Wendy Askew (Tasmania, Liberal Party) | Hansard source

I rise to speak on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. As a senator for Tasmania, I'm acutely aware of the profound and persistent challenges facing Australia's healthcare system. Nowhere are those challenges felt more clearly than in my home state. Tasmania is, in many respects, a microcosm of the pressures confronting health care nationally. We have the oldest population in the country, we have higher rates of chronic disease and socioeconomic disadvantage, and we are a regional and dispersed state where geography and limited transport options continue to create real barriers to care. Taken together, these factors have produced a perfect storm for a healthcare system that is struggling not only to meet demand but to recruit and retain the skilled workforce required to deliver high-quality, timely care.

For Tasmanians, difficulty in accessing health care is not an occasional inconvenience; it is routine. Access to general practitioners, particularly in regional and rural communities, is increasingly limited. Emergency departments are under sustained pressure, and hospital flow is routinely constrained. Too often, patients who are well enough to leave hospital remain stuck in beds, not because they require acute care but because there are insufficient aged-care or disability placements available to safely discharge them. This has a ripple effect across the entire system, reducing capacity and increasing delays for others who need care.

Behind these patient-facing challenges sits a workforce crisis. Tasmania, like many jurisdictions, relies heavily on interstate and overseas locums to fill critical gaps. While those clinicians play an important role, this reliance comes at a significant and unsustainable financial cost, further straining already stretched health budgets. All of these pressures persist despite increased investment from the Tasmanian Liberal government and additional funding from the Commonwealth. That reality demonstrates a crucial point: simply spending more money without meaningful reform will not fix a system under structural stress.

Tasmania shows us plainly that the challenges facing health care are national in nature and that the responsibility for reform must sit here in Canberra. It cannot be left solely to the states and territories to absorb growing demand, workforce shortages and outdated models of care.

The coalition supports the intent of this bill. Expanding prescribing capabilities to registered nurses has the potential to improve access to medicines and make better use of the skills already within our health workforce, particularly in regional, rural and remote areas. However, the government's narrow approach means significant pressure points remain embedded in the system. By limiting this expansion to registered nurses alone and excluding other suitably qualified health professionals such as podiatrists, Labor has missed an opportunity for more comprehensive reform. Reducing the burden on our healthcare system will not occur through a single policy lever. The coalition agrees that we must start somewhere. We support taking prudent first steps, but we are clear eyed that this legislation on its own will not deliver the systemic change required to address workforce shortages or growing patient demand.

I am a member of the Community Affairs Legislation Committee, which recently inquired into this bill. We received compelling evidence from a wide range of stakeholders supporting the inclusion of registered nurses as PBS prescribers. The Australian Medical Association, the Australian Nursing and Midwifery Federation, private health insurers such as Bupa, and other clinical experts all spoke to the benefits this change could deliver for patients. That evidence should be acknowledged. However, my coalition colleagues and I remain disappointed that the government has failed to present a coherent whole-of-system plan to improve access to PBS subsidised medicines across the board. More than 20 submissions to the inquiry specifically called for podiatrists to be included in the expansion of prescribing powers, yet under this legislation podiatrists and podiatric surgeons will remain the only nationally endorsed health practitioners whose patients cannot access PBS subsidised medicines from their treating clinicians. This outcome underscores the ad hoc nature of Labor's approach.

These reforms stem from the Unleashing the Potential of our Health Workforce—Scope of Practice Review, a review commissioned and completed some 18 months ago. Despite its significance, stakeholders are still waiting for the government's formal response. Disturbingly, Senate estimates recently revealed that the government has not even committed to delivering a response at all. That uncertainty leaves health professionals, service providers and patients without clarity, direction or confidence in Labor's long-term intent. While this bill will deliver some benefits, it falls well short of what is required to address rising demand, workforce shortages and access inequities across the country. Expanding prescribing powers for nurses is a step forward, but it does not and cannot resolve the systemic issues that are crippling the sector.

Australia's healthcare system is under significant strain. Addressing that strain will require bold, coordinated and comprehensive reform. This bill should be the first step, not the final word. The coalition, with patients and the broader health sector, will continue to call on the government to provide a comprehensive response to the scope-of-practice review—one that clearly outlines its position on each recommendation and provides an indicative timeline for action. Such transparency would offer much needed certainty to stakeholders and demonstrate a genuine commitment to improving health outcomes for all Australians.