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.