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

by leave—I, at the request of Senator Lambie, move Jacqui Lambie Network amendments (1) and (2) on sheet 3666 together:

(1) Schedule 1, heading, page 3 (line 1), omit "Amendments", substitute "Amendments relating to nurses".

(2) Page 12 (after line 4), at the end of the Bill, add:

Schedule 2 — Amendments relating to podiatrists

Health Insurance Act 1973

1 Subsection 81(1)

Insert:

eligible podiatrist prescriber has the same meaning as in Part VII of the National Health Act 1953.

2 Subsection 81(1) (paragraph (b) of the definition of service )

After "an optometrist,", insert "an eligible podiatrist prescriber,".

3 Subsection 92(7) (after paragraph (ba) of the definition of Part VII authority )

Insert:

(baa) the approval of an eligible podiatrist prescriber as an authorised podiatrist prescriber under section 84AADB of that Act;

4 Subsection 106U(5) (after paragraph (ba) of the definition of Part VII authority )

Insert:

(baa) the approval of an eligible podiatrist prescriber as an authorised podiatrist prescriber under section 84AADB of that Act;

National Health Act 1953

5 Subsection 4(2)

After "(1C),", insert "(1CA),".

6 Subsection 84(1)

Insert:

authorised podiatrist prescriber means an eligible podiatrist prescriber in relation to whom an approval is in force under section 84AADB.

eligible podiatrist prescriber has the meaning given by section 84AADA.

7 Subsection 84(1) (after paragraph (c) of the definition of PBS prescriber )

Insert:

(ca) an authorised podiatrist prescriber; or

8 Subsection 84(1) (after paragraph (a) of the definition of prescriber bag provisions )

Insert:

(aa) section 93AAA (supplies by authorised podiatrist prescribers);

9 After section 84AAD

Insert:

84AADA Meaning of eligible podiatrist prescriber

(1) For the purposes of this Part, a person is an eligible podiatrist prescriber if the person:

(a) is a podiatrist; and

(b) meets the requirements set out in a determination made under subsection (3).

(2) However, if there is no determination in force under subsection (3), a person cannot be an eligible podiatrist prescriber for the purposes of this Part.

(3) The Minister may, by legislative instrument, determine one or more requirements that a specified person must meet in order to be an eligible podiatrist prescriber for the purposes of this Part.

(4) The requirements that may be determined under subsection (3), include (but are not limited to) one or more of the following:

(a) a requirement to hold particular qualifications in podiatry;

(b) a requirement to have particular experience in podiatry;

(c) a requirement to be endorsed by a particular body.

84AADB Authorised podiatrist prescriber

(1) An eligible podiatrist prescriber may apply to the Secretary, in writing, to be an authorised podiatrist prescriber for the purposes of this Part.

(2) The Secretary may approve the application if satisfied that the eligible podiatrist prescriber meets the criteria determined under paragraph (3)(a). The approval is subject to any conditions determined under paragraph (3)(b).

(3) The Minister may, by legislative instrument, determine either or both of the following:

(a) criteria by which applications are to be considered under this section;

(b) conditions to which approvals under this section are subject.

(4) Without limiting paragraph (3)(a), the criteria may include the following:

(a) a requirement to have an agreement (a podiatrist prescriber agreement) in place with one or more other kinds of PBS prescribers;

(b) a requirement to have specified features in a podiatrist prescriber agreement.

(5) Without limiting paragraph (3)(b), the conditions may include the following:

(a) a condition that podiatrist prescriber agreements are to be retained and produced to the Secretary on request;

(b) a condition that the eligible podiatrist prescriber does not, under a podiatrist prescriber agreement, prescribe a pharmaceutical benefit that could not be prescribed by a PBS prescriber with whom the agreement is made.

(6) The Secretary must, as soon as practicable, approve or reject an application under subsection (1) and notify the applicant in writing of the decision.

Note: Section 266 of the Administrative Review Tribunal Act 2024 requires the person to be notified of the person's review rights.

84AADC Secretary may suspend or revoke approval of authorised podiatrist prescriber

(1) The Secretary may suspend or revoke an approval under section 84AADB if satisfied that the person to whom the approval relates:

(a) is not, at the time of the suspension or revocation, an eligible podiatrist prescriber; or

(b) does not, at the time of the suspension or revocation, meet the criteria that would apply if the person were to apply under subsection 84AADB(1) to be an authorised podiatrist prescriber at that time; or

(c) has breached a condition to which the approval is subject under paragraph 84AADB(3)(b); or

(d) has breached a condition to which an approval would be subject under paragraph 84AADB(3)(b) if the person were to apply under subsection 84AADB(1) to be an authorised podiatrist prescriber at that time.

(2) Before deciding to suspend or revoke the approval, the Secretary must notify the person that suspension or revocation is being considered. The notice must:

(a) be in writing; and

(b) include the Secretary's reasons for considering the suspension or revocation; and

(c) invite the person to make written submissions to the Secretary within the period of 28 days (the submission period) after being given the notice.

(3) In deciding whether to suspend or revoke the approval, the Secretary must consider any written submissions made by the person during the submission period.

(4) The Secretary must give to the person written notice of the decision. If the decision is to suspend an approval, the notice must specify the period for which the approval is suspended.

Note: Section 266 of the Administrative Review Tribunal Act 2024 requires the person to be notified of the person's review rights.

(5) If the Secretary does not give the person written notice of the decision within the period of 60 days after the end of the submission period, the Secretary is taken to have decided not to suspend or revoke the approval.

(6) If the Secretary suspends the approval, the Secretary may, by written notice at any time, further suspend or revoke the approval under subsection (1) or remove the suspension.

84AADD Review of decisions relating to authorised podiatrist prescribers

(1) If the Secretary:

(a) decides not to approve an eligible podiatrist prescriber under section 84AADB; or

(b) suspends or revokes an approval under section 84AADC;

the person to whom the approval relates may apply, in writing, to the Secretary for reconsideration by the Secretary of the decision.

(2) On receiving an application under subsection (1) relating to a decision not to approve an eligible podiatrist prescriber under section 84AADB, the Secretary must reconsider the decision and:

(a) affirm the decision; or

(b) approve the eligible podiatrist prescriber.

An approval under paragraph (b) is taken, for the purposes of this Act, to be an approval under section 84AADB.

(3) On receiving an application under subsection (1) relating to a suspension or revocation of an approval under section 84AADC, the Secretary must reconsider the decision and:

(a) affirm the suspension or revocation; or

(b) reinstate the approval.

A reinstatement under paragraph (b) has effect as if the approval had never been revoked.

(4) The Secretary must give to the applicant written notice of the Secretary's decision under subsection (2) or (3).

Note: Sections 105AC of this Act and 266 of the Administrative Review Tribunal Act 2024 require the person to be notified of the person's review rights.

(5) In this section:

decision has the same meaning as in the Administrative Review Tribunal Act 2024.

10 After subparagraph 86(1)(b)(iii)

Insert:

(iiia) podiatry treatment by an authorised podiatrist prescriber; or

11 After subsection 88(1C)

Insert:

(1CA) Subject to this Part, an authorised podiatrist prescriber is authorised to write a prescription on or after 1 July 2026 for the supply of any pharmaceutical benefit determined from time to time by the Minister for the purposes of this subsection, by legislative instrument.

12 Subsection 88(1EA)

After "(1C),", insert "(1CA),".

13 Subsection 88(1F)

After "(1C),", insert "(1CA),".

14 After paragraph 88(3)(c)

Insert:

(ca) by an authorised podiatrist prescriber otherwise than in relation to the podiatry treatment by the authorised podiatrist prescriber of a person requiring that pharmaceutical benefit; or

15 Paragraph 89(b)

After "section 93,", insert "section 93AAA,".

16 After section 93

Insert:

93AAA Prescriber bag supplies — authorised podiatrist prescribers

(1) Except as prescribed by the regulations, an authorised podiatrist prescriber is authorised to supply such pharmaceutical benefits as the Minister, by legislative instrument, determines to persons who are entitled under this Part to receive those pharmaceutical benefits.

(2) For the purposes of this section, the Minister may, by legislative instrument, determine the maximum quantity or number of units of a pharmaceutical benefit which may be obtained by an authorised podiatrist prescriber during a specified period.

(3) The regulations may make provision for or in relation to the obtaining of pharmaceutical benefits by an authorised podiatrist prescriber for the purposes of this section.

(4) The regulations may make provision for or in relation to payments by the Commonwealth in respect of the supply of pharmaceutical benefits under this section.

17 After paragraph 98(1)(c)

Insert:

(ca) an authorised podiatrist prescriber requests that the authorised podiatrist prescriber's approval as an authorised podiatrist prescriber under section 84AADB be cancelled; or

18 After paragraph 99ZJ(4)(aa)

Insert:

(aaa) a letter from an authorised podiatrist prescriber signed on or after 1 July 2026 to that effect; or

19 Subparagraph 99ZJ(4)(b)(ii)

After "optometrist,", insert "authorised podiatrist prescriber,".

20 After paragraph 99ZJ(4A)(a)

Insert:

(aa) for substances prescribed by an authorised podiatrist prescriber—on or after 1 July 2026; or

21 Subsection 99ZJ(5)

After "(aa)", insert "(aaa),".

22 After subparagraph 99ZK(3)(c)(iii)

Insert:

(iiiaa) a letter from an authorised podiatrist prescriber signed on or after 1 July 2026 to that effect; or

23 Paragraph 103(4AA)(a)

After "midwifery treatment,", insert "the podiatry treatment by an authorised podiatrist prescriber,".

24 After subsection 105AB(3)

Insert:

(3A) An application may be made to the Tribunal for review of a decision of the Secretary under paragraph 84AADD(2)(a) or (3)(a).

25 After paragraph 133(1)(ba)

Insert:

(baa) in the case of a defendant who is an authorised podiatrist prescriber—suspend:

(i) the approval of that person under section 84AADB; or

(ii) the authority to supply prescribed pharmaceutical benefits conferred upon that person by section 93AAA; or

26 Subsection 133(6)

After "optometrist,", insert "a podiatrist,".

27 Subsection 133(7)

Insert:

authorised podiatrist prescriber has the same meaning as in Part VII.

28 After paragraph 134(1)(c)

Insert:

(ca) the approval of a person as an authorised podiatrist prescriber under section 84AADB is suspended or revoked; or

29 After paragraph 134(4)(a)

Insert:

(aa) an approval of a person as an authorised podiatrist prescriber under section 84AADB;

30 Before paragraph 134(4)(d)

Insert:

(cb) an authority conferred upon an authorised podiatrist prescriber by section 93AAA;

31 After paragraph 135A(6)(gb)

Insert:

(gc) a person or persons who, under a law of a State or Territory that provides for the registration of podiatrists, or the authorisation (however described) of persons to practise as podiatrists, are empowered to:

(i) take disciplinary action with respect to podiatrists; or

(ii) investigate podiatrists in connection with the taking of such disciplinary action; or

32 Paragraph 135A(9)(c)

After "(gb)", insert ", (gc)".

33 After paragraph 139A(1)(db)

Insert:

(dba) a person was or was not an authorised podiatrist prescriber under section 84AADB;

34 Paragraph 139A(1)(de)

After "93,", insert "93AAA,".

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) | Link to this | Hansard source

I rise to speak to the amendment that's been moved by One Nation at the request of Jacqui Lambie. Can I just put on the record that the coalition will be supporting this amendment.

As identified in the Senate committee process, podiatrists have long raised concerns about their exclusion from this bill, as they currently face very similar issues to those that have been faced by nurses, and about the response of the government to those concerns raised by nurses. Specifically, while, under state and territory law, podiatrists can legally prescribe certain medicines, such as painkillers and antibiotics, as part of their scope of practice, they cannot currently issue such scripts under the PBS, as federal legislation does not enable it.

This amendment that has been put forward by Jacqui Lambie aligns with the coalition's broader position on the bill: that health professionals should be able to prescribe and issue a script under the PBS—that is, under federal law—for any medicines that they are already legally permitted to prescribe under state and territory law. The government has not provided any substantive argument as to why podiatrists cannot be also included in this bill. We urge the government to incorporate podiatrists as part of this bill, alongside nurses, so that Australians can get the access to the affordable medicines that the government keeps telling them that they're able to get access to.

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

The government won't be supporting these amendments. The government is committed to supporting access to health care and affordable medicines and to enabling health professionals to work to their optimal scope of practice safely. There has been extensive consultation, including with medical peak bodies and colleges, such as the AMA and the RACGP, over a period of 10 years, and that has contributed to this bill enabling designated registered nurse prescribers to become authorised prescribers under the National Health Act.

This same consultation and careful planning has not yet occurred for podiatrists. However, the government has engaged with stakeholders, including the Australian Podiatry Association, on the issue of access to PBS subsidies for endorsed podiatrists. Suggestions to expand access to the PBS to other professions are outside the scope of this bill, and they should be undertaken through a separate process. The Podiatry Board is currently working with the National Medicines and Poisons Advisory Group on updating the podiatry endorsement for scheduled medicines. The board will return to the advisory group later in 2026 as work progresses, including to facilitate broader consideration of endorsement for scheduled medicine arrangements for the wider podiatry profession. Accordingly, these steps—sensible, orderly steps—should be completed before podiatrists are considered for inclusion under the act.

I make the further point that any delay in passing this bill, the one that has been subject to consultation and has been worked through in the ordinary way, will result in a failure to utilise Australia's largest and most geographically dispersed health workforce: 400,000 hardworking nurses across the country. It will delay patients in regional areas from accessing cheaper medicines. It will delay efforts to strengthen the delivery of high-quality care in aged-care settings, supporting residents to receive the right care at the right time.

The sector has been preparing for this change. The sector has been preparing for the change that is before the parliament today. Universities are already accredited and delivering the required education programs, students commenced in January this year and the first registered nurses are graduating now. All states and territories are progressing updates to their drugs and poisons legislation to permit nurse prescribing. The ACT, Northern Territory and South Australia have already made these changes. The Pharmaceutical Benefits Advisory Committee, the PBAC, has begun recommending amendments to listings to add designated RN prescribers as authorised prescribers.

This is important work. It has been a long time coming. We are so pleased to be championing these reforms because we know how important they will be for patients, and for citizens, right across the country. We encourage the relevant podiatry organisations, including the Podiatry Board and the Australian Podiatry Association, to continue to work with the department, of course, and to continue to work with the Medicines and Poisons Advisory Group, with health ministers and other health and medical peak bodies on access to medicines in the PBS, as the nurses have for the last 10 years.

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

The question is that amendments (1) and (2) on sheet 3666 be agreed to.