Reg­u­la­tions ham­per use of nurse prac­ti­tion­ers

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un­re­ferred at­ten­dance’’ — which would at­tract a Medi­care re­bate of $21 rather than the nor­mal spe­cial­ist re­bate of $65-over $100 that would ap­ply if the re­fer­ral was by a GP.

Ged Kear­ney, act­ing fed­eral sec­re­tary of the Aus­tralian Nurs­ing Fed­er­a­tion, backed the study, say­ing it sup­ports what we al­ready know: that nurse prac­ti­tion­ers are be­ing un­der-utilised be­cause of bar­ri­ers cre­ated by cur­rent fund­ing mech­a­nisms’’.

This Gov­ern­ment has demon­strated an ap­petite for tack­ling health re­form,’’ Kear­ney said. The time is now right to bet­ter utilise the ex­per­tise of th­ese skilled prac­ti­tion­ers, en­abling greater ac­cess to and eq­uity within the pub­lic health sys­tem.’’

The ANF blames the slow take-up of nurse prac­ti­tion­ers purely as a re­sult of ef­fec­tive lob­by­ing from the med­i­cal pro­fes­sion’’.

The nurse prac­ti­tioner model has met fierce op­po­si­tion from the Aus­tralian Med­i­cal As­so­ci­a­tion. In the past the AMA has sig­nalled it is only pre­pared to ac­cept nurse prac­ti­tion­ers if they are re­stricted to ge­o­graph­i­cal re­gions too re­mote to have a doc­tor of their own, but AMA pres­i­dent Rosanna Capolin­gua says even the ar­gu­ment that nurse prac­ti­tion­ers were needed in rural ar­eas was weak­ened by the fact that the vast ma­jor­ity were prac­tis­ing in sig­nif­i­cant metropoli­tan re­gions, and even teach­ing hos­pi­tals’’.

That ar­gu­ment doesn’t hold wa­ter,’’ Capolin­gua said. Nurses are highly skilled and they have a highly sig­nif­i­cant role in the work­force. They have not got the train­ing, skills and un­der­stand­ing that other mem­bers of the pro­fes­sions have. We have to be cer­tain we are not cre­at­ing tiers of health pro­fes­sion­als that can­not pro­vide pa­tients with the very best of care.’’

Pro­fes­sor Gard­ner’s data shows nurse prac­ti­tion­ers have been most rapidly taken up in NSW, where there were 104 as at last Septem­ber — nearly dou­ble the num­ber in the next big­gest state, West­ern Aus­tralia, which had 54. Vic­to­ria had 29, South Aus­tralia had 24, Queens­land 14 and the ACT 13. There were none in Tas­ma­nia, which has only re­cently passed leg­is­la­tion en­abling their ex­is­tence, and none in the North­ern Ter­ri­tory, which is fur­ther be­hind.

Gard­ner said nurse prac­ti­tion­ers need ac­cess to the PBS and provider num­bers in the first in­stance. I guess the point is that if we are look­ing at re­form­ing health ser­vices and the health work­force, there has to be con­sis­tent leg­isla­tive sup­port from both lev­els of gov­ern­ment, oth­er­wise we are not go­ing to achieve the re­form agenda that’s been set up.’’

A spokesman for fed­eral Health Min­is­ter Ni­cola Roxon said La­bor had al­ready sup­ported sim­i­lar mea­sures for op­tometrists.

This (nurse prac­tioner pro­posal) is some­thing that we would con­sider as part of our health re­form agenda,’’ the spokesman said.

Pic­ture: Lyn­don Mechielsen

Re­stricted: Nurse prac­ti­tioner Ker­rie Cole­man tends to Stephen Can­ning

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