Australia’s peak nursing and midwifery groups are calling on the major parties at this federal election to commit to immediate and effective reform that will provide all Australians with quicker and more affordable access to the health services they need.
The nine peak groups are advocating seven nursing-led reforms to improve care, reduce waiting times, and deliver better health outcomes with minimal impact on the budget.
The Peaks are calling for commitments to:
ACTION 1: Enable Nurse Practitioners and Endorsed Midwives to directly refer patients to relevant specialists, reducing waiting times for care.
ACTION 2: Introduce funding and regulatory reforms that support nurse and midwife-led clinics and innovative care models, particularly in rural, remote, and underserved communities, enabling nurses and midwives to take leadership roles in delivering community-based primary care.
ACTION 3: Work with State and Territory Governments to pass laws to support qualified Registered Nurses in every State and Territory to prescribe approved medications under the Pharmaceutical Benefits Scheme.
ACTION 4: Increase the Workforce Incentive Payment Practice Stream to cover up to seven healthcare professionals, and tie payments to higher scope clinical care.
ACTION 5: Authorise Nurse Practitioners, Endorsed Midwives and qualified Registered Nurses to order diagnostic tests such as mammograms, X-rays and DEXA scans. For Endorsed Midwives, this includes tests such as NIPT, pelvic ultrasound, multiple pregnancy items and iron studies.
ACTION 6: New and amended Medicare Benefit Schedule items for Endorsed Midwives to support pre-conception counselling, primary sexual and reproductive health, intrapartum care outside of a hospital setting (homebirth), and a general consult item for women’s health.
ACTION 7: Implement a primary healthcare workforce development strategy to unlock 15,000 extra education and training places for Registered Nurses, Nurse Practitioners and midwives in the places and settings that need them most.
The plan reflects the recommendations of the Unleashing the Potential of our Health Workforce – Scope of Practice Review, which was led by Professor Mark Cormack.
The review identified significant barriers preventing nursing and midwifery professionals from working to their full potential. These barriers must be removed.
Nurses, nurse practitioners, and midwives make up 54 per cent of Australia’s health workforce. They are the most geographically dispersed health workforce in the country.
But one-third of nurses, nurse practitioners, and midwives in primary health care rarely work to their full scope. This must change.
For too long, our highly skilled nurses, nurse practitioners, and midwives have been held back by outdated regulations, restrictive funding models, and professional silos.
Health reform is complex, but enabling these essential healthcare professionals to deliver the full range of care they are trained and qualified to provide must be a priority for the next government.
The proposed changes will significantly improve access to primary care, especially in rural and remote areas, reduce wait times, further promote culturally safe care, and create more cost-effective pathways for patients.
Nurse-led primary health care has been operating successfully in Australia for decades.
These reforms represent a crucial step toward a more accessible and sustainable healthcare system.
The evidence is clear: when nurses, nurse practitioners, and midwives work to their full scope of practice, everyone benefits.
3 Responses
Point number 1 is incorrect. NPs have been able to refer to medical specialists directly for as long as the legislation has been in place. I have been in private practice for 14 years and always referred directly to medical practitioners. The barrier is that health organisations are not aware of NP authorisations so I have to call ahead and ensure that they are aware of the NP legislation. Over the 14 years I have built up many direct referral options now that these organisations have been made aware. This is off my own steam, not from a state or federal level of implementing NP authorisations.
More recently I have been approaching many health organisations asking them to update their HR policies to ensure that NPs are listed to incorporate their authorisations. ie. provide medical/sick certificates and provide treatment plans (including NP prescribing) if an employee is managing their medication at work.
Does the ANMF or all the “peaks” ensure that their organisation have their HR policies updated to include NP authorisations?
For those that have commented on Point 1 of the plan, it relates to Recommendation 12 of the Scope of Practice Review, which can be found on page 162, and aims to alleviate existing barriers here
“The Australian Government implement new direct referral pathways for consumer access to specified non-General Practitioner (GP) specialist Medicare Benefits Schedule (MBS) items which meet the following criteria:
A. The direct referral made by the health professional is within their scope of practice, and
B. The referral is accompanied by appropriate, timely notification of the consultation to relevant treating team members including the patient’s GP, and registered practice via digital mechanisms available.
These recommendations are to include:
Nurse Practitioners referral to:
1. Psychiatrist (e.g. for complex, high level assessment, treatment and prescribing)
2. Geriatrician (e.g for cognitive decline, depression and anxiety)
3. Urologist (e.g for prostate and other urinary tract issues)
4. Gyneacologist (e.g for reproductive health)
Agreed referring to specialist is part of the NP scope of practice for many years although we still face barriers in some areas of practice due lack of knowledge and authorisation from an HR point of view. Some areas still request that a medical practitioner or consultant signs a referral for example; for examination a referral for Bone Mineral Density to be signed by a Doctor before they can accept the referral. These creates unnecessary delay for patients which is unhelpful.