Rural health workforce audit 'screams' for health reforms

Nurses and midwives can be central to any effective solutions to the problems of poorer health outcomes in rural and remote areas. They have the dedication, they are currently situated there, and they consistently provide effective health care.

Advanced practice nurses such as remote area nurses and nurse and midwife practitioners offer fantastic opportunities for real and effective health reform if only the existing barriers to wider utilisation of the skills and knowledge these expert practitioners could be removed.

For example, for nurses and midwives to operate efficiently, particularly nurse and midwife practitioners, they must have access to the resources and funding that their medical colleagues receive. At present, nurse and midwife practitioners are able to prescribe medications, but the person they prescribe for must pay the full cost of the medication, with no subsidy from the Pharmaceutical Benefits Scheme.

Medications prescribed by GPs on the other hand are subsidised fully, a sufficient disincentive for most people to see a nurse practitioner when they can get the same drug from a GP for significantly less money because GPs have access to the PBS subsidy. With some medications running into the hundreds of dollars this makes no sense from the point of view of health care economics.

Due to a lack of access to the Medical Benefits Scheme (i.e. Medicare) the patient will again pay much larger out of pocket costs for consultations and tests ordered by nurse and midwife practitioners - as opposed to those ordered by a GP - here again is a financial disincentive for patients to utilise the full services of a nursing or midwifery practitioner.

Reform of the methods of funding these products and services must take place to give the community more complete access the services of nurse and midwife practitioners. It is quite ridiculous given the need to improve access to health care that these highly qualified practitioners are limited in the health care they can deliver because of funding and legislative barriers.

Australians deserve equal access to health care wherever they live and nurses are committed to delivering the very best health care to everyone, everywhere. This commitment is evident in the innovation nurses bring to rural health despite the pressures they face. The recent rural health audit reveals the strength of the nursing contribution to rural and remote health and puts the spotlight on the need to do more to provide equal access to quality health care in rural and remote communities. There is a lot that can be done but only effective health reform will do it.