Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025

Mark Butler

I move:

That the amendments be disagreed to.

This bill is the result of more than 10 years of work—work conducted in a proper, iterative, evidence based way, work that seeks to continue to expand the opportunity for nurses to work at their full scope of practice. Given that there are quite a number of different proposals for the expansion of what we would regard, I think, as the existing work provinces of different parts of the health profession, can I make my view clear that this is best practice. This has been conducted by the nurses board in very close consultation with all relevant groups—medical professionals, patients, colleges and universities. As a result of 10 years of hard work, this endorsement for registered nurses, appropriately qualified, to be able to prescribe medicines has been enthusiastically endorsed by all health ministers in the health ministers group.

The Senate has proposed a last-minute amendment to bolt on to this best-practice piece of work, conducted to support the work of our hardworking nurses, a proposal to expand opportunities to podiatrists to prescribe medicines, which reasonable people might think is a good idea in principle. I can indicate that we have been engaging with podiatry groups, including the Australian Podiatry Association, about this issue for endorsed podiatrists. There is a live discussion about whether the sort of expansion for registered nurses that we're seeing now, in the bill that the government presented, should be available to podiatrists as well. But let me be clear; the work in relation to podiatrists is not finished. It is still underway. It is far too early, in my view, to bolt on at the last minute an amendment to expand the opportunity to podiatrists to prescribe PBS medicines when that work has not yet been completed.

Unlike the work for podiatrists, the work for registered nurses has been completed. Universities have already started delivering their programs. The Pharmaceutical Benefits Advisory Committee is already considering the medicines that may be put on the list for registered nurse-prescribers to prescribe. That work has not yet been done for podiatry organisations.

I understand that some in this parliament—certainly, obviously, some in the other place and some out in the community—would like to see an expansion of the work of podiatrists. That is not something I have any problem with, in principle. But I do not support the idea that—after 10 years of work to set this up properly in an evidence based way in consultation with medical groups, patient groups and the like for registered nurses, the largest professional group in our healthcare system—at the last minute, we bolt on, because it seems like a good idea, a podiatry addition to this when that work has not yet been done. So we do not support the amendments sent to us by the Senate, and we ask the House to support the government's position.

Monique Ryan

I'd like to acknowledge that the government has concerns about podiatrists being registered in this fashion and that it feels that the work has not yet been done. I think I can speak on behalf of constituents who are podiatrists and who would argue that the work should have been done, that the work the government is doing on the extension of the scope of practice for many professionals in the health sphere is taking too long and that the work the government is doing to revise the PBS is taking too long. We're already seeing the impact of that excessive duration of wait with the loss of agents like Zoladex from communities and people we care about, because pharmaceutical companies are now saying that the commercial imperative for marketing those sorts of agents in this country is not present for them. We're also hearing from constituents about their frustration with the HTA review and the time that has taken as well.

So I would argue that we have to move where we can, in increments where we can, on behalf of those people like podiatrists and exercise physiologists who feel that they've been asking for a very long time for their scope of practice and the funding for that to be extended and have not seen the government act on that to date.

Sharon Claydon

The question is that the amendments be disagreed to.