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Nursing Research Online
The final report of the five-year long review of the Medicare Benefits Schedule (MBS) was quietly released in December. This process was established to ensure the MBS remains fit for purpose as health needs evolve. The final report’s recommendations in relation to nurse practitioners are deeply disappointing and we are working with the profession to ensure they are not implemented.
A perverse, offensive and oppressive rejection of nurses
Mary Chiarella & Jane Currie, 17 December 2020 Published 14 December 2020, the Medicare Benefits Schedule Review Taskforce (MBSRT) Final Report endorsed none of the 14 recommendations of its own Nurse Practitioner Reference Group (NPRG) Report. Instead, the report proposed three unrelated recommendations that further restrict the practice of nurse practitioners (NPs) who provide services subsidised by the MBS: a decision not to endorse any of the 14 recommendations can only be viewed as a decision not to invest in nursing and the health of Australian communities. The NPRG (one of five different professional groups established by the Taskforce) was multidisciplinary, comprising a range of practising NPs, both public and private; consumers; registered nurses; a medical practitioner from the MBSRT who was an ex-officio member; and professional and industrial nursing group representatives. Many of the recommendations focused on adjusting items that were already working well, or expanding recently introduced items through increased access or expanded scope. Fourteen evidence-based recommendations presented by the reference group sought to broaden the range of NP services subsidised through the MBS, and thereby encourage the growth of this much-needed nursing workforce. The review drew on various types of MBS data. It also used evidencebased data from the literature and clinical guidelines of peer-reviewed nursing and medical journals and other sources, such as government reports and professional societies, to address its remit from the MBSRT. Research evidence tells us that NPs provide quality care, that patients are highly satisfied with their care and that NPs have increased access to health services, particularly for marginalised populations in community settings. Other studies have demonstrated that NPs prevent representations to ED and that their expertise is drawn on significantly by the multidisciplinary teams. https://johnmenadue.com/ mary-chiarella-and-jane-curriea-perverse-offensive-andoppressive-rejection-of-nurses/
©2020 Commonwealth of Australia (Department of Health) The Australian Government established the Medicare Benefits Schedule (MBS) Review Taskforce (the Taskforce) in mid-2015 to review the more than 5700 items on the MBS. This has been the most comprehensive review of Medicare since its inception in 1984. The Taskforce is pleased to report it has completed its work, providing the government with more than 1400 recommendations to strengthen, modernise and protect Australia’s world-class health system. The Taskforce focused on ensuring MBS items meet the goals of affordable and universal access, best practice healthcare, and value for both the individual patient and the health system. Within the Taskforce’s brief, there was also considerable scope to review and provide advice on all aspects that would contribute to a modern, transparent and responsive system. This included not only making recommendations about consolidating, amending and updating MBS items, but also about an MBS structure that could better accommodate changing health service models. This Final Report outlines the Taskforce’s approach and its key achievements to date, as well as the need for continuous review and reform of the MBS, and the challenges and opportunities that lay ahead to improve the MBS within the broader health system. The Taskforce recommends implementing all MBS Review recommendations made to date. https://www.health.gov. au/resources/publications/ medicare-benefits-schedulereview-taskforce-final-report
2018 Nurse practitioners (NPs) have been practising in Australia for 18 years and were admitted as eligible providers under the MBS nearly a decade ago. Since that time, the interaction between the MBS and the NP role has not been reviewed for functionality, its relevance to consumers, or its impact on the provision of and access to highquality health care. Models of care provided by NPs have the primary goal of improving access to care within the MBS, particularly in priority areas including aged care, Aboriginal and/or Torres Strait Islander peoples’ health, mental health, chronic condition management and primary health care. Within these models, NPs may be the primary health care provider for a consumer or may be working as part of a team. Despite the innovation and flexibility of these models, they remain curtailed by the limited number of items for which patients may receive MBS rebates when cared for by an NP. Rebates available to patients of NPs under the MBS do not reflect contemporary NP practice in Australia. This restricted access to MBS items limits consumer choice, affects accessibility, creates fragmentation and, at times, drives unnecessary duplication and costs throughout episodes of care. https://www.health.gov. au/resources/publications/ taskforce-findings-nursepractitioner-reference-groupreport
