when they visit a GP. Labor's mismanagement is forcing Australians to make very difficult decisions about their health—decisions that no Australians should have to make. We are seeing more and more Australians avoiding seeing a doctor or refilling their scripts because they say they simply can't afford to. In fact, according to a survey conducted by the Consumers Health Forum, one in two Australians missed out on the health care they needed last year mainly because, they said, they couldn't afford it.

Supporting appropriately qualified registered nurses to prescribe PBS medicines is a step in the right direction to improving access and affordability. However, Australians are facing not only record GP fees under Labor but also increasing delays in gaining access to new medicines and treatments. The Albanese government's investment in the PBS fell in 2024-25 in real terms, declining by almost $200 million compared to the previous financial year. This stands in stark contrast to the record of the former Liberal-National government, which approved more than 2,900 new or amended PBS listings with investments totalling around $16.5 billion.

Australia is falling behind internationally, with medicines taking an average of 566 days after registration to become available through the PBS. That delay is unacceptable when patients are waiting for medicines and treatments that could change and even save lives. The Albanese government must ensure Australians gain faster access to life-changing, life-saving medicines. Patients and industry alike tell us the current system is slow, outdated and overly complex. The Health Technology Assessment Policy and Methods Review was commissioned to address exactly these challenges, yet more than 600 days later many of its recommendations are still collecting dust on the minister's desk. All that has seemed to result from this review today is simply more reviews. Minister Butler seems to be making an Olympic sport out of how many reviews and reports he can collect on his desk.

The ATO review presented a critical opportunity to modernise Australia's processes, so we can remain world class in our response to innovation and genuinely patient centred. This opportunity must not continue to be wasted. While we support enabling nurse prescribers to prescribe PBS medicines, the opposition condemns the government's failure to ensure Australians have timely and affordable access to life-saving and life-changing medicines through the PBS.

The changes proposed in the bill are consistent with recommendations in the 'Unleashing the Potential of our Health Workforce—Scope of Practice Review'. There is significant interest across the health sector in the government's response to this review. But the Albanese government so far has failed to provide a fulsome formal response in spite of the fact that it was commissioned by the government and finalised 18 months ago. While we wait for the formal response, the government's approach to scope-of-practice reform to date has been ad hoc and piecemeal. This is an important opportunity for the government to provide a clear roadmap for broader workforce reform. When health professionals are enabled to work at their full scope of practice and to the full extent of their training, patients benefit through improved access to care.

A comprehensive response from the government indicating its intent about each of the recommendations and an indicative timeline for implementation would help provide clearer guidance to stakeholders and the broader public. This would also address concerns raised by other groups, as part of the inquiry process, as to why some specific changes to scope of practice have been implemented while others seem to be ignored. The government must now respond to the final report as a matter of priority. This review must not join others commissioned by the Minister for Health and Ageing that ultimately result in delay, inaction or further reviews instead of reform.

The opposition supports the measures that responsibly improve access to healthcare services. We support the intent of the bill, recognising the important role of nurses in the delivery of health care to Australian patients and the benefit of scope-of-practice reforms; however, the Albanese government must stop its ad hoc approach to scope-of-practice reforms and provide a fulsome response to its own review. That is why I move:

At the end of the motion, add ", but the Senate:

(a) notes:

(i) the Government commissioned a review into health professionals' scope of practice,

(ii) the report, "Unleashing the Potential of our Health Workforce—Scope of Practice Review" was finalised and presented to the Government 18 months ago, and

(iii) not only has the Government failed to indicate when it will respond to this review, it has not even committed to providing a formal response; and

(b) calls on the Government to provide a comprehensive response to the 18 recommendations in the review as a matter of priority".