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

I move:

That the committee does not insist on its amendments to which the House of Representatives has disagreed.

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

The coalition is not going to insist on these amendments. But I would draw to the attention of the chamber the basis of the amendment, that was put forward by Senator Lambie, actually served to support two cohorts of people more particularly than others by endorsing podiatrists to be able to prescribe within their scope. It was to make sure that people who live in rural and regional areas, who often don't have access to a GP, and who have gone to their podiatrists are able to get access to the medications on the PBS that they need. And let's not forget, this is not about allowing podiatrists to prescribe. This is about podiatrists who already can prescribe being able to get access to medications on the PBS for their patients.

The other group of people who are most impacted by this are older Australians. We know that older Australians, more than younger Australians, rely on having their feet looked after. Australians who live with disability are also more likely to need the services of a podiatrist.

What we have here is the government refusing to accept an amendment that would allow people in rural and regional Australia, older Australians and people who live with a disability the ability for their prescribing podiatrist to actually let them get their medications on the PBS. The only options that now remain, because they're refusing to let this amendment go through, are these: they can either pay full tote odds for those medications or they've got to go and make a second appointment to visit a GP so they are able to get those medications on the PBS. This is an absolutely egregious decision by those in the other place not to allow this amendment to go through.

I absolutely commend Senator Lambie for putting the amendment forward. I also acknowledge the fact that the Greens supported this amendment. But we won't stand in the way of nurse prescribers being able to prescribe in the same way as I've just outlined for podiatrists. We obviously want to make sure that the people who are able to get their prescriptions by that mechanism are able to get it on the PBS.

The government needs to have a very close look at some of the pettiness of their decision-making, particularly when they have not even responded to the scope of practice review, which was handed to them nearly two years ago, that actually outlined why this was so important. But, as I said, we won't stand in the way of this because we believe nurse prescribers should be able to prescribe to make sure that more Australians are able to get access to cheaper medicines. This move by this government, to not accept this amendment, is actually making sure that medicines are more expensive—not cheaper medicines, more expensive medicines—than they would otherwise be able to get if you'd let this amendment go through.

David Pocock (ACT, Independent) | Link to this | Hansard source

I'd like to commend the government on their changes to the scope of practice for nurses. This is a very welcome change. I want to acknowledge everyone who's been pushing for this change for many years now—the hard work that has gone into making the case and building up the evidence base—and the government for actually going ahead with it.

I am confused, though, about the government's reluctance to allow prescriptions from podiatrists to be covered by the PBS. As Senator Ruston said, this is already happening—podiatrists can prescribe, but Australians just have to pay a lot more. Here in Canberra, where we have a shortage of GPs, it's very hard to get in to see a GP—at short notice it's almost impossible—and we have the highest gap fee in the country. We have an average 50-buck gap fee. We're essentially saying to mostly older Australians who go and see their podiatrist and have something prescribed that they now need to book in to see a GP and go to the GP to get the script that the podiatrist gave them prescribed by the GP so they're covered by the PBS.

We hear a lot about productivity. We hear a lot about the cost of living. We hear a lot about caring for older Australians. It seems like such a sensible move for the parliament to say, 'Podiatrists are already prescribing; we accept that; it's working well; we're simply going to cover those prescriptions with the PBS.' I really think we need an explanation from the government as to why they're not backing this change. This seems like evidence based policy. It seems like it's in the best interests of all Australians and builds on the health system that we have. On behalf of Canberrans, I want to raise my concerns about a government that won't back an amendment from the Senate that I think is clearly in line with what most Australians would probably already think happens—if you can prescribe, you're covered by the PBS.

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

I want to place a couple of things on the record. First of all, I want to very clearly state the Australian Greens' support for the underlying legislation. This is a good reform. We would have liked to see the government pass this legislation earlier in the year. There were many opportunities for this bill to be resolved and passed earlier in the parliamentary agenda. There was a guillotine in March that they could have added it to. There was a guillotine at the beginning of the week they could have added it to. I know waiting to see the resolution of this legislation has caused a bit of stress and strain for the profession. As I said, we support this reform, so we will not be insisting on the amendment that passed the Senate but has been rejected by Labor in the House in order to see this legislation pass and for the profession to have certainty.

I will also say this. I read the government's reasoning for rejecting this amendment last night. It's a very simple amendment, an amendment which would have ensured, had the government supported it, that Australians that seek the healthcare support of endorsed podiatrists were able to receive and fill scripts from their podiatrists that were claimable and usable under the Pharmaceutical Benefits Scheme. It's a very sensible amendment. It closes one of the ridiculous gaps and loopholes in our healthcare system.

As others have contributed and stated very clearly in this debate, right now, Australians—a lot of older Australians, a lot of disabled people—who seek the expertise of an endorsed podiatrist or podiatric surgeon, those professionals who are enabled by state and territory law to prescribe, are in the position where they then face additional costs because they cannot utilise the PBS to fill in that script. They have to go back to the GP, where they then face the very real prospect of having to pay a gap fee before then getting a script that would then allow them to get the medication that they need more affordably. That doesn't make sense. It creates additional cost for the person seeking health care. It creates unnecessary, larger wait times for healthcare services.

The reasoning given by the government to reject this amendment in the House was, quite frankly—and I say this with a genuine acknowledgement of the diligence with which the minister and his team have worked across many areas of the healthcare system and the reform agenda, which we've been supportive of and are supportive of—ridiculous. The reasoning was ridiculous, folks. You rejected this amendment based on the idea that it's too hasty and doesn't take account of the required consultation needed to enact such a reform.

You've had the scope-of-practice review for two years, and this issue has been raised with this government for so long that, if my memory serves right, it was being raised with you when you were last in government in the Rudd-Gillard-Rudd years. This has not come out of nowhere, and this is not extending the ability to prescribe to a profession that can't already prescribe, because it already can.

The patients of those healthcare professionals can't access affordable medicines. We've heard really clearly basic examples: somebody goes to a podiatrist with an issue. They are prescribed a regular 12-week course of treatment cream for the condition that might have led them to the podiatrist in the first place, and, because of this gap in the law, they pay upwards of $27 to $28 more than they need to—and that's without factoring in the additional costs of going back to the GP, the travel time, the complexity. That's ridiculous. We could have closed this loophole and made this form of health care more affordable to Australians right now. Right now we could have done that in this vote, but the government has said no.

Well, let me say this: we are not going to let this one go. This is a common-sense reform whose time has well and truly come. We're going to keep pushing this, and my message to the minister and their team is really crystal clear: this is going to keep coming back up, so let's get this done. Let's just come together around something that makes total sense and give people access to more affordable podiatric surgery and more affordable treatment from their endorsed podiatrist. It just makes sense.

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

I thank senators for your contributions to this debate on the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025, in committee. I want to make a few brief remarks—not extended ones, because I did address many of the issues that have been canvassed here this morning in my contribution yesterday.

Based on the contributions that senators have made this morning, I understand that the bill will shortly pass this chamber, and I want to emphasise how pleased I am that that is the case. I think I share that with all senators here. This bill will allow the 400,000 nurses across the country to engage more widely and to work more fully within their scope of practice, and that is a very good thing for patients all across the country.

I note the comments about podiatry, and I emphasise, as I did yesterday, that the Podiatry Board is currently working with the National Medicines and Poisons Advisory Group on updating the podiatry endorsement for scheduled medicines. The Podiatry Board will return to that advisory group later this year as their work progresses, including to facilitate broader consideration of endorsement for scheduled medicine arrangements for the wider podiatry profession.

The government is, of course, deeply committed to supporting access to health care and increasing access to health care. I note Senator Pocock's remarks earlier in relation to the ACT. We are delivering our commitment in the ACT to strengthen Medicare and bulk-billing here. Just recently I saw Minister Gallagher and Minister Butler opening the two additional fully bulk-billed clinics in the ACT, and there's another one to come. Strengthening access to public health is a core commitment for the government. Strengthening Medicare, investing in public hospitals, expanding bulk-billing and restoring the integrity of that bulk-billing offering in the context of 10 years of cuts to services—this is core business for our government, and we intend to continue.

I think the Senate for your consideration of this bill. Without wishing to get ahead of the Senate processes, I look forward to the bill passing this chamber shortly.

Question agreed to.

Resolution reported; report adopted.