The start of a new era

Nurses celebrate new laws giving PBS and MBS access for nurse practitioners and midwives.

The government has finally given the right prescription to fully recognise the skills of nurse practitioners and midwives.

Landmark and historic are just two of the words used to describe the Senate passing new laws giving PBS and MBS access for nurse practitioners and midwives. A new professional indemnity scheme for midwives has also been passed.

It has been a long road to get to this point, with the legislation attracting bitter opposition from some doctor groups.

However, the right decision was eventually made, said the Australian College of Nurse Practitioners (ACNP).

“This is a historic decision and is a great first step in improving health care in Australia,” said Helen Gosby, ACNP president.

“We still have to work out the details but this is good news. These highly qualified and skilled nurses will offer the community greater choice and access to healthcare.

“Those who seek the services of a nurse practitioner will now be able to access some benefits and that means an improvement in healthcare accessibility.”

The new professional indemnity scheme for eligible midwives will be available from 1 July and the new Medicare and PBS arrangements will be available from 1 November.

The framework includes a request for nurses and midwives to form a collaborative relationship with doctors, requiring their sign-off to access Medicare insurance and pharmaceutical benefits.

This is a point that nursing groups remain cautious about, said Kathleen McLaughlin, RCNA acting CEO.

“We want to ensure that there are no additional barriers imposed on nurse practitioners and midwives that may limit public access to these services,” she said.

Despite the wide spread welcome, there is still contention and frustration surrounding homebirths.
Under the new laws, a national register will be set up for midwives, who will require indemnity insurance before being signed up – insurance which hasn’t been available to midwives since 2001.
The government has promised to provide support for indemnity insurance, and offered a two-year reprieve for those having trouble finding a provider.

But midwives offering homebirths won’t be able to access this insurance support.
Coalition senators were at first opposed to the legislation for fear it would drive home birthing underground, but on March 16 “determined that the legislation is perhaps better than nothing”.
The discussion on giving all midwives equal rights was not over, said Associate Professor Jenny Gamble, president of the Australian College of Midwives.

“These reforms have the potential to greatly enhance women’s access to primary midwifery care. But we want to see access to professional indemnity insurance becomes available for all midwives, including those providing professional care for women who choose to labour and birth at home,” Gamble said.

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