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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It’s time we balanced the ledger

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Let me introduce you to Gerald, a 12 year old living in the small outback NSW town of Bourke – population 1,800. Gerald loves fishing, Rugby League (he barracks for the Penrith Panthers) and lives with his Mum, Dad, Nan, brothers – Steven (14) and Adrian (5), and sisters – Becky (3), Isabel (1 ½) and Ruthie (two weeks old).

Gerald is an Indigenous Australian. As we are unfortunately aware, Australia continues to retain developing world standards when it comes to the health of Aboriginal and Torres Strait  Islander people. In fact, Aboriginal Australians rank 103rd on the United Nations Index of Human Development (which considers life expectancy, literacy, and standard of living) compared to all Australians, who come in 4th.

Gerald’s Dad, Shaun, is 45 years old and suffers from diabetes and kidney disease. Last week, Gerald travelled 300km to the ‘big metropolis’ of Cobar (population 5,200) for his first-ever visit to the dentist (two adult teeth were removed and three fillings added). Little Ruthie was born with a low birth weight and has an 80 percent chance of developing hearing problems before her 5th birthday. And Nan (60), who has been suffering dementia for six years, was admitted to the local hospital two weeks ago where she will spend the rest of her days.

It’s time we balanced the ledger when it comes to Aboriginal health

It’s time we balanced the ledger when it comes to Aboriginal health

Indigenous health is an issue high on the agenda of the Public Health Association of Australia’s annual conference, which kicked off last week in Adelaide.

According to the Australian Bureau of Statistics (ABS), the health of Indigenous Australians is inequitable when compared to the rest of the Australian population. The rate of suicide in the Indigenous population is more than three times the non-Indigenous population. The burden of disease and injury for Aboriginal people is 2.5 times the level for non-Indigenous Australians, and dementia rates for older Aboriginal people are five times more than that of non-Indigenous Australians.

What’s more, Indigenous children born in Australia are three times more likely to die before the age of five than non-Indigenous children – survival rates similar to that of Cambodia. Indigenous men and women can expect to live 11.5 years and 10 years respectively, less than their non-Indigenous neighbours.

A harsh outlook this may seem – but it is the reality for 562,681 Indigenous people living in Australia.  So how and when will we Close the Gap 

Last week, the previous Indigenous health minister – Warren Snowdon – was reinstated along with the Indigenous health portfolio as a result of public backlash.

One way to tackle the appalling statistics is to produce more Indigenous doctors. 150 Indigenous Australians are studying medicine in universities across the country – a move in the right direction. And 420km up the road from Bourke, the small rural town of Wilcannia has struck a pioneering agreement with the federal and NSW governments to set-up Indigenous-run small businesses, in addition to improving health services by establishing nurses in schools and setting up better healthcare for pregnant women. Gerald and his family have fingers and toes crossed that Bourke will soon follow suit.

We need to see proactive strategies based at ground level and focused on the premise of community education if we are to see any genuine improvements in the state of Australia’s Indigenous health.

When the health of some Australians is comparable to that of people living in third world countries we must commit to real change to close the gap and dissolve all inequities.

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