Australian Medical Association

AMA response to nurse practitioner and midwife legislation that the Government announced in the 2009/10 Federal Budget.

In the 2009/10 Federal Budget, the Government announced that it would move to allow some nurse practitioners and midwives to provide services funded under the Commonwealth Medicare Benefits Schedule (MBS) and to prescribe medications that are subsidised under the Pharmaceutical Benefits Scheme (PBS).  It also announced that the Commonwealth would subsidise indemnity insurance for midwives, although it decided not to extend this cover to home births.

The Government recently introduced three Bills into the Parliament to implement its Budget announcements. These are the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009, the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 and the Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009.

These Bills have been referred to a Senate Community Affairs Legislation Committee Inquiry and the AMA has provided a detailed submission to this Inquiry. The AMA submission highlights that, if implemented carefully, the legislation may help address unmet community health needs - provided it is done in a coordinated way and medical practitioners are still involved in the overall care of the patient. The AMA has warned the Committee that if the legislation is not implemented carefully, it will fragment care, increase the risks of inadvertent patient outcomes, cause duplication and increase costs.

The AMA submission outlines detailed recommendations designed to ensure that the ultimate arrangements work in practice and patient safety is safeguarded.

The AMA Position Statement on Electronic Prescription Transfer Systems – 2009 supports the development of an electronic prescription transfer system as a fundamental building block for a broader eHealth system in Australia. It sets out the high level principles that should underpin an electronic prescription transfer system.

The development of an e system in Australia is supported by:

1. the National eHealth Strategy
2. the KPMG Consultancy in Electronic Prescribing and Dispensing Final Report (commissioned by the Department of Health and Ageing);
3. the National Health and Hospital Reform Commission (NHHRC) Interim Report, including the supplementary paper on person-controlled electronic health records; and
4. commercial vendors actively promoting their prescribing systems.

The AMA position on other aspects of eHealth are set out in the following position statements:

AMA Position Statement – Unique Healthcare Identifiers – 2008
AMA Position Statement – Connectivity – 2007
AMA Position Statement – Safety and Quality of E-Health Systems – 2006

AMA Position Statement: Unique Healthcare Identifiers - 2008

AMA Position Statement: Medicines - 2008

Results of AMA's fax poll on brand substitution.

The AMA believes the arrangements promulgated by the Fourth Community Pharmacy Agreement should not stand in the way of improvements in the way medicines are distributed. In that regard, it does expect electronic prescribing to become the normal with electronic transmission of scripts to a pharmacy of the patient's choice. The AMA concurs in the Department's assessment that electronic claiming for benefits will become more popular.

AMA Position Statement: Pharmacy Intranet Scheme - 1997

AMA Position Statement: Doctors' Relationships with the Pharmaceutical Industry - 1994. Revised 2002

Submission to the Commonwealth Department of Health and Aged Care: The Better Medication Management System (BMMS): Draft Exposure Legislation: July 2001

AMA Position Statement: Drugs in Sport - 2000

AMA Position Statement: Complementary Medicine - 2002

Youth Health: Sex and your health

AMA Position Statement: Use And Misuse Of Medicines And Drugs - 1998