Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025
Senator COX (Western Australia) (18:39): I rise to speak in support of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This is a practical and carefully designed piece of reform. It makes sure that Australians can access medicines through the Pharmaceutical Benefits Scheme when those medicines are prescribed by appropriately qualified, endorsed and authorised registered nurses.
At its heart is a simple Labor principle. It's about getting quality health care. All you should need is your Medicare card, not your credit card.
That's what Medicare is about, that's what the PBS is also about and that's what this bill helps to deliver. This bill amends the National Health Act 1953 to enable endorsed registered nurses, known as designated registered nurse prescribers, to prescribe certain pharmaceutical benefits under the PBS. It also amends the Health Insurance Act 1973 so the Professional Services Review can review PBS prescribing by nurse prescribers, ensuring that they are subject to the same oversight as other PBS prescribers.
This bill establishes a regulated Commonwealth PBS framework as well. It creates the approval process for authorised nurse prescribers to allow approvals to be suspended or revoked, including nurse prescribers as a category of the PBS prescriber. It enables the minister to specify which benefits they may also prescribe and ensures that patients can access those medicines through the PBS.
That is all extremely important. Authorising a nurse to prescribe is only part of this reform. The other part is making sure that, when a patient receives a prescription, they can access the medicine affordably through the PBS.
Without this bill, we risk creating a gap between what the health workforce is trained and authorised to do and what patients can afford to access. That would simply be not fair. It would especially be not fair for people who live in regional, rural and remote communities and, in particular, in my home state of Western Australia.
This bill doesn't replace doctors or diminish the role of GPs or specialists or pharmacists or nurse practitioners, but it absolutely complements the existing health workforce. It supports team based care and allows nurses to work to the full scope of their training, endorsement and professional capability. Designated registered nurse prescribers must meet the requirements set by the Nursing and Midwifery Board of Australia.
They must have proper education, qualifications and endorsement. They must prescribe within their competence and scope of practice and within a clinical governance framework in partnership with an authorised health practitioner and under an active prescribing agreement. So this is definitely not a loose model.
It is regulated, it is accountable and it is designed around safe and collaborative care. Registered nurses are already at the centre of health care in this country. They are often the health professionals people see first, know best and absolutely trust the most.
In regional, rural and remote Australia—especially, again, in my home state of Western Australia—nurses are often holding the health system together. They are in hospitals, community clinics, Aboriginal community controlled health services, aged-care settings, schools, outreach services, palliative care services and primary care teams. They manage chronic conditions.
They support families. They provide things like wound care, vaccinations, health education, screening and also follow up. They are often known to the patient, they know the family and sometimes they also know the community.
Importantly, they know what delay means. In a metropolitan area, a delayed prescription might mean booking another appointment or waiting until another day, and that's frustrating enough. But, in a rural or remote community in Western Australia, delay can mean something very different.
It can mean a long drive. It can mean taking time off work. It can mean arranging transport.
It can mean waiting for the next visit to a clinician. It can mean a patient deciding it's all too hard and, in fact, going without. For someone with a chronic condition, that delay can mean also deterioration of their condition.
For an older person in aged care, that can mean unnecessary distress. For someone receiving palliative care at home, it can mean pain that could have been avoided. For a woman seeking time-sensitive reproductive healthcare, it can mean uncertainty, cost and a loss of control.
For someone in a remote Aboriginal community, it can mean the difference between care close to home and care that requires leaving a community. This is why nurse prescribing matters. This is not an abstract workforce reform.
It's a practical access reform. Western Australia in particular understands this. WA Health has recognised that designated registered nurse prescribing can strengthen access to timely, safe and reliable medicines, particularly for people who live in rural and remote communities and in aged-care settings.
In a WA first, Edith Cowan University has launched a Graduate Certificate in Registered Nurse Prescribing, and that course will upskill experienced registered nurses so they can safely prescribe or renew medications in partnership with authorised independent prescribers such as doctors and nurse practitioners. That matters because workforce challenges are absolutely real.
Across regional WA, communities simply cannot wish more health professionals into existence. We need to fully utilise the skills of the workforce that we absolutely have, and we need to support all of our nurses to work to their full scope of practice. We need to build team based care that reflects the realities of country WA, not just the convenience of metropolitan service models.
A nurse in a regional clinic should not have to identify the need for a medicine, know that the patient needs it, know that delay will make it worse and then be prevented from helping someone simply because the PBS framework cannot keep pace. That's what this bill absolutely fixes. It brings Commonwealth PBS law into line with modern health care.
It reflects the direction of the Strengthening Medicare Taskforce and the Scope of Practice Review. Our health system must support health practitioners and professionals to work to their full scope of practice. When nurses can do the work that they are trained and authorised to do, patients get care sooner, GPs and other health professionals are better supported and the pressure that's on hospitals and acute care is reduced.
Communities, particularly rural and regional communities, especially have a great benefit from getting a health system that works better for them. The Senate inquiry into this bill received submissions that reflected strong support from across the health sector. This bill sets that legislative foundation.
It creates the framework, accountability and PBS access needed for the model to operate safely and fairly. The committee recommended that the bill be passed, and I'm pleased to speak today in support of that. This bill is about access.
It's about affordability. It's about strengthening primary care. It's about backing nurses.
It's also about recognising that, in a state as vast as Western Australia, health care cannot be designed only around an assumption that every patient has a GP appointment just around the corner. For people in the Kimberley, the Pilbara, the Goldfields, the Wheatbelt, the Great Southern, the Mid West, the South West and communities right across my beautiful home state and regional Western Australia, health access depends on practical reforms just like this.
It depends on making sure that a health professional who is there, who is qualified, who is trusted and who is authorised can actually help them. Labor built Medicare. Labor created the PBS.
Labor believes health care should depend on your need, not your post code and definitely not the size of your wallet. This bill honours that principle in a practical way. It says that when a nurse is properly trained, endorsed and authorised to prescribe, the patient should not lose access to affordable PBS medicines.
That is simple. That is fair. For rural and regional WA, this bill matters.