Influencing health reform agenda

ROYAL College of Nursing, Australia (RCNA) established the Community and Primary Health Faculty (the Faculty) in 2009 to strengthen the voice of community and primary health care nurses.

With the national focus on reshaping the health system around primary health care, RCNA, through the Faculty, aimed to ensure community and primary health care nurses, who are instrumentally engaged in community-based care provision, were better informed and positioned to influence the national health reform agenda.

The Faculty is guided by an advisory committee of nursing experts who came together to identify issues to be pursued over the coming 12 months. Despite the unique issues that surfaced, we found overriding concerns for all of us revolved around the current health reform agenda and its impacts on community-based care and the nursing profession.

The establishment of local decision-making processes thro­ugh Local Health Networks and Medicare Locals have and continue to cause unease among many community-based nurses. Common concerns relate to how community-based nurses, particularly those who work outside the general practice environment, will connect with Medicare Locals and Local Health Networks.

Community nurses are eager to know how they will fit within the better integrated primary health care environment envisioned for the future. Medicare Locals are of particular interest given they are the vehicle designed to better coordinate primary health care service delivery. Their capacity to achieve this will be dependent on their effective engagement with community and primary health care nurses.

Many nurses in the field are overwhelmed by the detail of the current health care reforms, which is limiting their level of engagement.

The reform processes and the many different layers of discussion and negotiation which occur between the key stakeholders can be confusing and many community-based nurses feel isolated from these activities.

It will remain a challenge for nurses to keep in touch with all these changes, but as the largest proportion of the health workforce, nurses must actively contribute to discussion about reform.

Despite the many demands placed on organisations and individual nurses, I would encourage my colleagues to ensure the role of primary health and community care nurses are promoted within all these new policy initiatives, as we are indeed an integral part of the longer term sustainability of Australia’s health system.
Mark Smith
Chair, RCNA Community and Primary Health Care Faculty