Leading nursing and midwifery organisations will gather at Parliament House today with a united call for the Federal Government to address the unprecedented strain on the healthcare system by acting on review recommendations to let nurses and midwives care for people using all their skills and knowledge.
Nearly one-third of primary health care nurses are not routinely working to the full extent of their expertise.
That represents an untapped resource that could be better used to address Australia’s struggling primary health care system, with Australia recording higher rates of preventable hospitalisations than the Organisation for Economic Co-operation and Development (OECD) average.
Rates of preventable hospitalisations – a key indicator of primary care effectiveness – are worse than in comparable countries such as Canada and the United Kingdom, and come at a cost of about $7.7 billion a year. That’s despite Australia spending more per person on healthcare than most of the OECD.
A significant proportion of those admissions are attributable to chronic conditions – including diabetes, heart failure and chronic respiratory disease – that nurses are educated to prevent and manage in the community. Evidence indicates that nurse-led models of care for chronic disease are associated with reduced hospitalisations and readmissions.
Australia has almost 410,000 employed registered nurses, nurse practitioners and midwives, and more than 40 per cent work outside hospitals – across a broader range of settings and communities than any other healthcare profession. There are five nurses for every medical professional in small rural towns. Yet current funding arrangements limit nurses’ ability to deliver care to these communities using the full scope of their skills and expertise.
“Australians are rightly proud of Medicare, but the system is under extraordinary pressure, and we are failing to make the most of our most distributed clinical workforce,” said ACN Chief Executive Officer Adjunct Professor Kathryn Zeitz FACN. “The Scope of Practice Review, and review after review of the primary healthcare system have already told governments how to fix this. We have the evidence – now we need the action.”
Midwives: Underutilised across the system
In the maternity sector, evidence shows that privately practising midwives deliver the most positive birth experiences and the lowest rates of birth trauma, yet they represent just over 2% of maternity services. The current default, fragmented public hospital model of maternity care costs the health system 20% more than continuity of midwifery care in community-based group practice or birth centre settings. The evidence supporting continuity of midwifery care, from clinical outcomes to workforce sustainability, is well established. In three years, the number of endorsed midwives has doubled, yet this highly skilled workforce continues to face barriers to working to full scope and providing primary maternity care. In rural and remote areas, midwives are key to providing equitable and accessible maternity care to Australians.
“When poor health outcomes are preventable, the system has failed to act early enough. For women and babies, this means ensuring access to continuity of midwifery care provided by midwives working to their full scope. Continued underuse of this workforce is holding back better outcomes, and it must change. It’s time for decisive investment and reform to make this model of care the standard,” said Australian College of Midwives CEO, Mia Dhillon.
Nurses and midwives to gather at Parliament House today
At the Showcase of Contemporary Nursing and Midwifery, hosted by ACN’s Parliamentary Friends of Nursing, nursing and midwifery organisations will show parliamentarians first hand what nurses and midwives can deliver in the primary care sector – from nurse-led skin-cancer checks and wound closure to rural and remote-area advanced care, and maternity care for both mothers and babies – and demonstrate the case that Australia’s largest and most widely distributed health workforce is being held back by an outdated funding model.
The organisations are calling on the Government to refresh the Medicare settings that keep nurse- and midwife-led care on the outside, by:
• implementing the recommendations of the 2024 Scope of Practice Review;
• directing the proposed Baseline Practice Payment to nurse-led primary care;
• allowing nurse-led clinics to register for MyMedicare and access bulk-billing incentives; and
• enabling Endorsed Midwives to access multi-disciplinary care funding, such as bundled funding, practice accreditation and primary health incentives.
“Nurse- and midwife-led models are safe, proven and already working in communities across the country,” said Adjunct Professor Zeitz. “With the right funding settings, they can reach the Australians the current system leaves behind.”
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