Royal College of Nursing Summit 2010
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Previous MinistersPDF printable version of Royal College of Nursing Summit 2010 (PDF 45 KB)
27 May 2010
Acknowledgements
- Traditional custodians of the land;
- Associate Professor Stephanie Fox-Young, President, RCNA;
- Debra Cerasa, CEO, RCNA;
- Rosemary Bryant, Commonwealth Chief Nurse and Midwifery Officer and President, International Council of Nurses;
- Nurses of Australia, ladies and gentlemen.
Introduction
Good morning and thank you for having me here this morning.
There is a lot on in parliament today, but I didn’t want to miss the chance to talk to a captive audience of nurses – this was too good an opportunity to miss!
A few weeks ago I was able to talk to a room full of practice nurses up on the Gold Coast, just before the budget. There was a lot I wanted to say then, but couldn’t.
Thankfully the budget is now out, and the Government’s reform plan is laid out in full – all of the pieces of the reform jigsaw puzzle now fit into place.
And one of the largest pieces of the puzzle now in place are nurses. It is no exaggeration to say nurses are front and centre of our national reform plan.
Nurses are the backbone of our health system.
Of almost 600,000 Australians employed in health service occupations, 233,500 or 40 per cent are nurses. You outnumber doctors by about four to one.
The health system can’t run without you. And our reform plan won’t work without you. Which is why we’re so pleased to continue our work with you now we are in the implementation phase of reform.
Today I’d like to give you a run down of all the features of the health budget that will be important to you as nurses – which will cover just about every part of the health budget.
Before that, it is worth taking a moment to take stock of what the Rudd Government has already delivered for nurses.
Reforms for nurses already delivered
We were the first national government to appoint a nurse to represent and speak for nurses and midwives nationally.
Rosemary is here today, and she’s your seat at the table when government policy decisions are being made.
We took immediate action to address the national shortage of nurses and midwives by boosting number of university places by more than 1,000 each year.
We provided long overdue recognition of the skills of nurses, with nearly $60 million in last year’s budget to expand MBS and PBS access to nurse practitioners. This is the first expansion of frontline access to the MBS since the optometrists were given access in 1985.
Utilising the considerable skills of nurse practitioners, especially in multidisciplinary teams can greatly improve the capacity of Australia’s health workforce and access to primary care.
These new MBS and PBS arrangements will commence on 1 November this year – less than 6 months from now.
Two weeks ago I joined the ACT Health Minister to open the new Nurse Practitioner Walk-in Centre at Canberra Hospital. It’s the first clinic of its kind in Australia, where primary health care services are provided by nurse practitioners, for free.
By treating more minor cases, it will reduce pressure on the Canberra Hospital emergency department and allow emergency staff to concentrate on more serious and life-threatening cases.
It’s another exciting innovation.
These were immediate reforms we implemented whilst our plans for the longer term, root and branch reform of the nation’s health system took shape.
I remember speaking to many of you last year in Melbourne, just after the release of the Reform Commission’s final report, and giving you a power point presentation of the report’s recommendations. The budget also replied to all 3 reform reports.
I want to take the time to give you the key points of our plans so you can see just how central nurses are to the reforms.
2010 Health budget overview
Our Budget announced earlier this month included a package of $7.3 billion over five years in additional funding to deliver more doctors, more nurses, more hospital beds and shorter waiting times for all Australians.
Most key elements of that package relate directly to nurses and their work –
- more support for nurses, particularly aged care nurses;
- locum relief for rural nurses and allied health professionals;
- incentive payments to general practices to employ practice nurses;
- quicker emergency department and elective surgery treatment times;
- personally controlled electronic health records;
- 1,300 new sub-acute hospital beds and 2,500 additional aged care beds;
- new investments in prevention, including anti-smoking measures; and
- new investments in mental health services, especially for young people.
The Commonwealth will also take full funding and policy responsibility for public GP and primary care services, and all aged care services.
These funding changes are not just about who pays for what.
The Commonwealth will introduce national systems and standards, and to greatly improve the integration and collaboration between various types of health services.
Our reform plan provides the platform for comprehensive and systemic changes to health services – building on our current strengths, whilst reshaping the system to better meet the needs of patients and health care in the 21st century.
The changes will affect every part of our health system, and create for the first time one national, rational, efficient, effective system that is focussed on patients, not processes.
I can’t stress enough that I believe these reforms represent a great opportunity for the nursing profession. I want to encourage you to grav that opportunity to now help to put them into effect.
You will be very central to the delivery of the new National Health and Hospitals Network.
Hospitals and Health Reform
In very broad terms, the new National Health and Hospitals Network will mean better care for patients in health and hospitals because:
- there will be much greater continuity of care across sectors of the health system, including between hospitals and local primary care; and
- hospitals will have to meet high national performance standards – on a range of issues such as waiting times in emergency departments and for elective surgery, adverse reactions, unsuccessful treatments;
Nurses and midwives working in primary health care will notice some significant reforms in their workplace.
The Commonwealth has agreed to majority funding and policy responsibility for public GP and primary health care services, and aged care services.
These reforms will create pathways between primary care and other parts of the health system – making it easier to traverse for both patients and for health professionals.
In particular, nurses will play an expanded and important role in the future primary health care system.
The increasing employment of nurses in general practice has been a major change over the past decade. Most general practices now employ at least one nurse to work with the doctor and complement their services with a range of primary health care and treatment.
This has been a step forward, allowing GPs to focus more on the complex medical work for which they are trained and give practice nurses a greater role, with the ultimate winner being patients, who will get the care they need.
The Rudd Government’s health reforms will extend this trend, enabling and encouraging GPs to work in a team environment with nurses and with other types of health professionals – such as psychologists, dieticians, podiatrists, and physiotherapists.
In the budget, we have provided $390 million to support around 4,600 more full-time equivalent practice nurses working in general practice and primary health care centres.
Practice nurses can relieve the pressure on GPs by providing immunisations and wound care, by educating patients on managing and preventing illness, and managing appointments.
The Australian General Practice Network has found that practices employing a practice nurse see more than 800 extra patients each year. On that basis our Budget package will allow an extra 3.8 million patients across Australia to get an appointment with their local practice.
For the first time, funding will be available to GPs in urban areas to help them to employ practice nurses.
Eligible practices will be able to get annual incentive payments of $25,000 per full-time GP for a registered nurse, and $12,500 per full-time GP for an enrolled nurse.
Nurses will also be essential in delivering the Government’s $447 million initiative to provide better coordinate care for patients with diabetes, of whom there are currently nearly 1 million.
Our program will allow people with diabetes to sign up with a general practice of their choice, which will be paid by the Government to manage their care and organise additional services as they need them - such as a diabetes nurse, a dietician or podiatrist.
This will help patients to maintain and improve their health, with GP practices for the first time being rewarded for meeting performance benchmarks.
It will reduce the costs associated with managing complications of diabetes and of unnecessary hospital admissions.
Both the Reform Commission report and the National Primary Health Care Strategy recommended this type of voluntary enrolment with a primary care service, for people with chronic and complex conditions.
The Government will work with patient and health consumer representatives and key primary health care groups, including GPs, nurses and allied health providers, on detailed implementation arrangements for this policy.
Hospitals
Those of you who work in our public hospitals will also notice some significant changes for the better.
Under our new national system, the Commonwealth will provide funding for public hospitals of 60 per cent of the efficient price of the services delivered by each hospital to public patients.
There will be additional funding to support small regional and rural hospitals. We know they don’t have the same economies of scale as the big city hospitals and will need special attention.
We also recognise the good job that private hospitals do in many areas, and our reforms will encourage much greater collaboration between public and private health services to get the best care for patients.
We have agreed with the States that some services are best managed on a State-wide basis. They include research and training in public hospitals.
The Commonwealth will pay the States and territories directly for this and also provide a funding stream for major capital investment in public hospitals.
It will be the first time that either research and training in hospitals or their capital needs have received an ongoing funding commitment from the Commonwealth.
I think you will agree that’s a really important step forward in itself. Training of nurses, allied health workers and of course doctors is essential to the future of our health system, and so is making the investment in buildings and equipment.
The other element of our new funding structure is the creation of the Local Hospitals Networks.
Responsibility for hospital management will move from the State Health Departments, to the new Local Hospital Networks. The LHN Governing Councils will include a range of community representatives and health professionals including potentially nurses and midwives. Each network will be able to tailor services to needs of the local community and will be responsible for managing and delivering hospital services.
The Local Hospital Networks will be paid directly by the Commonwealth, and will responsible for hospitals within their regions. The States will remain as system managers for the public hospitals.
All hospitals, private and public, will be subject to new, higher national standards and transparent reporting.
This will provide Australians with more information than ever before about the national, state and local performance of the health system.
These reforms and investments will drive major improvements in service delivery and better health outcomes for Australians.
Our reforms will result in changes in every hospital that will make it easier for nurses to do their fantastic work, and will allow them to take on new roles.
We are very pleased to be offering these increased opportunities for nurses. It is good for nurses, and good for the patients who will ultimately benefit.
Rural locum scheme
That’s why the Budget also provided $28.8 million over four years from 1 July 2010. This will give 3,000 nurses time to take leave to attend continuing professional development.
The Government recognises it’s not always easy for nurses or any other workers with very demanding jobs to take the time to undertake the extra training they need.
Many of our health facilities in rural and regional Australia rely heavily on nurses to keep things ticking over. Nurses are better distributed across the country than doctors, which places extra pressures on nurses to maintain services in areas experiencing doctor shortages-and we’d like to keep them supported in these roles.
It might be the duty nurse keeping the doors of the local hospital ED open through the night. Or the practice nurse working long hours to immunise kids at the district central school.
Working hard, long hours, often alone and without much support, and with little time to do things like study. These nurses need a hand. So the locum program will be a great chance to provide support and relief to those rural nurses.
Super clinics
Our GP Super Clinics program is also playing an important role in expanding the role of nurses in primary care.
Since 2007, the Government has funded the development of 36 GP Super Clinics in communities across Australia that lacked adequate access to primary care.
These Clinics provide comprehensive services in a single location, bringing together GPs, nurses, visiting medical specialists, allied health professionals and other health care providers.
For example, in Strathpine, the GP Super Clinic has provided almost 4000 nursing and allied health services since opening earlier this year- bringing more comprehensive health services to the local community.
The Super Clinic model has been warmly embraced in these 36 communities, and the Government will further expand the roll out of this important community infrastructure.
I am very pleased that the Budget included funding of more than $355 million to add to this network with another 23 GP Super Clinics -
and also to upgrade around 425 general practices, community health services, and Aboriginal Medical Services.
There will be around 9 new large GP Super Clinics, and 14 new medium GP Super Clinics.
The new GP Super Clinics will open for extended hours and be staffed by teams of health professionals, including doctors, nurses and allied health professionals.
The large clinics will also have offer more specialised services such as renal dialysis, minor surgical procedures, rehabilitation services, radiology and state funded services.
They will have significant capacity for inter-professional clinical training and education and help train the next generation of health professionals
Medicare Locals
The Budget also included $416 million to establish a nationwide network of Medicare Locals and improving access to after hours primary care.
The National network of “Medicare Locals” will mean that anyone needing to see a GP outside normal business hours will:
- Call their usual general practice, and if it’s closed, their call will be directed to the National Health Call Centre Network,
- Then speak to a nurse or GP about their problem;
- If required, they will be referred to a local after hours GP service which will be coordinated by Medicare Locals.
These will develop from current Divisions of General Practice- so time to go and see them in your area to talk nursing if you are in primary care.
By improving access to primary care, and boosting services, our goal is to reduce demand for highly expensive acute care as much as possible, and treat patients in the community and as close to home as possible.
Aged care
That brings me to the next big area of change and progress for nurses – aged care.
As our population ages, we will of course need more aged care, and we will need more aged care workers including nurses.
The Budget includes $103 million to better support nurses and other aged care workers working in aged care settings:
- $59 million to provide incentive payments to existing aged care workers who upgrade their qualifications, and remain working in the aged care sector;
- $21 million to fund an additional 600 enrolled nurse training places and 300 registered nurse scholarships for aged care nurses to upgrade their skills so they can deal with the increasing frailty of people in aged care;
- $18 million to trial new models of care to expand and improve the role of nurse practitioners in aged care; and
- $3.5 million to explore regulation of personal care workers and assistants in nursing in aged care.
We will also commission research to see how we can make sure we have the right number of staff with the right mix of skills to provide the care people should receive.
I hope I have been able to demonstrate that this truly is a budget, and a reform plan, that delivers for Australia’s nurses in the years to come- building on the work of our first busy year.
Conclusion
What I have given you today is really just a brief rundown of what is going on.
It is very exciting for health policy. After a decade of inaction by the former government, we are now rolling out the most significant changes since Medicare was introduced almost three decades ago.
I am sure you agree it all adds up to big change and very positive change for our health system and our hard working workforce and nurses.
Nurses and midwives are central to our reform plans for acute hospital care, primary care, and preventative health.
I believe the changes which are now underway represent a major advance in the development of the nursing and midwifery profession.
You’ve already come a long way in two and a half years since the Rudd Government was elected. Under our reform plan, this progression will accelerate further.
Nurses in hospitals, general practice, community health, aged care, nurses in rural and regional Australia will all be called on to contribute to help deliver even better care for Australian patients.
That is a good thing for you and a very good thing for all Australians who will continue to rely on you at every point in our health care journey, throughout our lifetimes.
The Rudd Government is committed to continuing to work with you all to continue to support, and nurture the growth of nursing.
I wish you all the best for your 2010 Summit – there is much to discuss, and I look forward to some updates of your work.
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