The bill amends the National Health Act 1953 and the Health Insurance Act 1973 to allow endorsed registered nurses to prescribe specified pharmaceutical benefits under the Pharmaceutical Benefits Scheme (PBS), with clear approval, suspension and review processes. It also enables authorised nurse prescribers to supply limited PBS medicines directly under prescriber bag arrangements, improving access to subsidised medicines—particularly in rural, remote and underserved communities.
This Bill amends two key Commonwealth statutes—the National Health Act 1953 (NH Act) and the Health Insurance Act 1973 (HI Act)—to establish "authorised nurse prescribers" as a new category of PBS prescriber. Under the NH Act, it defines “eligible nurse prescriber” (a registered nurse meeting qualifications and endorsement requirements under the Health Practitioner Regulation National Law) and creates an approval process (Part VII) by which the Secretary may grant, suspend or revoke PBS prescribing rights. It empowers the Minister to determine, by legislative instrument, which pharmaceutical benefits authorised nurse prescribers may prescribe (new subsection 88(1EAA)). It expands patient entitlement provisions (ss 86–88) and co-payment rules (s 87) to include nursing treatment by authorised nurse prescribers. It also introduces "prescriber bag" supply arrangements (new s 93AC) to allow limited direct supply of PBS medicines by authorised nurse prescribers.
Concurrently, the HI Act is amended to include eligible nurse prescribers in the Professional Services Review (PSR) Scheme (Part VAA), ensuring the same oversight and disciplinary mechanisms apply to nurse prescribers as to other PBS prescribers. Other consequential amendments update definitions, export evidence provisions, offence and secrecy regimes, and appeal rights to reflect the new nurse-prescriber category. The Bill is not expected to incur any net financial impact on the PBS.
Australia faces rising demand for medicines due to an ageing population and chronic disease. Enabling qualified registered nurses to prescribe PBS medicines will reduce delays in treatment, lower avoidable hospitalisations and improve population health outcomes, thus maximising overall well-being at minimal cost [Judgment].
Registered nurses account for about half of the health workforce and are the most geographically dispersed profession[1]. Expanding their scope of practice promotes equal access to subsidised medicines for rural, remote and vulnerable populations who may otherwise face significant travel and financial barriers.
The Bill includes robust safeguards—standards set by the Nursing and Midwifery Board, mandatory prescribing agreements with other PBS prescribers, and PSR oversight—ensuring patient safety while unlocking substantial efficiency gains in primary care delivery.
See Explanatory Memorandum, p. 1: “Registered nurses comprise approximately half of the Australian health workforce and are the most geographically distributed health profession.”
While expanding nurse prescribing may seem promising, there is limited large‐scale evidence on the safety and effectiveness of authorised nurse prescribers managing complex medication regimens across diverse patient populations[1]. Without rigorous pilot data, the policy risks unintended medication errors and fragmented care.
Introducing a new prescriber category also increases administrative complexity: monitoring prescribing agreements, enforcing PSR reviews, and managing sanctions may burden Services Australia and dilute clear chains of clinical authority.
Moreover, delegating prescribing authority to nurses could weaken doctor–patient continuity in multidisciplinary teams, potentially compromising holistic oversight of chronic conditions and counterintuitively increasing downstream costs for adverse events and readmissions [Judgment].
No national longitudinal study has yet assessed the outcomes of nurse prescribing under the PBS at scale.
2025-11-26
House of Representatives
Before House of Representatives
Unspecified
Health, Disability and Ageing
Healthcare, Social Support / Welfare