Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025
Senator STEELE-JOHN (Western Australia) (13:12): I am pleased to continue speaking to the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. Nurse prescribers have been pushing for this for a very long time—to be able to work to their full scope of practice and support patients to access faster, more affordable quality health care.
The Greens are pleased to support this bill. Nurse prescribing will allow for greater efficiency in the healthcare system, as many patients will only need to visit a single point of care. Fewer referrals and hospital admissions will bring down the cost of treatment for many patients, which will lower the cost barriers to accessing health care during this cost-of-living crisis.
To get the full benefits of this change, nurse prescribing needs to be implemented not only in hospitals but also in primary healthcare settings, such as local clinics and aged-care settings. This bill went before a Senate inquiry and was supported by the Australian Primary Health Care Nurses Association and the Australian Nursing and Midwifery Federation, among many others.
Some submissions to the inquiry raised concerns about ensuring that nurse prescribing is implemented in a way that upholds the highest standards of patient safety. The Greens are firmly committed to making sure that people feel safe, supported and confident when accessing health care, regardless of who is providing that care. I am pleased that this bill introduces a number of important safeguarding measures, including the requirement for nurse prescribers to be in a prescribing agreement with existing prescribers and to complete a six-month clinical mentorship process with an authorised health practitioner; additional training and qualification requirements beyond those needed to be a registered nurse; the ability for the minister to designate which medicines can and can't be prescribed by nurse prescribers; and the expansion of the Professional Services Review, ensuring appropriate oversight of nurses in their role as PBS prescribers.
Additionally, I understand that further safeguarding measures will be detailed in the delegated legislation. With these details that are in development, as they are in development, the Greens will be playing a careful, scrutinising role to ensure that patient safety remains at the centre of reform. While we are discussing healthcare professionals working safely within their scope of practice, it is important to recognise that many submissions to the Senate inquiry identified opportunities to go further.
More than 20 submissions highlighted a clear and practical reform—expanding access to PBS subsidised prescribing for additional qualified health practitioners. One of those professions is podiatrists and podiatric surgeons. I have had the pleasure of meeting with podiatric surgeons and representatives at the University of Western Australia's Podiatry Clinic, and their message was clear: podiatrists and podiatric surgeons are already endorsed prescribers.
They are fully qualified and authorised to prescribe medicines. However, they cannot access the PBS for PBS subsidies for those prescriptions. This means their patients are left paying full price for medicines that would otherwise be subsidised.
As the Australian Podiatry Association noted in its submission: … a podiatrist with an endorsement to prescribe medicines may clinically decide a medicine is needed today, yet the patient must still book a second consult … just to obtain a PBS-subsidised script. This is not just inefficient; it creates barriers to care. We have a clear example provided to us from the Advanced Practicing Podiatrists High Risk Foot Group.
A 72-year-old man on the age pension living with diabetes attends the podiatry clinic for his annual foot health review under an enhanced primary care referral. During the consultation, the podiatrist identifies a probable fungal infection and recommends a standard 12-week course of oral antifungal medications. The podiatrist is qualified to prescribe and can initiate treatment immediately, but, because the prescription is not covered by the PBS, the patient must pay out of pocket.
At a discount chemist, this would be $27.99. He is left with a choice: pay out of pocket or book for an additional GP appointment just to access a subsidised script. This is unnecessary.
It wastes time and it increases costs for patients and for the system. It reflects rules that have not kept pace with how people actually access health care. We have an opportunity to fix this.
The Australian Greens are calling on the government to update the law to allow podiatrists and podiatric surgeons to access PBS benefits when prescribing within their scope of practice. This is a practical reform that would make health care more affordable, more timely and more patient centred. The Greens call on the government to make this change, and I foreshadow that I will move the second reading amendment in my name to give effect to it.
In conclusion, allowing registered nurses to prescribe PBS medicines within their scope of practice will expand choice, improve access and reduce pressure on other parts of the healthcare system. The scope-of-practice review recommended this change, along with many other pathways to enable non-medical practitioners to play a greater role in the provision of safe, quality health care.
The Greens encourage the Labor government to go further in their response to the scope-of-practice review and to implement the identified opportunities for ensuring more healthcare professionals can work to the top of their scope of practice. Getting this work done helps everybody in the system. It's complicated.
It's detailed. It's often behind the scenes, but it is the work that, when achieved, delivers better care for people—more affordable care for people. In the time that I've had the health portfolio for the Greens, I have had the opportunity to learn from many experts—treating clinicians, allied health professionals, general practitioners and so many others—and the common thread between them all is a desire to work with government to get good health outcomes for people and to reform the system so that it works.
It's the responsibility of elected officials to be up for the hard and complicated work to get that done. It's sometimes not glamourous, but, when it is ultimately resolved, it makes a real difference in people's lives. I look forward to continuing to work across the chamber to advance the implementation of the scope of practice review and to bring down healthcare costs in the Australian community.