Professional News: September 2010

A good result for collaborative arrangements

In May last year the Federal Labor Government introduced historic health reform enabling access to the MBS and PBS for nurses and midwives. The Health Legislation Amendment (Midwives and Nurse Practitioners) Act 2010 was passed in April this year. In July, Health Minister Nicola Roxon finalised the determination for collaborative arrangements. This legal requirement followed many months of discussion with nursing, midwifery and medical groups about collaborative practice.

Nursing and midwifery groups have argued against the need for a legal requirement to collaborate. More often than not, nurses and midwives are the drivers of collaboration. They collaborate with the person receiving care, their family/significant others and a range of health professionals, including doctors. A practice that already exists doesn’t need to be written into the legislation. Despite our views, the determination for collaborative arrangements was made and it seems we have a good result as it reflects what nurses and midwives already do.

Nurse practitioners and eligible midwives can meet the requirements for collaborative arrangements in one of four ways:

• being employed by a doctor or an organisation that also employs a doctor;
• a written referral from a doctor;
• a written agreement with a doctor; and
• written records demonstrating arrangements for consultation, referral, and transfer should it become necessary during the clients treatment.

There has been a barrage of misinformation put out by the medical media focusing on one aspect of the legislation, the written agreement, in an attempt to convince themselves and the public that doctors have control over the scope of practice of nurse practitioners and eligible midwives. In response to some of this media, the ANF has suggested that medical groups should take another look at the determination as there are four possible ways to demonstrate a collaborative arrangement. A written agreement with a doctor is only one of them.

Nurse practitioners and eligible midwives will be able to continue to provide high quality care, collaborating with all appropriate health professionals as they have always done. They can get on with the incredible work that they do every day. The only difference is that this legislation will now allow people to seek MBS and PBS reimbursement for the services of these experienced nurses and midwives. Nurse practitioners and eligible midwives as regulated, qualified health professionals determine the extent and scope of their practice, not doctors. The determination for collaborative arrangements will not change that.

Like all new processes there may be some issues that arise during implementation and if that is the case we will continue to work with the nurse practitioners, eligible midwives and the federal government to resolve them in the best interests of clients.

For more information about the work of the Federal Office Professional Team go to the National News section.

Julianne Bryce
ANF Federal Senior Professional Officer