Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) | Hansard source

One Nation will support the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. It amends the National Health Act and the Health Insurance Act 1973 to enable approved registered nurses to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme, the PBS. Australia's health system is experiencing increasing demand due to an ageing population and rising prevalence of chronic disease, something we do need to better understand. Improving access to safe and effective medications is essential to meeting the health needs of everyday Australians.

Registered nurses comprise around half the Australian health workforce and are the most geographically distributed health profession. They're the best placed to prescribe certain common medications, taking the pressure off doctors while reducing travel and inconvenience to patients. This will support rural pharmacies. Registered nurses must complete a three-year bachelor's degree in nursing. Nurse practitioners must hold a master's degree in nursing and complete 5,000 hours of advanced clinical practice.

The history of the idea of allowing nurses, suitably trained, to write prescriptions is quite long. It began with a trial in New South Wales between 1991 and 2000—a generation ago. This went national in 2001 with the advent of the national Nursing and Midwifery Board, designed to bring regulation of nurses closer to the system used for doctors. It was at this time that the pathway to nurse practitioner was introduced. In 2010, nurse practitioners were approved to write prescriptions under the PBS, although only while working in collaboration with a registered medical prescriber. Then, in 2024, the government removed the need for collaboration with a registered prescriber, allowing nurse practitioners to prescribe most medications under their own Medicare Benefits Schedule prescriber number. Finally, in 2025, the government introduced the ability of registered nurses to prescribe. There are suitable checks and balances. Nurses must meet specified qualifications, complete the course and maintain endorsement. The first cohort were enrolled and have now completed their training.

This legislation will enable these health professionals to prescribe certain medications. Perhaps this could have been done the other way around, with the heads of power to allow registered nurses to prescribe written into law before we started training them, disrupting their careers and offering them a career path which didn't yet exist. Maybe that's just a sensible One Nation thing.

This legislation is being supported across the chamber and could have been supported a year ago. The point of this history lesson is clear. The move to allow registered nurses to prescribe is not a thought bubble. It's the result of a generation of evolution in the education and professional certification of and skill base within the nursing profession.

The system they've put in place appears fit for purpose. Not all drugs can be prescribed by registered nurses, just certain ones: birth control; repeat prescriptions across a wide range of conditions. There are lots of opportunities to take the pressure off our doctors. This is particularly beneficial to regional and remote areas.

For those who may be concerned about this measure—and One Nation is not concerned with it—I reference the PBS auditing framework. The PBS has excellent audit routines which scan all the prescriptions written across the system and zero in on any patterns out of the ordinary. These are then followed up with a phone call or, if necessary, a visit. Misuse will be detected. One Nation does contend medical professionals are given insufficient discretion to use their wealth of medical knowledge. In this case, it will provide an additional check. The initiative in part stems from the Strengthening Medicare Taskforce. One Nation is pleased to strengthen Medicare with this initiative.

Next, I must address 'Mediscare' 3.0, which disreputable media have been promoting in the last few weeks. I say 'Mediscare' version 3 because the last two elections saw the Labor Party, or their supporters, smear the Liberals with a false 'Mediscare' campaign. Now it's One Nation's turn to be smeared, and Labor is smearing One Nation. They must fear us. While it has been only one week since the last time I defended Medicare and the PBS in a Senate speech, it seems I need to do it again. Very well. One Nation will defend the Pharmaceutical Benefits Scheme and Medicare. Both are part of a social-welfare safety net which maintains a healthy population and contributes to Australia enjoying a high standard of living. Medicare and the PBS are why people pay taxes—and don't forget it, government.

Taxes are, of course, not the government's money. Taxes are the people's money and should only be spent accordingly. Hardworking Australians do not deserve to have their money wasted or handed over to fraudsters. One Nation will work with and better resource the Benefits Integrity Division and the Fraud Fusion Taskforce to ensure every cent of money spent through Medicare and the PBS goes to people who need it and who qualify for the benefit.

It's intolerable to me that new drugs, drugs that could save lives, are held back, despite agreement between the Pharmaceutical Benefits Advisory Committee and the drug maker, because of the cost, because billions are being taken out of the system in fraud. And, yes, some prescribers are complicit, although a tiny amount.

No patient with a legally obtained Medicare card should ever be afraid of using that card under a One Nation government. No Australian will have to pay more for a prescription under a One Nation government. We will support and maintain the system of the Medicare urgent care clinics, and we will work constructively with all stakeholders to extend operating hours for service delivery to take further pressure off public hospital emergency departments—which we will be able to afford because we will remove the criminals and fraudsters from the system and ensure everyone who uses a Medicare card is entitled to use that card. The government knows who these people are—yes, you do. The government knows where the $3 billion a year in fraud is coming from. Their own integrity division said as much in Senate estimates recently. The fraud figure is the government's, not One Nation's—we didn't cook it up; the government's own agency told us. The Albanese-Burke government doesn't have the guts to do anything about it.

I'm concerned that the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 could create a two-tier health system. Rural, regional and poorer suburbs would get registered nurses and nurse practitioners. Richer suburbs would get doctors galore. In fact, I'm sure that's going to happen because it's happening now. The Australian Institute of Health and Welfare and the federal department of health track their workforce using a framework called the Modified Monash Model. Their data shows a stark imbalance. Roughly 84 per cent of private hospital medical practitioners and the vast majority of medical specialists operate exclusively within major capital cities and metropolitan centres. Small, regional, rural and remote towns classified as MM4 to MM7 contain the lowest number of healthcare workers per capita. In these areas, access to medical care drops drastically. In these areas, GPs provide primary care and act as emergency doctors and hospital doctors, making up 60 per cent of the entire available hospital workforce because there are so few dedicated specialists. The bill before the Senate will help take the weight off those GPs, yet will not solve the issue of doctors gravitating to wealthy suburbs and cities. What may solve that problem is to do more to assist children from the bush to take up medicine as a career. One Nation's health policy, to be released later this year, will add more detail to that statement.

Finally, I'll be moving amendments to this bill on behalf of Senator Lambie, who's recovering after recently herself quality-testing our healthcare system. As it currently stands, properly qualified podiatrists and podiatric surgeons can prescribe specific medicines to their patients, although these prescriptions are not recognised under the Pharmaceutical Benefits Scheme. Patients either have to pay the full price or meet with the GP to get the same medicine prescribed under the PBS—or, worse, go without and suffer the consequences. That's ridiculous. Podiatrists require a university degree, must maintain membership of their professional association and are affiliated with Ahpra, like other medical associations. Their medical expertise in their area of care is well capable of supporting improved prescribing rights. The focus of our healthcare system must be what's best for the patient, and what's best for the patient cannot include bureaucratic roadblocks and financial pain. The amendments I foreshadow do not reduce safeguards. They do not give podiatrists greater prescribing powers. They will ease GPs' workload and make things easier for patients. They are commonsense amendments, and they should be supported.