Helen Polley (Tasmania, Australian Labor Party) | Hansard source

I rise to speak on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025, a bill that represents a practical, overdue and historic reform to the way we deliver health care in this country, which is what this government has done since it came into office. At its core, this bill is about patients. It's about making it easier for Australians to get the medicines that they need, when they need them, at a price they can afford. It is also about recognising the skill, training and professionalism of our nurses and ensuring they are able to work to their full scope of practice in service of the communities and patients that they care for every single day.

This bill came about in part because of the Strengthening Medicare Taskforce and the subsequent Unleashing the potential of our health workforcescope of practice review. I acknowledge the Minister for Health and Ageing, Minister Mark Butler, for his determination and commitment in this space to make Australia the healthiest country in the world. Both the taskforce and the review recognised a simple truth: Australia cannot meet rising health demand by relying on old structures that leave highly trained professionals underutilised. The review, led by Professor Mark Cormack, found that many health professionals face barriers unrelated to their education or competence and recommended reforms so more of the workforce can deliver care safely and effectively in primary care settings. This bill responds directly to that national challenge.

Specifically, the bill amends the National Health Act 1953 to authorise registered nurses who are endorsed under the registration standard. It will also allow for designated registered nurse prescribers to prescribe certain medicines under the Pharmaceutical Benefits Scheme, attracting Commonwealth subsidy. It also amends the Health Insurance Act 1973 so that a designated registered nurse prescribing under the PBS is subject to the Professional Services Review scheme, providing peer review oversight and an important safeguard for integrity and safety. In short, the bill combines expanded access with strong accountability, which is exactly how good health reform should be—which is why the Australian people can always rely on Labor to deliver better health outcomes.

As the minister has stated, the significance of this reform is enormous. By enabling designated registered nurse prescribers to prescribe medicines under the PBS, the bill ensures that medicines prescribed by those nurses are affordable for patients and not out of reach. It aligns squarely with the government's commitment to cheaper medicines and with the principles of the National Medicines Policy, which seeks equitable, affordable and timely access to high-quality medicines and related services. For patients, that means fewer delays, fewer unnecessary appointments and fewer situations in which cost becomes a barrier to proper treatment.

If you had listened to the contribution before mine, you would have wondered why those opposite don't support, and didn't support, cheaper medicines. They haven't supported the cost-of-living measures that this government has introduced. But now all of a sudden we hear that they support Medicare, and they suddenly support cheaper medicines. We're a government with a record of actually delivering. We don't talk about it. We take the action and we deliver on those commitments.

Returning to the bill, at present many registered nurses are highly skilled and highly educated professionals who make up the largest and most geographically distributed health workforce in Australia. But they remain underutilised in primary care. That is not efficient for the health system, and it's not fair on patients. Allowing appropriately endorsed registered nurses to prescribe under the PBS will boost efficiency, strengthen care coordination and free GPS and nurse practitioners to focus on patients with more complex needs. In a system facing increasing demand from an ageing population—which we are—chronic disease and workforce shortages, these changes are not merely desirable; they are necessary.

This matters especially for rural and regional and remote communities like my home state of Tasmania, and we heard from my colleague from Western Australia. For communities that live in the regional areas of WA, which is so expansive, this reform will make a huge difference, as it will for all Tasmanians. Too often people outside our major cities must travel long distances, wait too long or navigate fragmented services to receive even basic care. We know that better access to primary health care reduces avoidable hospital visits and preventable hospitalisations. We also know that nurses are often the most trusted and most accessible health professionals in smaller communities. When we empower them to provide treatment directly and prescribe affordable medicines within a clear clinical framework, we bring care closer to home and improve equality across our nation.

Tasmanians know that geography can shape access to care. For communities in regional and more isolated parts of our state, timely access to GPs or to other primary care professionals cannot always be taken for granted. Tasmania's own Health Workforce 2040 strategy recognises the need to build a workforce of the right size and shape, foster innovation and ensure health services remain sustainable into the future. This bill complements that ambition. By enabling nurses to contribute more fully, it will help strengthen access not only to community settings but across hospitals as well, easing pressure where delays in primary care flow directly into emergency departments and acute services. This will complement the 137 urgent care clinics that we have introduced and which are going to be funded on an ongoing basis to help reduce that pressure on our accident and emergency departments. So this complements the delivery that this government has already demonstrated that we have to provide better health care for all Australians.

Importantly, this reform has not emerged in haste, nor has it been developed without rigorous professional input. Since 2017, the Nursing and Midwifery Board of Australia and the Australian chief nursing and midwifery officers have undertaken extensive research and consultation on nurse prescribing models. The board developed the relevant standards for designated registered nurse prescribers through multiple rounds of public consultation, and those processes received strong support. In December 2024, the health minister approved the new registration standard, and it came into effect on 30 September 2025. The first cohort of nurses is expected to complete the required education and receive endorsement from mid-2026.

There are also clear safeguards embedded in the reform. Designated registered nurse prescribers will not prescribe without structure or oversight. It's very important that people understand that. The list of medicines that may be prescribed under the PBS will be considered by the independent Pharmaceutical Benefits Advisory Committee, the PBAC, ensuring decisions are informed by evidence and national standards. Under the registration standard, nurses must meet specific qualifications and endorsement requirements, and they must prescribe in partnership with an authorised health practitioner under a prescribed agreement. The extension of the Professional Services Review framework further ensures public confidence in safety, quality and proper stewardship of public funding.

This reform is in the true Labor tradition. Labor understands that universal health care is not only about the existence of a system. As much as we created Medicare and we have always defended it and we always will, it is about whether that system is accessible, affordable and fair in practice. Unlike those opposite, we actually believe in universal health care. We believe that Australians should have access to affordable medications and they have the best support that they can possibly have when they need it. It's about whether a person can get care close to home. It's also about whether hospital emergency departments are reserved for emergencies rather than becoming the default option when primary care is too hard to access. It's about whether every member of the health workforce is enabled to contribute at the top of their training and their competence, so this will actually encourage more into the nursing profession.

This is what this bill delivers: it strengthens Medicare's promise by making sure that care is going to be responsive, and that it will be delivered to all communities in our modern Australia. The practical benefits will be felt across the system. Patients with straightforward and ongoing care needs will be able to receive treatment more quickly. Nurses will be able to resolve issues that currently require extra appointments, sometimes extra delays. GPs will be able to devote more of their time to complex issues that they're presented with every single day. Hospitals will face less pressure from patients whose needs could and should be addressed earlier in the community. That's why, with these measures in this bill along with our urgent care clinics, we will be able to reduce pressure on accident and emergency departments. When you go to an urgent care clinic, you will get the service, the support, the care that you need and all you will need is your Medicare card. It will no longer be dictated by whether you've got a credit card in your wallet or your wallet's full of cash.

Rural and regional Australians will have a fairer chance of receiving timely care without the burden of distance and cost. That is better for patients, better for providers and better for the sustainability of our health system over the long term. This bill delivers on the government's commitment to ensure our health workforce can operate at full scope, while maintaining the safeguards Australians rightly expect. It is a thoughtful reform grounded in evidence, developed through consultation and aimed squarely at improving care for people who rely on our health system every day. It is a win for the nurses, it's a win for the patients, it's a win for rural and regional communities and it is a win for the future strength of our health system, including in my home state of Tasmania. It is also a win for any future governments.

If we invest in primary health care, access becomes quicker than in the past. We will have better health outcomes, which means we will have fewer hospitalisations. It will mean that patients will be healthier and communities will be healthier. People will be able to stay in their communities and get the support that they need, thereby reducing the need for those in rural and regional areas to travel long distances. This is a win for all Australians, and I think it is very good use of our health professionals so they're able to fulfil their professional capabilities. I commend the bill to the Senate, and I hope that it's not just going to be this bill that the people in One Nation are supporting. I wish that they would support all the recommendations that we have brought into this parliament to ensure better health outcomes for all Australians.