Full scope of practice for health practitioners is going to boost national productivity, treasurers agree.
Reforms to allow health practitioners to work to full scope are key to boosting Australia’s productivity, the nation’s treasurers have decided.
At a meeting last week, treasurers from around the country finalised an update to the National Competition Policy Federation Funding Agreement Schedule.
“Allowing health practitioners to work at their full scope of practice to improve productivity and reduce costs in the health sector” was one of four “new reforms” included in the agreement, announced by federal treasurer Jim Chalmers on Friday.
States that implement this and other reforms will get a share of the $900 million National Productivity Fund.
The Treasury has not yet provided any further details about this reform.
Jim Chalmer’s office told The Medical Republic that the states agreed at the meeting to sign the updated NCP agreement by the end of the year, and it will then be made public.
It said that the states, territories and federal government will work together, through the Health Ministers’ Meeting and the National Advisory Group on Drugs and Poisons Legislation Reform, to harmonise drugs and poisons regulation with professional scope to assist with enabling designated registered nurse prescribing.
“Payments from the $900 million National Productivity Fund will only be made once states implement reforms to remove barriers to practitioners working at their full scope,” the treasurer’s office said.
The RACGP told TMR it was “keen to engage directly with the federal and state treasurers” on specific ways that general practice could contribute to the conversation on the funding agreement.
“There are many kinds of care that could be delivered more effectively and efficiency through general practice. For example, if iron infusions were funded through the MBS rather than the NHRA it could save tax-payers between $40.0 million and $75.7 million annually, allow patients to receive care closer to home and free up State Health Systems to focus on more complex kinds of care,” said RACGP president Dr Michael Wright.
“Likewise, enabling pharmacists to dispense medications in general practice clinics, as is done in hospitals, would enhance patient care and allow faster and easier access to appropriate medications. Studies have shown that integrating pharmacists in general practice could save our health system $545 million over four years.”
The Australian College of Nursing told TMR that even without the detail, the fact that scope of practice was now on the Treasury’s agenda was important.
“ACN is looking forward to more detail on how the productivity measures will be rolled out, and will be engaging with stakeholders to highlight the many opportunities for enabling nurses to work to their full scope of practice,” a spokesperson said.
ACN CEO Adjunct Professor Kathryn Zeitz FACN said earlier that it was “a significant endorsement from Treasurers that full scope of practice is not just good for patient care – it’s economically essential”.
“This is particularly timely, given the regulatory change now in effect that will enable registered nurses to prescribe medications,” said Professor Zeitz.
The ACN said now it needed the systemic support to enable the changes, which involved releasing the National Nursing Workforce Strategy, awareness campaigns, employer education and PBS subsidies for nurse prescribers.
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The $900 million National Productivity Fund, which is part of the National Competition Policy, is in aid of getting the states and territories to work together to boost the nation’s GDP.
It “will reward states and territories for productivity-boosting reforms in areas such as commercial planning and zoning and modern methods of construction,” explained assistant minister for Productivity, Competition, Charities and Treasury Dr Andrew Leigh MP.
And health, it seems.
The health sector is Australia’s largest employer so it would be surprising if it didn’t make an appearance in this context.
And it didn’t come out of the blue.
The Department of Health, Disability and Ageing published Professor Mark Cormack’s report, Unleashing the Potential of our Health Workforce – Scope of Practice Review, in October 2024.
The review, an initiative of the Medicare Taskforce, looked specifically at primary care practitioners’ ability to work to their full scope of practice. That includes GPs, nurses, midwives, pharmacists, Aboriginal and Torres Strait Islander health practitioners and workers, allied health and paramedics.
“Barriers to working to full scope of practice contribute to workforce shortages, as they prevent the most effective use of the existing workforce and potentially deter future recruits,” wrote Professor Cormack.
“Being prevented from working to full scope of practice also contributes to some health professionals’ decision to leave the health workforce, with rates of individuals leaving the profession higher amongst the professional categories who broadly experience the greatest barriers to working to their full scope of practice.”
The task of the review was to “identify barriers in the existing legislative environment to health professionals working to full scope of practice. The Review sought to identify a shortlist of legislative and regulatory matters considered which, if amended, would be likely to have the greatest positive impact on health professional scope of practice.”
This ties in very nicely with the aims of the National Competition Policy, introduced in the early 1990s by then prime minister Paul Keating to remove impediments to market competition and thereby boost productivity.
The National Productivity Fund was announced by treasurer Jim Chalmers last year as part of a reinvigoration of that policy. At the time, the head of the Productivity Commission, Danielle Wood, told The Conversation’s politics podcast that if the government “can actually get the states to come to the table and agree on areas where we can reduce regulatory and other barriers to competition across the country, that’s a really important lever for getting economic dynamism moving again”.
The other reforms in Friday’s announcement were:
- a single National Market for workers – occupational licensing reforms, partnering with employers and unions, to make it easier for skilled labour to work in different states prioritising electrical and engineering occupations;
- a single National Market for goods – harmonising standards for household electrical consumer goods, waste and recycled products, building and construction, and a commonwealth‑only reform on food standards;
- heavy vehicle reforms to boost productivity and increase the uptake of electric heavy vehicles.
And of course, don’t forget the National Health Reform Agreement, which got a brief mention. (“Treasurers discussed the ongoing negotiations on the National Health Reform Agreement and NDIS reforms”, the treasurer’s statement said.)
“The RACGP also continues to call for a seat at the table for the National Health Reform Agreement negotiations considering the increasing role of the Federal Government in the primary care space and the reforms’ impact on general practice,” said Dr Wright.
