A RAPIDLY expanding chain of private clinics has applied for permission to run a pilot scheme under which prescriptions written by nurses would qualify for Pharmaceutical Benefits Scheme subsidies.
The Revive Clinic chain, staffed entirely by highly trained nurse practitioners, has also sought federal government permission for its consultations to be covered by Medicare -- a demand likely to infuriate the doctors lobby.
The groundbreaking plan, contained in a submission to the Preventative Health Taskforce, says "greater access and equity of access to nurse practitioner services in the community is required".
Patients of Revive -- which has opened its first nurse-run clinic in Perth and plans up to 20 more nationwide -- cannot claim their visits on Medicare and/or their prescriptions on the taxpayer-subsidised PBS.
Federal Health Minister Nicola Roxon has long championed the need both for better health prevention and more effective use of nurses.
In October, she declared to a nurses conference that she was a "firm believer in the vital role nurse practitioners can play in our overall health system".
Ms Roxon cited lack of access to PBS subsidies for nurse practitioners as a barrier, and told the conference that reform processes in train would "entail a redefined and extended role for nurses -- including nurse practitioners".
The first nurse-run Revive Clinic opened in Perth in November. Under West Australian law, its nurses are allowed to treat patients for a defined list of minor conditions, ranging from colds, coughs and flu to bronchitis, ear infections, skin infections and bladder infections as well as nausea, vomiting and diarrhoea.
They can also prescribe drugs for these conditions that are classified as S4 -- a category that includes various antibiotics but excludes strong painkillers such as morphine, and other powerful medications such as for cancer and heart problems.
But these state laws do not affect Medicare and PBS eligibility. As a result, patients attending the Perth clinic have to pay a consultation fee of $65 out of their own pocket.
Revive director and owner Louise Stewart said doctors were overstretched in many places, and towns where the chain intended to set up clinics included Port Hedland, where four general practitioners were struggling to meet the needs of 17,000 residents -- nearly three times more patients than recommended under professional guidelines.
The submission to the taskforce argued for nurses' consultations to be covered under Medicare for health prevention services, health checks and the development of care plans.
These are currently among the single most lucrative Medicare-funded services for doctors, being worth $175 to a GP for a health assessment of a patient over 75, or $130 for development of a management plan for patients with complex health needs.
Australian Medical Association president Rosanna Capolingua warned against the proposed trial, saying the existing ranks of nurses working under GP supervision within doctors' surgeries was a safer and more cost-effective model.
"They don't seem to get the fact that they don't have the training," Dr Capolingua said.
"If they are pretending to be doctors, I invite nurse practitioners to go to medical school and to do the training required."
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