Brian Mitchell (Lyons, Australian Labor Party) Share this | Hansard source

I was quite happy for the member for Wentworth to speak so I could get my breath; I just rushed up here! The Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) Bill 2024 before the House today will help modernise Australia's healthcare sector, delivering better and more affordable health care to more Australians—like Medicare, the Pharmaceutical Benefits Scheme, urgent care clinics and cheaper medicines.

What we do today is build on the proud Labor tradition of improving Australian health care. That is because better and more affordable health care is in Labor's DNA. We know how important it is for Australians to be able to access quality health care without it sending them broke. When we look at what happens overseas, we know that Labor's approach to health care is better than just about anywhere else in the world. We reject utterly the failed model that applies for example in the United States, where so many Americans on low and middle incomes have no way to access quality, affordable health care and where an unanticipated injury or illness can literally send you broke.

In Australia, you should never have to put off getting health treatment when you need it. That is why, upon coming to government, we opened 58 Medicare urgent care clinics across Australia, including four in Tasmania. Those clinics are open extended hours and fully bulk-billed; all you need is your Medicare card. And they treat Australians for urgent, non-life-threatening health care. Hundreds of thousands of Australians have been treated at Medicare urgent care clinics, and that's hundreds of thousands of Australians who have not had to clog up emergency department waiting lines.

This Labor government has made the largest investment into bulk-billing in the proud 40-year history of Medicare. In our first 20 months in government, we have tripled incentives for GPs to bulk-bill children, pensioners and concession cardholders, delivering direct benefits to 11 million patients. In our first 20 months in government, we have delivered the biggest reduction to PBS medicine prices in the history of the PBS, saving Australians $250 million in 2023 alone. We're also cutting the cost of more than 300 common medicines by allowing doctors to prescribe 60-day prescriptions.

Today, we seek to expand the role that Australia's fantastic, incredible nurses get to play in delivering health care by allowing our most experienced and qualified nurses to work to their full scope of practice. In addition to about 35,000 midwives, Australia has 337,000 registered nurses, and amongst those are 2,250 nurse practitioners. A nurse practitioner is a registered nurse who holds a master's, who is highly experienced and who has undertaken extra training. It's a legally protected profession. Only people who meet the criteria and are dually registered with the appropriate agencies can call themselves a nurse practitioner. Nurse practitioners have the authority to practice independently in an expanded clinical role and provide Medicare Benefits Scheme and Pharmaceutical Benefits Scheme services. But, currently, they must be attached to a general practitioner. This legally required collaborative arrangement serves to limit the full scope of practice that nurse practitioners can offer the community. Instead of our medical system trusting that nurse practitioners know how to act within their scope of practice and education just like it does for general practitioners, it treats them with suspicion, requiring a GP to effectively look over their shoulder and tick a box on their work. Under the current system, a doctor in their first year on the job as a GP has more authority and is assumed to know more about a patient's health care than an NP with 30 years of clinical experience and a master's. When you consider that over 90 per cent of nurse practitioners are woman, you can see how patronising this has been and what a waste of time and resources it is.

The bill before the House today is transformative. It recognises midwives and nurse practitioners for the highly trained, highly qualified healthcare professionals that they are. It will serve to see more health care delivered throughout our cities, suburbs, towns and regions. I see the member for Indi is here to speak on this bill. I'm sure she will have great pleasure in talking about the benefits this bill will bring to her region in particular.

In response to a recommendation by the Medicare Benefits Schedule Review Taskforce, the government commissioned an independent review of the collaborative arrangements that are currently legally required for nurse practitioners to provide services under the Medicare benefits scheme. The review included analysis of Australian and international literature and extensive stakeholder consultation on the efficacy and appropriateness of these arrangements. The findings of the review supported the need for ongoing clinical cooperation between all health professionals. We all know the importance of multidisciplinary teams and of health professionals talking to each other, but what the review found was that the legislated requirement for collaborative arrangements duplicates existing professional standards and guidelines and can indeed create barriers to accessing care. Removing this legislated requirement for an arrangement will assist in removing barriers to primary care for Australians, particularly in regional, rural and remote areas, where there are big challenges in attracting and retaining general practitioners.

The bill has strong support from the nursing and midwifery sectors and is expected to result in very positive change for the Australian community. By supporting more effective use of the highly feminised nurse and midwife healthcare workforce—90 per cent of nurses and 98 per cent of midwives are women—this bill will improve gender equity and healthcare outcomes and access and take practical action to reduce the gender pay gap.

I would like to briefly talk about the Cygnet Family Practice in the Huon Valley, which became the first general practice in Australia to implement an urgent and after-hours service from April 2023. It's run solely by the practice's nurse practitioners within a collaborative arrangement with a GP. I had the pleasure of being invited to the practice's official opening in August last year. While it's quite a few kilometres outside of my own constituency—it's in the heart of the Huon Valley, around 50 minutes out of Hobart and Franklin—I was keen to get along there because I'd heard about the Cygnet Family Practice and what an amazing difference it was making for people in the south of the state. Kerrie Duggan and her team are doing an incredible job. I was delighted to meet Kerrie again when she visited Canberra last week for the launch of the initiative that is before the House today. The Cygnet Family Practice gives a real insight into how health care could be serviced in our regions in the future. In the first 10 weeks of opening, the Cygnet Family Practice saw more than 300 people in the after-hours clinic alone. It's clear that they are reducing the impact on our emergency departments, just like the government's Medicare urgent care clinics are.

This bill before the House today will pave the way for more regional practices like the Cygnet Family Practice to let our nurses and midwives do exactly what they need to do—help people in need when they need it and where they need it. We know in the care economy the highly feminised workforce is too often underpaid, undervalued and underutilised. I think we all remember those scenes during COVID. Everybody wanted to thank a nurse, But thanks only go so far. Nurses need support, they need pay and they need respect. This bill certainly delivers on the respect. A bill which empowers nurse practitioners and midwives is one that empowers women. By removing the requirement for collaborative arrangements, this bill also supports the implementation of the Women-centred care strategy by providing birthing women with greater choice and access to care and services. Removing the red tape that holds back our nurses, nurse practitioners and midwives from providing the high-quality care that Australians so clearly and dearly need will finally go some way to recognising this.

It builds on other Albanese Labor government measures to recognise and support nurses and midwives, like more nursing and midwifery scholarships, opportunities for re-entry to practice, fee-free TAFE and higher Medicare rebates for nurse practitioners. Allowing women to choose to receive care by a nurse practitioner or midwife will go a long way to ensuring that women are always treated with respect and dignity in our maternity care system, whether they are the professional delivering the service or the person receiving the service. As the Albanese Labor government works to develop the National Strategy for the Care and Support Economy, we will continue to deliver practical and structural changes across our care workforce. As women make up the vast majority of workers in this sector, this bill will support women's economic equality.

We said that we would strengthen Medicare and that's exactly what we're doing with bills like this one before the House today. I get great pleasure in commending this bill to the House.

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