NPs made to wait

Professional Update

After more than a decade of lobbying and advocacy, the May Federal Budget saw the introduction of funding for long-awaited reforms for NPs and for, most importantly, the people for whom they provide care. But the joy felt following the Budget announcement was short-lived, as NPs, yet again, have been made to wait.

Health Minister Mark Butler announced there would be $46.8 million to fund Medicare rebates for care provided by NPs, and that the rebate would increase by 30%. A great outcome, given the recommendation for a significant increase to the rebate from the NP Reference Group to the MBS Taskforce under the previous government, was ignored.

Listed as a 2022-23 budget initiative, this increase was expected to start in July.

But 1 July 2023 came and went with no explanation for the delay.

It wasn’t until the Commonwealth Chief Nursing and Midwifery Officer’s newsletter was circulated that peak nursing groups became aware that the rebate increase wouldn’t come into effect until 1 July 2024, a year later than promised.

As devastating as this delay is for NPs, people trying to access healthcare, particularly disadvantaged and marginalised people, will be impacted most.

This is not new territory for NPs. NP roles have been limited in growth and number by both policy and funding restrictions since their inception.

Once again, delays to real, meaningful reform to a health system under immense strain right now will impact the health and wellbeing of people seeking care.

The ANMF, along with our colleagues at nursing colleges with NP members, wrote to the Federal Health Minister and Assistant Health Ministers, Mark Butler, Ged Kearney and Emma McBride, to voice our deep concern and disappointment that this increase is not being implemented as a matter of urgency.

It was highlighted that delaying the rebate rise would cause undue disadvantage to people seeking access to NP care and affect the sustainable delivery of services. The increased pressure caused by the current cost of living crisis makes this particularly significant. This is of greatest concern, where an NP may be the only locally accessible primary healthcare provider.

We also noted that other MBS budget announcements, namely the increase in bulk billing incentive for GPs, are being prioritised for implementation in November 2023, and called for the rebate increase for NPs to be treated with the same urgency.

As a result, the ANMF, ACNP, CATSINaM, CRANAplus, APNA and the ACMHN met with Minister Butler at Parliament House in August. Collectively, we conveyed our dismay and frustration, and that of our members, about the delay. We sought to understand the reasons for the long wait and requested that the date for implementation be aligned with that of our medical colleagues, November 2023.

Nevertheless, we were told the rebate increase is part of a package of reforms and that there will be no possibility of earlier implementation.

Feedback already received from the Department of Health and Aged Care was that they need advance notice, specifically a minimum of 12 months, to adjust even an existing item number and that all changes must be sent to the AMA at least three months prior. What’s that about? These rules don’t appear to have applied to the MBS item changes for GPs. This bureaucratic go-slow has ensured that this NP 2022-23 Budget initiative won’t even begin until midway through 2024.

Policy mechanisms to limit access to NP services are harming an already underutilised and undervalued workforce, and reducing healthcare access to those most in need, particularly disadvantaged and marginalised populations. In the interests of equality, mechanisms to improve access to MBS items for NP services requires urgent action.

Following, the meeting with Minister Butler, the group also briefed Minister Kearney about our concerns with the implementation delay for the rebate. The ANMF will continue our advocacy for change at every opportunity and every level of government.

For too long, NPs have been made to wait to provide the care they know they can deliver. These NP reforms cannot come soon enough for those who are desperate for access to care right now.

It’s time for the Government to recognise NPs true worth and how crucial they are to improving access to quality care for people when and where they need it, particularly in rural and remote areas, where crippling workforce shortages continue to impact healthcare.

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