Nurses, pharmacists held back by red tape, turf wars: health minister

Health Minister Mark Butler says too much red tape and too many turf wars are limiting nurses, pharmacists and other allied health professionals from stepping in to fix a Medicare system under strain from rising costs and demands.

As the federal government pursues an overhaul of Medicare, Butler warned “more of the same is not going to cut it” and flagged the government was considering a wraparound model of care that enhanced the role of all healthcare professionals.

Federal Health Minister Mark Butler.Credit:Alex Ellinghausen

“At a time of skyrocketing demand for health care, and workforce shortages… It doesn’t make sense not to have every single one of our health care professionals working to the top of their scope of practice, whether that’s doctors, nurses, allied health professionals, pharmacists, and others,” Butler said on Monday.

“We just don’t have that happening in Australia. There are too many regulations, too many constraints within the [Medicare] system, too many turf wars that constrain the ability of people who want to deliver their full range of skills and training.

“I want to see, out of this strengthening Medicare process, a much more liberated ability for all healthcare professionals – doctors, nurses, allied health professionals – to be able to contribute to the need that we have out there to deliver world-class health care to Australian patients.”

As state premiers ready for the year’s first national cabinet meeting next Wednesday, they have backed a campaign by doctors for the Medicare rebate to be raised, in the hopes that this would encourage more GPs to bulk bill or work extra hours, taking the strain off overcrowded emergency departments.

The Australian Medical Association and the Royal Australian College of General Practitioners are also resisting the push for pharmacists to prescribe more drugs to patients directly, arguing they have a conflict of interest.

But Butler said simply adding more money to the health system’s existing structures would not meet the needs of an ageing population with increasingly complex health issues.

Asked whether he would commit to raising the Medicare rebate for GP visits or capping the patient gap fee, Butler said: “I’m not going to get into pre-empting what we what might come out of the taskforce with”.

The final report from the “Strengthening Medicare” federal taskforce – which includes the AMA, RACGP, academics and nursing associations – will be finalised within weeks and will guide the government’s decisions ahead of the May budget.

“Simply adding more money to the existing structures is not going to deliver the quality the wraparound care [that] particularly people with complex chronic disease need and deserve,” Butler said at a press conference in Canberra on Monday.

“I want [to be] very clear with people. This is not easy. It’s not going to be quick, and our government is not simply going to be adding more money to the existing system.”

Butler said the taskforce had probed a blended “wraparound” model of funding as one option to consider. This could involve providing doctors’ clinics with lump sums that enabled them to offer care from nurses or different health professionals as well as traditional fee-for-service funding.

“No one’s advocating for replacement of fee-for-service. Fee-for-service is still a very effective, efficient way to deal with many cases that people will want to go and see their GP about,” he said. “So the question is whether on top of the traditional fee-for-service system, you add some sort of flexible funding.”

Prime Minister Anthony Albanese also said additional funding for healthcare professionals such as nurses and paramedics was just “one of the things” the government was examining.

    “The big thing we are looking at is how do you take pressure off the system. We are talking to the AMA, talking to the Royal Australian College of General Practitioners, talking to health experts because we want to make sure that this Medicare taskforce is listened to. We will receive the report,” he said on Sunrise on Monday.

    “We want to see all of the detail. We will also work it through with the states and territories.”

    With Angus Thompson

    Cut through the noise of federal politics with news, views and expert analysis from Jacqueline Maley. Subscribers can sign up to our weekly Inside Politics newsletter here.

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