Nurse prescribing enshrined in law but impact remains elusive

IT’S official: nurses will now be able to prescribe, refer and access the MBS from 1 November after Parliament passed the controversial nurse practitioner legislation last week. 

And while the AMA and RACGP are optimistic that doctors can still secure effective rules on collaboration with GPs, the lobby group Doctors Action has warned Medicare costs will skyrocket. 

Doctors Action president Dr Adrian Sheen warned that giving MBS and PBS access to nurses will put unsustainable financial pressure on the health system. 

“Competition is not a problem for the doctors; the problem is for the taxpayer to fund a whole lot of people to do medical diagnosis, examination and investigations without training.” 

Dr Sheen, who recently met with Opposition Leader Tony Abbott to discuss his concerns, said there was a lack of appreciation for what family doctors did and this was driving policy.

The controversial Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 was passed after a long journey through Parliament. It specifies that nurses must demonstrate collaboration “with one or more medical practitioners”.

While welcoming the new laws, Louise Stewart, director of the Revive Clinic chain, said that without detail on what services the MBS items would cover and what the collaborative requirements would entail, it was too early to predict their impact.

She did not think they would lead to a mass rollout of bulk-billing nurse practitioner clinics.

“I don’t think you will see a huge number of nurse practitioner clinics pop up, because it is very complex and difficult to get Health Department [approval] to employ nurse practitioners.” 

Dr Patrick Byrnes, RACGP representative on the Government’s Nurse Practitioner Advisory Group, said GP and nurse groups remained divided on some aspects of the collaborative frameworks but he was optimistic of a satisfactory outcome.