New AIHW chronic disease data has reignited the debate over who should deliver primary care, with the nursing profession calling for expanded funding and GPs warning against fragmented care.
Australia’s peak nursing body is pushing for greater primary care funding and scope of practice in response to recent AIHW data showing Australia’s growing chronic disease burden.
But the proposal has drawn a warning that reform must be carefully managed to avoid further fragmentation of the healthcare system.
Former RACGP president Adjunct Professor Karen Price told The Medical Republic that while she deeply valued allied health nursing professionals and supported them playing a larger role in chronic disease management reform must occur within integrated, GP-led multidisciplinary care.
“Doctors and nurses have always worked together, but rarely does a system work when people are working autonomously and separately,” she said.
Nurses’ role in managing chronic disease should be integrated into a centralised, coordinated medical system rather than separate, parallel models that risk duplicate pathology ordering and fragmented care, said Professor Price.
“We already need systems to stop the duplication of care, and similarly, this needs to be looked at from a system perspective, not simply from one craft group’s perspective. That’s the way we get better outcomes for patients,” she said.
Duplication also carried a significant financial cost. Professor Price pointed to the Productivity Commission’s 2024 findings that better-integrated medical records could save up to $5.4 billion per year, including $355 million through reduced duplication of pathology and imaging.
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“Everyone needs oversight because chronic disease management, and not missing a diagnosis, is a difficult, highly skilled job,” she said.
“Anything else calling for the relief of the burden of general practice is ridiculous, because we’re trained exactly to do the generalist job, and we need to be enabled to do that job properly.”
Professor Price’s comments come as the Australian College of Nursing (ACN) pushes for full use of the nursing workforce to meet the growing demand for chronic disease care.
The ACN’s chief executive officer, Adjunct Professor Katheryn Zeitz, said the system treated GPs as the sole primary health care providers.
“General practitioners are core to primary health care – but we need to reorient the system to recognise that not every primary health care encounter requires a medical practitioner, and reduce pressure on hospitals,” she said.
Nurse practitioners and nurse-led clinics already provided high-quality chronic disease care, including monitoring, prescribing, wound care, health checks and prevention, at lower cost and closer to home, Professor Zeitz said.
Nurses must be granted access to primary care funding they were currently locked out of, she said.
“Nursing care in the community prevents expensive hospitalisations and re-hospitalisations. But we are blocking our largest, most trusted and most widespread workforce – nurses – from delivering it,” Professor Zeitz said.
It’s a position the AMA also supported earlier this year, backing calls to enhance the role of practice nurses within GP-led, team-based care.
Professor Zeitz said Australians most in need were being “priced out” of primary care, pointing to the AIHW’s 2026 report card, which showed almost twice as many patients had skipped or delayed GP visits due to costs over the past decade.
Between 2023 and 2024, the AIHW reported one in five patients presented to the ED because a GP was unavailable or appointment wait times were too long.
The ACN is calling for a Baseline Practice Payment, extended WIP for nurse-led services, MBS 75% rebate for nurse practitioners, and access to MBS items, incentives, and telehealth.
It also wants nursing activity outcomes to be included in the National Primary Health Care Data Collection to quantify their contribution and inform funders, and for 2500 nurse-prescribing scholarships annually with eligibility for Commonwealth-supported places.
Registered nurse prescribers gained access to PBS medicines on 1 July, but the first graduates are not expected until at least mid-year.
