Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to 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".

Ellie Whiteaker (WA, Australian Labor Party) Share this | Link to this | Hansard source

The Albanese Labor government has a big agenda on health care—a big agenda to strengthen Medicare. We are committed to expanding access to the health care that Australians need, to making accessing health care more affordable for ordinary Australians right across the country. We want to make sure that Australians can get the health care and the medicines that they need when they need them at an affordable price. The truth is that, when we came to office, it had never been harder to access health care. It had never been harder or more expensive to see a doctor. Bulk-billing was in freefall after years of neglect by the Liberal Party. Too many Australians were putting off getting the health care they needed because they couldn't afford it. That's why strengthening Medicare has been a key focus for the Albanese Labor government since coming into government in 2022 and now into our second term—more bulk-billing, more nurses and doctors, and cheaper medicines, because what we know is that, when people can access the healthcare that they need, their outcomes are better. When they access care early, they can catch health issues sooner before they become more serious and costly to treat.

Everywhere I go I hear this same story from doctors and patients in the community, particularly in my home state of Western Australia. Patients say that, when it's tough for them to access the health care they need, they put off seeing a doctor. When medicines are more expensive, they put off buying the medicines that they need. This is why we have made the single largest investment in Medicare since it was created by Labor over 40 years ago, expanding bulk-billing so that more people can see a GP for free, delivering Medicare urgent care clinics right across the country, delivering Medicare mental healthcare clinics, training more doctors, supporting nurses and, of course, delivering cheaper medicines. We want to make sure that no Australian is held back from getting the health care that they need and that no Australian is left behind because of the cost.

This bill builds on that work in a really practical and targeted way. It is another example of our government's commitment to making health care more accessible and more affordable for Australians. It empowers nurses to work to their full scope of practice and will improve access to medicines for ordinary Australians. The bill allows registered nurses to prescribe certain medicines under the PBS. Simply, it means that patients will be able to get a prescription easier and at a lower cost. It ensures that care delivered in appropriate settings is backed by affordability and that access to medicines is not restricted by whom you see but by what you need.

This is about making better use of the healthcare workforce that we already have—the healthcare workforce that works day in and day out to help Australians. Registered nurses are highly trained, highly skilled and highly trusted. They are present right across the country and are often the first contact for patients. They play a critical role in delivering the health care that Australians need. But, too often, they're not able to work to their full scope of practice. This reform goes to changing that so that health care can be delivered further to those who need it most. Medicines can be accessed more quickly. Alongside our cheaper medicines plan, where medicines are $25 on the PBS and the lowest that they've been since 2004, it means the whole system works better—the right care delivered by the right professional at the right time.

We've seen the impact of our investment on health care right across the system, whether it's in primary care, in making GPs able to bulk-bill, in hospitals or in aged-care, disability and mental-health settings. We can see that our investment is working. I am seeing it in my home state of Western Australia. We are committed to a health system that works as a system. When different professionals across the healthcare sector are supported to do the work that they are more than capable of doing and to work at their full capacity, patients will see the full benefits.

Of course this matter everywhere across the country, but I think it is particularly important in rural, regional and remote parts of our country, where access to health care can be much more challenging. Travel is often required over long distances for basic care. This is another way we can support people in these parts in receiving the health care they need closer to home—easier access to the medicines that they need. We want patients to benefit from this faster, more coordinated care.

It is important to say that this bill is backed up by extensive research by the Nursing and Midwifery Board and the Chief Nursing and Midwifery Officer. We know that many registered nurses have the capacity to prescribe certain types of medicines, so this is something that we know will work. With a national registration standard already in place, we can kick off these nurse-prescribers pretty quickly, with the first cohort of enrolled nurse-prescribers expected from July this year, just a couple of months away. We are taking quick action to deliver this bill. It's a measured reform that improve access, supports affordability and will strengthen Medicare.

I am really proud of our government's record on health care. I am so proud to be a member of the Albanese Labor government, which is committed to making sure every Australian, no matter where in our great country they live, can access affordable and accessible health care. We want every Australian to know they can see a doctor when they need it, where they need it. We want nine out of 10 Australians to be able to see a bulk-billing GP. We want Australians to be able to afford the medicines they need. We don't want Australians to have to put off seeing a doctor or getting the medicines they need in order to stay well because cost is a barrier.

That is why we have made the biggest investment in Medicare since it was created 40 years ago. Medicare is a proud Labor legacy. It is our commitment to every Australian, no matter where they live, no matter their age, that they can access the health care they need when they need it. Only Labor is committed to doing the important work of protecting and strengthening Medicare.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

In the time I have today, I want to begin my speech on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This bill will enable qualified registered nurses, known as nurse prescribers, to work to their full scope of practice and support patient access to faster, more affordable, quality health care. Nurses have been pushing for this reform for a very long time. This is a change that is long overdue, and we must acknowledge that, historically, the role of nurses has been underappreciated and underutilised within our healthcare system.

The Greens are pleased to support this reform. This reform comes at an important time. To share the impact of this change, I'd like to quote Rebecca Manski, who gave an interview to the ABC. Ms Manski is a registered nurse in a rural New South Wales community who is training to become a nurse prescriber. She said:

Patients will feel validated that they're being heard and that their conditions are a priority to manage.

Earlier treatment, or prompt treatment, is going to reduce the likelihood of an unnecessary hospital admission

Patients feeling heard, having timely access to health care, earlier treatment and fewer hospitalisations—these are all good things, especially as we are seeing more and more people unnecessarily coming to spaces within the healthcare system that they need not be in, with additional unnecessary costs to them as members of our community in the context of a cost-of-living crisis.

The Consumers Health Forum today launched the results of their first National Consumer Sentiment Survey, which has found that while people generally trust the health system they cannot afford it. According to the report, 50 per cent of people avoided necessary health care in the past year because they could not afford it. This is completely unacceptable in a nation as wealthy as ours, and I'm pleased to be enabling nurse prescribers to treat the community and provide the community with essential medications that will help alleviate some of the cost burden people face.

To get the full benefits of this change, nurse prescribing needs to be implemented not only in hospitals but also in primary healthcare settings, such as local clinics and aged-care settings. This is critical. When this bill went before a Senate enquiry, many submissions made to the inquiry were largely supportive of the change, and I'd like to amplify some of those submissions.

Firstly, there's the Australian Primary Health Care Nurses Association submission, and I will quote it:

Nurses play a critical role in providing essential health care access, managing complex and chronic health conditions and keeping people out of hospitals which is particularly necessary where there is limited or no access to a regular general practitioner.

Slade Brockman (WA, Deputy-President) Share this | Link to this | Hansard source

Senator Steele-John, you will be in continuation. It being 12:15, I shall now proceed to senators' statements.