All Australian governments understand that our health system must change. An ageing population, a shrinking health workforce and increasing health demands and costs mean health services must focus on keeping Australians well and in the community. To remain well Australians must have early access to quality health education and primary health care.
The nursing and midwifery workforce is pivotal to Australia’s health education and primary health care system and nurses and midwives understand the complexities and requirements for health reform. Health reform must put nursing and midwifery at the centre of the health system in order to create a sustainable model of care.

Governments are now acknowledging that nurses constitute the main health care workforce, and are beginning to organise the health sector to better utilise the skills and qualifications of nurses. For instance, patients of nurse practitioners and appropriately qualified midwives will soon be able to claim rebates on prescriptions, tests and specialist referrals.

The ANF meets with all levels of government on the key areas of health reform and contributes submissions to inform and influence policy decisions in all areas of health.

Submissions are on the website under Publications

The federal government has made some major commitments to health and in 2009 reports commissioned by the Australian government will be released, along with the decisions made through COAG, which will steer the future direction of Australia’s health system. The ANF will continue to work to ensure nurses and midwives remain at the centre of Australia’s health policy.

1. Primary Health care:

The Australian Nursing Federation supports the role of nurses as central to primary health care and, in conjunction with the ‘Primary Health Care Group’ the ANF has produced a consensus paper on the role of nursing in primary health care.

The paper was funded through a Department of Health and Ageing Discretionary grant.

The ‘Primary Health Care Working Group’ is a collaboration of the following nursing organisations: the Australian Nursing Federation (ANF), the Australian Practice Nurses Association (APNA), the Australian Nurse Practitioners Association (ANPA), the Royal College of Nursing, Australia (RCNA), the Council of Remote Area Nurses of Australia (CRANA), and the Australian College of Mental Health Nurses (ACMHN), with input from independent nursing experts.

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2. Advanced Nursing Roles and Nurse Practitioners:

Nurses and midwives want to be able to use their extensive skills, education and experience to the full level; this is central to Australians receiving quality health care. Positions such as the advance practice nurse, and clinical nurse specialists are an important part of a nurse’s clinical career path. (See Snapshot of Nursing Career Paths)

Giving patients and clients of nurse practitioners access to MBS and PBS is a great step forward in a new era of primary health care in Australia.

Nurse practitioners are the most advanced clinical registered nurses with the education and experience required to perform in an advanced clinical role. A nurse practitioner's scope of practice extends beyond that of the registered nurse and their title is protected. There is now a growing body of evidence to support the effectiveness of the nurse practitioner role, particularly in primary health care.

The role gives advanced registered nurses the incentive to progress their nursing career without leaving the clinical setting and the position is designed to augment the services of other providers of health and medical services.

Nurse practitioners have advanced educational preparation and experience, with authorisation to practise in an expanded nursing role. Key to their role is the nursing model of practice with an emphasis on health promotion and preventative health care.

A nurse practitioner's scope of practice is determined by the context in which they are authorised to practise. Generally, their scope of practice differs to that of registered nurses in that it encompasses:

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3. Meeting the need in Australia’s Maternity services:

Women should be in control throughout their pregnancy and the postnatal period and have their individual needs and choice of maternity care respected. Giving suitably qualified midwives access to MBS and PBS and access to government supported indemnity insurance is a great step forward in a new era of maternity care in Australia.

However more needs to be done, the healthy development of families through access to maternal and child health services must be improved in Australia. Enabling women to have access to midwifery care across the pregnancy and postnatal period improves their access to care centered on the mother’s needs.

Midwives believe maternity services in Australia should be focused on the woman and based on the principle of universal access to safe, quality and comprehensive care.

The ANF views the future of a sustainable maternity service in Australia as a collaborative model of care. Where women have choice and receive appropriate and timely care from doctors, midwives, physiotherapists and other health professionals focused on working together to secure the best and safest pregnancy, delivery and post natal period for mothers and their babies.

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4. Equal access for Rural and Remote Australia:

Australians have an equal right to healthcare, unfortunately the amount and type available to you can change depending on where you live.

The ANF estimates that rural Australia needs 6,000 more nurses, and although it is nurses and midwives who appear to be “holding the fort” in rural and remote primary health care, professional boundaries, legislative barriers, and lack of support are hampering effective delivery of care.

The ANF welcomes the establishment of a department to specifically deal with reforms in the rural health, issues that continue to require attention are:

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