Charlotte Walker (SA, Australian Labor Party) | Link to this | Hansard source

For an older Australian leaving hospital, it could mean getting home sooner with the medication that they need. For someone living with a chronic illness, it could mean fewer appointments, less travel and one less obstacle to staying healthy. These might sound like small things, but they make a big difference in people's lives.

The Albanese government has been clear that strengthening Medicare isn't just about investing more money, although we have done that too. It's also about making sure our health workforce can work to the full extent of their skills, which means backing doctors, nurses and allied health professionals—and, ultimately, it means backing patients. This reform has been years in the making, with extensive consultation across the health sector and agreement from health ministers across the country. It has the appropriate safeguards, appropriate training requirements and clear professional standards. It's a sensible reform because it's built on evidence, not ideology.

There is another point worth making. Nursing is one of Australia's most trusted professions. Every day, nurses care for Australians at some of the most difficult moments in their lives with compassion, professionalism and skill. This bill, the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025, says that we recognise that expertise. It says we trust properly trained nurses to do the job they have prepared for and, most importantly, it says that the health system should be designed around patients, not bureaucracy. If someone can receive safe, affordable treatment closer to home more quickly and with fewer barriers, that's a good outcome. That's what this bill delivers. It's practical, it's sensible and it will make a real difference for communities right across Australia, especially those that have too often found themselves at the back of the queue when it comes to accessing health care. I commend the bill to the Senate.

Alex Antic (SA, Liberal Party) | Link to this | Hansard source

I rise to speak against the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 and I seek to set out some of the reasons for that. The bill speaks in the language of aiming to improve access to medicines, particularly in rural and regional Australia, to remove the pressure that's on the health workforce and, most notably, to allow registered nurses to work the full scope of their practice. These, of course, are legitimate policy goals for consideration, and they do deserve consideration, but the key question really is whether or not the proposed safeguards are sufficient to protect patients, nurses and collaborating practitioners from the risks, and I think there are quite a number of risks in what's being proposed here.

It's important that improved access to prescribing shouldn't be confused with improving health care itself. Many times in health care the actual act of prescribing is the end point of the diagnostic process. Of course, we know that nurses and nurse practitioners are highly skilled professionals, but they're not doctors; they're not trained medical professionals. Often times the training that the nurse will have will be focused on the care of the patient and all the other important stuff. There is, I see, a foreseeable risk that treatment might be even initiated before an underlying diagnosis has been adequately explored or excluded.

The bill also raises questions about medication safety, including adverse drug reactions, interactions and prescribing cascades, particularly in elderly patients, many of whom will have very complex chronic disease. As I've been speaking to people in the industry, they've described to me the risk of fragmented care, which is where assessment, diagnosis and prescribing and ongoing management are shared across multiple practitioners where no single clinician can assume overall responsibility for the patient's care.

Finally, the one that was so egregiously overlooked during the COVID period is the issue of informed consent. That really does require a particular degree of consideration here. Many patients are unlikely to understand the substantial differences in training and diagnostic expertise and the scope of practice between the nurse and the medical practitioner. Patients really should be able to make an informed decision about who's providing that care and the nature of the clinical decision-making involved.

The bill also heavily relies on prescribing agreements, endorsement standards and conditions of approval and regulatory oversight, but we should consider whether these are genuine clinical safeguards or primarily administrative safeguards. A safeguard ultimately is only effective in the prescription if it changes behaviour and reduces risk in practice. The existence of prescribing agreements doesn't necessarily measure and ensure meaningful supervision, clinical oversight or accountability. So my question is: will the proposed governance arrangements provide real-world protection or just be in the business of creating documentary compliance?

As you can see, there are a range of issues that arise as a result of this bill. One that really hasn't been properly covered is the risks to the nursing profession itself. With the responsibility of prescribing what can be up to schedule 8 drugs, the reform in this bill may actually expose nurses to increasing complaints, to litigation, to regulatory scrutiny and to professional liability. So the issue is not really whether the nurses are capable and whether they're able to do this job. Rather, it's a question of whether or not workforce shortages are being addressed by transferring responsibilities which were traditionally borne by medical professionals and trained practitioners, without equivalent safeguards and support structures. The nursing profession, of course, has an enormously high level of public trust. Arguably, it may be said in some circumstances the nurses are even more trusted than the doctors themselves. But any expansion of prescribing authority has got to be accompanied by clear accountability, sound governance and ongoing evaluation.

Finally, this does overlay the cloud of overprescription. We know that pharmaceutical companies love nothing more than getting their products into the hands of willing recipients. For those reasons—and many, many others—I simply won't be supporting this bill today.

Dorinda Cox (WA, Australian Labor Party) | Link to this | Hansard source

I rise to speak in support of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This is a practical and carefully designed piece of reform. It makes sure that Australians can access medicines through the Pharmaceutical Benefits Scheme when those medicines are prescribed by appropriately qualified, endorsed and authorised registered nurses. At its heart is a simple Labor principle. It's about getting quality health care. All you should need is your Medicare card, not your credit card. That's what Medicare is about, that's what the PBS is also about and that's what this bill helps to deliver.

This bill amends the National Health Act 1953 to enable endorsed registered nurses, known as designated registered nurse prescribers, to prescribe certain pharmaceutical benefits under the PBS. It also amends the Health Insurance Act 1973 so the Professional Services Review can review PBS prescribing by nurse prescribers, ensuring that they are subject to the same oversight as other PBS prescribers.

This bill establishes a regulated Commonwealth PBS framework as well. It creates the approval process for authorised nurse prescribers to allow approvals to be suspended or revoked, including nurse prescribers as a category of the PBS prescriber. It enables the minister to specify which benefits they may also prescribe and ensures that patients can access those medicines through the PBS. That is all extremely important.

Authorising a nurse to prescribe is only part of this reform. The other part is making sure that, when a patient receives a prescription, they can access the medicine affordably through the PBS. Without this bill, we risk creating a gap between what the health workforce is trained and authorised to do and what patients can afford to access. That would simply be not fair. It would especially be not fair for people who live in regional, rural and remote communities and, in particular, in my home state of Western Australia.

This bill doesn't replace doctors or diminish the role of GPs or specialists or pharmacists or nurse practitioners, but it absolutely complements the existing health workforce. It supports team based care and allows nurses to work to the full scope of their training, endorsement and professional capability. Designated registered nurse prescribers must meet the requirements set by the Nursing and Midwifery Board of Australia. They must have proper education, qualifications and endorsement. They must prescribe within their competence and scope of practice and within a clinical governance framework in partnership with an authorised health practitioner and under an active prescribing agreement. So this is definitely not a loose model. It is regulated, it is accountable and it is designed around safe and collaborative care.

Registered nurses are already at the centre of health care in this country. They are often the health professionals people see first, know best and absolutely trust the most. In regional, rural and remote Australia—especially, again, in my home state of Western Australia—nurses are often holding the health system together. They are in hospitals, community clinics, Aboriginal community controlled health services, aged-care settings, schools, outreach services, palliative care services and primary care teams. They manage chronic conditions. They support families. They provide things like wound care, vaccinations, health education, screening and also follow up. They are often known to the patient, they know the family and sometimes they also know the community. Importantly, they know what delay means.

In a metropolitan area, a delayed prescription might mean booking another appointment or waiting until another day, and that's frustrating enough. But, in a rural or remote community in Western Australia, delay can mean something very different. It can mean a long drive. It can mean taking time off work. It can mean arranging transport. It can mean waiting for the next visit to a clinician. It can mean a patient deciding it's all too hard and, in fact, going without. For someone with a chronic condition, that delay can mean also deterioration of their condition. For an older person in aged care, that can mean unnecessary distress. For someone receiving palliative care at home, it can mean pain that could have been avoided. For a woman seeking time-sensitive reproductive healthcare, it can mean uncertainty, cost and a loss of control. For someone in a remote Aboriginal community, it can mean the difference between care close to home and care that requires leaving a community. This is why nurse prescribing matters. This is not an abstract workforce reform. It's a practical access reform.

Western Australia in particular understands this. WA Health has recognised that designated registered nurse prescribing can strengthen access to timely, safe and reliable medicines, particularly for people who live in rural and remote communities and in aged-care settings. In a WA first, Edith Cowan University has launched a Graduate Certificate in Registered Nurse Prescribing, and that course will upskill experienced registered nurses so they can safely prescribe or renew medications in partnership with authorised independent prescribers such as doctors and nurse practitioners. That matters because workforce challenges are absolutely real.

Across regional WA, communities simply cannot wish more health professionals into existence. We need to fully utilise the skills of the workforce that we absolutely have, and we need to support all of our nurses to work to their full scope of practice. We need to build team based care that reflects the realities of country WA, not just the convenience of metropolitan service models. A nurse in a regional clinic should not have to identify the need for a medicine, know that the patient needs it, know that delay will make it worse and then be prevented from helping someone simply because the PBS framework cannot keep pace.

That's what this bill absolutely fixes. It brings Commonwealth PBS law into line with modern health care. It reflects the direction of the Strengthening Medicare Taskforce and the Scope of Practice Review. Our health system must support health practitioners and professionals to work to their full scope of practice. When nurses can do the work that they are trained and authorised to do, patients get care sooner, GPs and other health professionals are better supported and the pressure that's on hospitals and acute care is reduced. Communities, particularly rural and regional communities, especially have a great benefit from getting a health system that works better for them.

The Senate inquiry into this bill received submissions that reflected strong support from across the health sector. This bill sets that legislative foundation. It creates the framework, accountability and PBS access needed for the model to operate safely and fairly. The committee recommended that the bill be passed, and I'm pleased to speak today in support of that. This bill is about access. It's about affordability. It's about strengthening primary care. It's about backing nurses. It's also about recognising that, in a state as vast as Western Australia, health care cannot be designed only around an assumption that every patient has a GP appointment just around the corner. For people in the Kimberley, the Pilbara, the Goldfields, the Wheatbelt, the Great Southern, the Mid West, the South West and communities right across my beautiful home state and regional Western Australia, health access depends on practical reforms just like this. It depends on making sure that a health professional who is there, who is qualified, who is trusted and who is authorised can actually help them.

Labor built Medicare. Labor created the PBS. Labor believes health care should depend on your need, not your post code and definitely not the size of your wallet. This bill honours that principle in a practical way. It says that when a nurse is properly trained, endorsed and authorised to prescribe, the patient should not lose access to affordable PBS medicines. That is simple. That is fair. For rural and regional WA, this bill matters.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) | Link to this | 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.

Helen Polley (Tasmania, Australian Labor Party) | Link to this | 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.

Josh Dolega (Tasmania, Australian Labor Party) | Link to this | Hansard source

I rise in support of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This bill introduces a practical reform to improve the efficiency of our health system and ensure Australians can access timely health care. This bill amends the National Health Act and the Health Insurance Act to enable nurse practitioners to prescribe certain medicines under the Pharmaceutical Benefits Scheme, and this will in effect help Australians get the care and medicines they need when they need them.

Strengthening Medicare has been a key priority of the Albanese government since we came into office in 2022. When we did, it had never been harder or more expensive to see a doctor. Bulk billing was in decline, and too many Australians were putting off seeking care because of cost. That shouldn't happen in a country like Australia, so we've acted. We've made the largest investment in Medicare in its 40-year history. We've tripled the bulk-billing incentive. We've expanded the Medicare urgent care clinics to take pressure off hospitals and provide walk-in care for urgent but non-life threatening conditions. In Tasmania, this includes eight urgent care clinics, which are already making a real difference for families. These services are giving people confidence that they can get seven-days-a-week bulk-billed care close to home. They are easing pressure on the hospital emergency departments in Burnie, Launceston and Devonport, and we've got five around Hobart. They're ensuring that local healthcare workers can deliver care in the right settings at the right time.

Investments have also been made in general practice, headspaces, aged care, women's health and mental health support, and primary care infrastructure alongside direct investment in the GP workforce, but we know there is more to do. This bill builds on that work in a practical and tangible way. It acts on the Strengthening Medicare Taskforce and the Unleashing the potential of our health workforce review, which identified that highly trained nurses are often restricted from practising to their full potential due to outdated regulatory frameworks. This bill changes that. It allows appropriately trained and endorsed registered nurses to prescribe certain medicines under the PBS. This means patients can get prescriptions more easily, more quickly and often at a lower cost. This is about using the skills of our healthcare workers more efficiently.

Our nurses are highly trained, highly skilled and trusted professionals. They are often the first point of contact for patients, especially in regional community settings. For too long, outdated rules have limited what they can do. This reform changes that. It will empower nurses to work within their full scope of practice while maintaining the high-safety standards that Australians expect. Only nurses who meet the Nursing and Midwifery Board's requirements will be able to prescribe, and the medicines list will continue to be independently reviewed to ensure patient safety. Oversight arrangements are also being strengthened to protect the integrity of the system.

This is a careful evidence based reform that improves access without compromising quality. It will also take pressure off other parts of the system. By allowing nurses to manage straightforward cases, we can reduce unnecessary appointments and free up our GPS to focus on more complex care. This will mean shorter wait times, more efficient services and better outcomes for patients. We know this matters, especially in rural and regional communities like Tasmania, where access to health care can be more challenging and travel distances can be greater. These changes will help people get care closer to home without unnecessary delays.

This bill is part of a broader effort to modernise our health system and build a stronger, more connected model of care. The future of primary care is team based. It brings together doctors, nurses and allied health professionals, each playing their role. This reform supports that approach. It doesn't replace doctors; it supports them. It also complements our work to make medicines more affordable. Whether it's reducing PBS costs, listing new treatments or investing in women's health, we are focused on easing the cost-of-living pressures and improving access.

Millions of Australians are already benefiting from cheaper medicines and better services, and this bill builds on that progress. More broadly, we're investing in the workforce that underpins the entire system. We are training more doctors, we are supporting nurses, and we are supporting primary care. The Albanese Labor government is allocating $14.5 million to provide 306 additional GP training places in 2026 through the Australian General Practice Training Program. This initiative will increase the total number of doctors commencing GP training to approximately 2,100, representing a 14 per cent rise compared to 2025.

Continued government support has resulted in a greater number of doctors in the Australian health system over the past three years than at any point in the previous decade. We know that a strong health system depends on people, skilled supported health professionals delivering care every day. This bill is about making the system work better for patients. It's about removing barriers, improving access and making care that is delivered in the right place at the right time by the right professional.

I'm proud to be part of a government that is committed to strengthening Medicare and ensuring that no Australian is left behind because of the cost of care. This bill is sensible, it's practical and it will make a real difference, and I commend the bill to the Senate.

Carol Brown (Tasmania, Australian Labor Party) | Link to this | Hansard source

I rise today to speak in support of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This is an important reform that will help ensure Australians can access medicines they need when they need them and at an affordable price through the Pharmaceutical Benefits Scheme. At its heart, this bill is about improving access to health care and making better use of the skills and expertise that already exist within our health workforce. It's about ensuring registered nurses can work to their full scope of practice while maintaining appropriate safeguards and professional oversight.

The bill amends the National Health Act 1953 and the Health Insurance Act 1973 to enable suitably qualified and endorsed registered nurses to prescribe certain medicines under the PBS and to bring their prescribing services within the Professional Services Review framework. These reforms build upon the new national registration standard approved by Commonwealth, state and territory health ministers, which established the role of the designated registered nurse prescriber. The first cohort is expected to commence prescribing from July 2026—so from tomorrow.

For Tasmania, these reforms will be particularly significant. Tasmania has one of the oldest populations in the nation. We have communities spread across a large geographic area, and many Tasmanians live in rural, regional and remote locations where accessing health care can be challenging. Whether it's on the west coast, in the north-east, on King Island or Flinders Island, or in smaller regional communities, many people face long travel times to see a doctor, particularly for routine healthcare needs. Nurses are often the healthcare professionals who know these communities best. They are trusted and highly skilled and already play a central role in delivering care across our state.

By allowing designated registered nurse prescribers to prescribe certain PBS medicines, we can reduce unnecessary delays, improve continuity of care and make it easier for Tasmanians to access treatment close to home. For an elderly Tasmanian managing a chronic condition, this would mean obtaining timely access to medication without waiting weeks for a GP appointment. For families in regional communities, it could mean receiving care sooner and avoiding lengthy travel. For aged-care residents, it could mean more responsive treatment delivered by health professionals already involved in their care. These reforms recognise the reality of modern health care. They acknowledge that healthcare delivery is increasingly team based and that nurses have an essential role to play in meeting growing healthcare demands.

Importantly, this bill does not remove safeguards. Nurses will be required to meet rigorous education, training and endorsement requirements before becoming authorised prescribers. Their prescribing will occur within established regulatory frameworks and will be subject to the same professional scrutiny and accountability that Australians rightly expect.

This legislation is also part of a much broader agenda by the Albanese government to strengthen Medicare and rebuild Australia's healthcare system after years of neglect. Since coming to government, Labor has delivered the largest investment in Medicare in decades. We've expanded bulk-billing through the tripling of the bulk-billing incentive, helping millions of Australians access free visits to their GP. We are delivering additional Medicare urgent care clinics across the country, including in Tasmania, ensuring people can access urgent care without needing to attend a busy hospital emergency department. We have made medicines cheaper by reducing the maximum cost of PBS prescriptions, easing cost-of-living pressures for families, pensioners and concession card holders. We have delivered the largest investment in strengthening Medicare's primary-care workforce, supporting the doctors, nurses and allied health professionals who are the backbone of our healthcare system.

The Albanese government has also invested heavily in women's health, mental health services, aged-care reform and strengthening healthcare access in rural and regional Australia. For Tasmania, these investments are making a real difference. Tasmanians are benefiting from stronger Medicare services, cheaper medicines, expanded urgent-care options and targeted investments in healthcare infrastructure and workforce development.

This bill complements those initiatives. It recognises that improving healthcare access is not achieved through a single reform. It requires a comprehensive approach that supports patients, strengthens Medicare and enables health professionals to work effectively together. This reform before us today is consistent with the recommendations of the Strengthening Medicare Taskforce and the Scope of Practice Review, both of which recognise that better utilisation of healthcare professionals can improve access to care while maintaining safety and quality. As demand on our health system continues to grow, particularly in regional states such as Tasmania, we must embrace sensible reforms that improve capacity and improve patient care. This legislation does that exactly. It supports our nurses, it supports our community, it supports affordable access to medicine and it supports a stronger Medicare system for all Australians.

The Albanese government was elected with a commitment to strengthen Medicare and improve access to health care. This bill is another example of that commitment being delivered, and that is the difference between Labor and the parties of the right. Labor asks how we can make health care more affordable and accessible. The Liberals and the Nationals have repeatedly asked how much they can cut, and how much more patients can pay.

The Abbott government tried to impose a $7 fee on GP visits. It then proposed a $5 fee and extended the freeze on Medicare rebates, putting more pressure on doctors and patients. The coalition treated universal health care as a budget problem to be managed down, rather than a national institution to be protected. The Nationals backed those decisions every step of the way. They did so, despite the greatest impact often being felt in regional communities—communities they claim to represent—where workforce shortages, travel distances and fewer services already make access harder. Then there is One Nation. It talks about protecting Medicare, but its own policy proposes abolishing the Therapeutic Goods Administration and reviewing $3 billion worth of medicines approved for the PBS. Australians should be very cautious when a party promises to protect health care while proposing to pull apart the institutions that keep medicines safe and accessible. The Liberals, Nationals and One Nation may use different slogans, but they share the same instinct: to weaken public systems, undermine expert institutions and leave individuals to carry more of the costs and risks themselves.

Labor takes a different view. We believe health care is a right, not a privilege. I am proud to support these reforms, because they will help Tasmanians receive the care they need, closer to home, sooner and more affordably. I commend the bill to the Senate.

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) | Link to this | Hansard source

The Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 amends the National Health Act 1953 to authorise designated registered nurses as prescribers under the Pharmaceutical Benefits Scheme. These nurses will be able to prescribe specific medicines that qualify for Commonwealth subsidy under the PBS. This bill advances scope-of-practice reforms identified by the Unleashing the potential of our health workforce review and the Strengthening Medicare Taskforce. Since 2017, the Nursing and Midwifery Board of Australia and chief nursing and midwifery officers have conducted extensive research and consultation on nurse-prescribing models. The NMBA developed the standards—

Debate interrupted.