Nursing Australians back to health

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This week marks a landmark moment in Australia’s healthcare system when a key item in the Government’s health reform plans is fully realised.  In a major change that will affect nurses – but also GPs, patients and the pharmaceutical industry – nurse practitioners and midwives will now have the power to access specific Medicare Benefits Schedule (MBS) items and prescribe certain medicines subsidised on the Pharmaceutical Benefits Scheme (PBS).

The change in legislation recognises the highly-skilled and capable Australian nursing and midwifery workforce, providing a new framework to enhance and expand their role in providing quality healthcare.

Nurse prescribing is common practice overseas. The UK has seen a significant shift in the last two decades in nurse prescribing – which started in the 1990s when community based nurses were able to prescribe independently from a limited formulary. Since May 2006 independent nurse prescribers have been given the ability to “prescribe any licensed medicine for any medical condition within their competence.”

With this local shift in prescribing power now happening in Australia’s healthcare system, divisions in opinion and the murmur of a ‘turf war’ were always going to be inevitable. Great effort has been made to ensure the change in legislation preserved the requirement for nurse practitioners and midwives to work in collaboration with medical practitioners to access the MBS and PBS – essentially ensuring GPs are ‘kept in the loop’.  The AMA has gone to considerable lengths to help GPs prepare for the changes asking them to ‘embrace the changes’ or risk the possibility of jeopardising the mandated collaborative arrangements.

Importantly everyday Aussies are reportedly supportive of the Government’s move. Research just released by the Australian Primary Health Care Research Institute (APHCRI) has shown Australians know the difference between being sick and needing a doctor and those “everyday health concerns” when a nurse practitioner would suffice.

Responses to the ongoing APHCRI survey has stated nurses are “good listeners” and could cater for “everyday health concerns, such as repeat prescriptions and minor illnesses, to free up GPs to manage more complex conditions.”  Shorter waiting times and better access to primary care has been identified as important advantages.

There is no doubt this represents a major milestone in Australia’s healthcare system. Ensuring this significant move enhances the delivery of best possible healthcare to Australians will be critical.  Time will tell whether or not we can indeed reach the levels of contribution nurse practitioners are making in the UK.

Big changes for Aussie nurses...

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If the Coalition gets into office, what could Australia’s health system look like?

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What could the health system look like if the Coalition was in power?

What could the health system look like if the Coalition was in power?

With an election pending, there has been a lot of noise from the Opposition about potential policies and reforms. In a parallel universe, what would the Australian health system look like if the Coalition was in power?

Recent proposals  from the Federal Opposition include cutting funding from current Labor health reforms including…

  • Medicare Locals
  • GP infrastructure to upgrade primary care facilities 
  • A national e-health system
  • 24 hour GP phone helpline grants

…and using this cash to roll out a $1.5 billion plan to improve mental health services, including:

  • 20 new early psychosis intervention and prevention centres 
  • 60 additional Headspace sites for young people with mental illness  
  • 800 early intervention beds
The Coalition also announced a $35 million grant towards the establishment of a Clinical Trials Network for diabetes. This supplements the $5 million that former PM Kevin Rudd announced back in March.

Whilst Tony Abbott claims Labor has been inactive in mental health reform, Nicola Roxon was quick to hit back against the proposals, saying national hospital and health reforms will be at risk if Labor is voted out of office

“It’s very important we do not neglect mental health and one of the disappointing aspects of the Government’s health reform proposals is that there’s been so little on mental health.”

Tony Abbott

 “The Coalition’s policy is undermined by the fact it is funded by cutting Labor’s health reforms, such as GP super clinics and e-health.”

Nicola Roxon

What are the stakeholders saying?

The AMA is currently sitting on the sidelines and waiting for further updates on what funding would be left for GPs, whilst the Mental Health Foundation of Australia expects the Federal Government to announce its own mental health reforms in the near future.

Australian of the Year, Professor Patrick McGorry, has called on the Federal Government bring physical and mental health together under a new mental health plan, whilst speaking at the National Press Club last week.  

The Coalition said last week they would unveil their primary care policy before the election, in response to concerns about how much (if any) funding would remain for primary care.

With a few months to go until an election, there is plenty of time for further announcements, proposed reforms and complete u-turns, so watch this space!

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Will Gillard get health?

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Last week’s departure of former PM Kevin Rudd and Julia Gillard’s ascent into leadership broke Australian news site traffic records. And with every other media outlet in the country still running red hot with Gillard news, it would seem almost unfair not to mention our new PM’s impact on health policy.
 
As a start, Julia Gillard has proficient experience in the area, serving for three years as the Opposition health spokeswoman during Abbott’s tenure as Federal Health Minister. She has also been involved in Rudd’s own ‘health revolution’.
 
A recent Galaxy poll shows nearly a quarter of us want to see a fast-track of the health reforms as a first priority. But what do the various industry bodies have to say about whether or not health policy will be given the red light by the new leadership?
 
The doctors
 
The AMA says that a leadership change is not likely to change the track of health policy. The group is also of the belief that Rudd’s National Health and Hospitals Network will remain in place.
 
The nurses
 
The ANF believes Gillard has what it takes to win the election – ‘Australians want a hospital, aged care and primary health care system that works and Labor has demonstrated a keen understanding of this’. The group also welcomes the first female PM into the fold.

The e-health experts
 
…say Gillard gets it and they look forward to see how the e-health agenda progresses.

The mental health advocates
 
Mental health experts are hopeful that our new leader will put mental health higher on the agenda. A great deal of momentum developed in the lead up to the leadership shake up, with over 60 organisations delivering nearly 100,000 signatories calling for an urgent focus on mental health – but this was unfortunately delivered to the wrong PM.

Professor Patrick McGorry sees this momentum as an incredible opportunity for the Gillard Government to take action and score some ‘brownie points’ in the lead up to the election.

But watch out Julia – Tony Abbott just pledged $1.5b to improve front-line mental health services if the Coalition is elected.
 
Health got a mention in Julia Gillard’s acceptance speech (video below, in case you missed it). Will this enthusiasm translate into action?

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