Australian Medical Association

The AMA welcomes the Government's introduction of new regulations that require midwives and nurse practitioners to collaborate with medical practitioners in order to provide Medicare-funded services to patients or prescribe them medications under the Pharmaceutical Benefits Scheme (PBS).

AMA President, Dr Andrew Pesce, said today that the new arrangements would provide a safer higher standard of care for patients.

“These new arrangements are the result of a comprehensive consultation process between the Government, doctors, nurses, nurse practitioners, and midwives, throughout which the AMA played a constructive role,” Dr Pesce said.

Three of Australia’s peak medical groups today called on the Senate Community Affairs Committee that is inquiring into the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills to support the Government’s amendments to the Bill.

The Australian Medical Association, Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Royal Australian College of General Practitioners support Government amendments that will require midwives and nurse practitioners to work in formal collaborative arrangements with medical practitioners.

They said that collaborative care was essential for the quality, safety and continuity of patient care.

AMA President, Dr Andrew Pesce, said today that the AMA welcomes the Government’s decision to amend the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 to specify a formal requirement that midwives and nurse practitioners must work in collaboration with medical practitioners.

Dr Pesce said the AMA has been negotiating with the Government for this vital change to the legislation for some time, and the AMA had received recent support from other medical groups, most notably the Royal Australian College of General Practitioners.

“We made it clear to the Government that without a requirement in law that there be collaborative arrangements between midwives, nurse practitioners and doctors then the legislation did not have any safeguards to ensure continuity of patient care, nor did it have any protections against the fragmentation of patient care services,” Dr Pesce said.

“I repeat – the amendments impose a legal requirement for collaborative arrangements between medical practitioners and midwives or between medical practitioners and nurse practitioners.

“The AMA has worked cooperatively with the Government on these amendments to the legislation.

The AMA wants the government cash incentive scheme designed to lure nurses back into the workforce to be extended to include nurses who want to work in general practice.

It was reported this week (The Australian, 27 August 2009) that the Federal Government’s program to bring nurses back into the workforce was failing to meet targets, with only 541 nurses recruited.

AMA President, Dr Andrew Pesce, said nearly $40 million over five years in funding had been set aside for the Bringing Nurses Back Into The Workforce program and it was vital that the money was used effectively.

AMA President, Dr Andrew Pesce, said today that the Government must reject calls for independent nurses to be allowed to carry out ‘healthy kids’ checks in Child and Maternal Health Centres.

Dr Pesce said the health of our children is far too important to allow these health checks to be 'dumbed down'.

“General practitioners and their practice nurses, in close collaboration, are the appropriate people to be conducting these health checks, and they are conducting them diligently and skilfully,” Dr Pesce said.

“Allowing people other than doctors to perform 'healthy kids' checks independent of doctors would further fragment health care and would erode the quality and safety of child health care,” Dr Pesce said.

AMA response to nurse practitioner and midwife legislation that the Government announced in the 2009/10 Federal Budget.

In the 2009/10 Federal Budget, the Government announced that it would move to allow some nurse practitioners and midwives to provide services funded under the Commonwealth Medicare Benefits Schedule (MBS) and to prescribe medications that are subsidised under the Pharmaceutical Benefits Scheme (PBS).  It also announced that the Commonwealth would subsidise indemnity insurance for midwives, although it decided not to extend this cover to home births.

The Government recently introduced three Bills into the Parliament to implement its Budget announcements. These are the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009, the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 and the Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009.

These Bills have been referred to a Senate Community Affairs Legislation Committee Inquiry and the AMA has provided a detailed submission to this Inquiry. The AMA submission highlights that, if implemented carefully, the legislation may help address unmet community health needs - provided it is done in a coordinated way and medical practitioners are still involved in the overall care of the patient. The AMA has warned the Committee that if the legislation is not implemented carefully, it will fragment care, increase the risks of inadvertent patient outcomes, cause duplication and increase costs.

The AMA submission outlines detailed recommendations designed to ensure that the ultimate arrangements work in practice and patient safety is safeguarded.

Boosting the number of practice nurses who work with GPs would help improve patient access to care, the AMA said today.

AMA Federal President, Dr Andrew Pesce, today used GP Week to renew calls for the Government to increase support for nurses who work in general practices.

A recent report funded by the Australian Primary Health Care Research Institute found practice nurses helped take pressure off GPs and increased access to care for patients.

The AMA's response to Matter number AM 2008/13.

The AMA has made a submission in response to the draft national awards and also appeared before AIRC hearings in Sydney. The AMA has argued that the new awards may result in cost increases for some private medical practices as they prescribe, in some cases, more generous working conditions than those contained in existing awards. The AMA submission called on the AIRC to bring working conditions in the proposed awards back into line with current awards so that medical practices are not hit with increases in costs.

Doctors in hospital emergency departments are under increasing pressure from administrators to allow nursing teams to take responsibility for patients without being seen by a doctor.

AMA President, Dr Rosanna Capolingua, said the practice had come under scrutiny in NSW where it had been linked to the deaths of two patients.