Australia’s peak nursing and midwifery organisations welcome the release of the Scope of Practice Review Issues Paper Two. The paper provides a considered, evidence-based approach that recognises four challenges to the delivery of primary health care (PHC) in Australia:

1. Poor recognition of the skills that primary care health professionals have
2. Inadequate preparation [of health professionals] for primary care
3. Legislation that impedes health professionals working to their full scope
4. Funding and payment arrangements that impede health professionals working to their full scope

Nurses and midwives together are the largest professions in primary health care with ~96,000 nurses and midwives working in multiple PHC settings. The four issues identified by the Review prevent nurses and midwives from working to their full scope of practice which is known to restrict consumer access to optimal care.

The Scope of Practice Review is a once in a generation opportunity to:

Realise the full value of using every health profession: To improve Australia’s health, the health system must utilise the skills, expertise and experience of the whole health workforce. Australia trains excellent health workers but many barriers persist which prevent this critical workforce from using their full skill set. The 2023 APNA Workforce Survey shows that 31% of PHC nurses are only occasionally or rarely working to their full scope of practice. This same survey shows that nurses who cannot work to their full scope are more likely to leave PHC. Using our health care workforce well also helps retain them.

Enable modern models of health delivery: The Health System requires more than funding. It also needs changes to how the health system works. Access must be improved. General practitioners are the gatekeepers of the system, but RACGP data shows that around 1 in 5 Australians (5.4 million people) do not have a regular general practitioner. Given this, it is rational to explore different funding and clinical models to ensure all Australians have access to high quality care.

Embed evidence-based workforce decisions in Australia’s health system: Health policy often diverges from the evidence. We urge the government to continue to focus on evidence rather than politics as it reforms the health system. The Scope of Practice review provides a strong, evidence-based foundation for this process.

We encourage Australia’s health leaders to continue to be bold. Australia’s health system needs change. This issues paper represents another step towards reform. Our organisations will continue to work constructively with Minister for Health and Aged Care Mark Butler and Assistant Minister for Health and Aged Care Ged Kearney, and Professor Mark Cormack and all those supporting reform of Australia’s health system.

It’s time for change. It’s time to be bold. Australia’s health depends on it.

The Nursing and Midwifery peak group consists of the major Associations, Colleges and Unions. Together, they represent the 448,000 nurses and midwives registered to work in Australia.

Authorised and supported by:

Leanne Boase
Chief Executive Officer
Australian College of Nurse Practitioners

Ken Griffin
Chief Executive Officer
Australian Primary Health Care Nurses Association

Annie Butler
Federal Secretary
Australian Nursing and Midwifery Federation

Karen Grace
National Director – Professional Practice
Australian College of Nursing

Adrian Armitage
Chief Executive Officer
Australian College of Mental Health Nurses Inc.

Helen White
Chief Executive Officer
Australian College of Midwives

Ali Drummond
Chief Executive Officer
Congress of Aboriginal and Torres Strait Islander Nurses and Midwives

Karen Strickland
Chair
Council of Deans of Nursing and Midwifery

Mary Chiarella AM
Professor Emerita
Susan Wakil School of Nursing and Midwifery The University of Sydney Deputy Chair, Northern Sydney Local Health District Board
Honorary Fellow, Australian College of Nurse Practitioners
Adjunct Professor, University of South Australia