Australian Medical Association

The Department of Health and Ageing is seeking applications from eligible individuals and organisations to develop, test and evaluate innovative models of practice for nurse practitioners in residential and community based aged care. To ensure collaborative care models between GPs and nurse practitioners are part of the trial, the AMA encourages its members who practice in the aged care sector to apply.

Applications close at 2:00pm (AEST) on 14 June 2011.

AMA President, Dr Andrew Pesce, said today that the Health Minister, Nicola Roxon, must urgently clarify the intent and coverage of the new regulations for collaborative care arrangements between doctors and nurse practitioners.

Dr Pesce said that claims in the media by some groups, especially Revive Clinics, that their models of care are eligible for access to Medicare and the PBS are throwing the new arrangements into disarray and confusion.

The AMA today reaffirmed that it does not support nurse practitioners working independently of doctors.

AMA President, Dr Andrew Pesce, said today that the AMA supports meaningful collaborative care arrangements between doctors and nurses under new measures that came into effect this week, and welcomes Health Minister Roxon’s public confirmation that the arrangements will not make nurse practitioners substitutes for doctors.

The Commonwealth Government is implementing reforms to allow nurse practitioners and midwives to provide Medicare-funded services to patients and to prescribe medications listed on the PBS. These changes are scheduled to commence on 1 November 2010.

The AMA has prepared a guide "Collaborative Arrangements - What you need to know" to help answer many of the questions doctors will have about collaborative arrangements and how they should be structured, as well as identify key issues that doctors should take into account when considering being part of a collaborative arrangement.

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.