A seat at the table

Under federal Labor, nurses now have a say in the formulation of health policy.

The voices of nursing and midwifery unions and their members were rarely heard in Canberra’s corridors of power during the nine years of Liberal/National governments before May 2022.

The Morrison government and its Liberal/National predecessors typically failed to include nursing and midwifery professionals in consultations with health stakeholders.

“Nurses and midwives weren’t represented at the table and therefore their voices and input weren’t recognised in the formulation of health policy,” says Annie Butler, ANMF federal secretary.

Things have changed since the election of the Albanese Labor government last May.

Annie got a meeting with federal health minister Mark Butler within a week of him being sworn in and has since spoken with him often.

She said her appointment to the Strengthening Medicare Taskforce last year showed that the new government “recognises the importance of nurses and midwives in these critical discussions, shaping long-overdue health reforms”.

“In my view the minister totally understands the problem and solutions (regarding Medicare) including the need to enhance the roles of nurses and midwives to reduce duplication of services and unnecessary additional costs.

“It is such a different relationship with this government than the one we had during the previous nine years.”

She says greater access to the government “doesn’t mean everything is rosy all the time – we’ve still got to fight our case pretty hard”.

“But this government’s starting point is fundamentally different to their predecessors – they are much more about trying to ensure equal access to care for everybody.”

Member Involvement Is Vital

The ANMF has taken groups of NSWNMA members and union members from other states to see Mark Butler about reforms to Medicare and aged care.

“No one puts the issues more eloquently than our members themselves,” Annie says.

“They are in the best position to explain the ridiculousness of the way the system is currently set up and the barriers it creates to effective primary health care.

“Without member involvement, stories about the failings and frustrations of the current system just don’t make any sense.”

Annie joined a range of health professionals on the Strengthening Medicare Taskforce, including the Australian Medical Association and the Royal Australian College of General Practitioners, the main doctor organisations.

She says the government will need “political courage” to manage “predictable opposition” from the AMA and RACGP and craft a new Medicare that faithfully reflects the Taskforce recommendations.

“People across the health system know the solutions that are urgently needed but we’ve got to find a way to make reforms that can’t be undone by a future government with a different view.”

She hopes to further involve nurse union members in discussions with the government as it formulates policy based on the Taskforce report.

PM ‘COMMITTED’ TO AGED CARE REFORMS

Annie has twice met Prime Minister Albanese in her capacity as ANMF federal secretary. They talked mainly about aged care reform.

“The PM is deeply committed to the aged care program that his government has started to set in place,” she says.

“Aged care reform is really hard because it is very complicated and will take time.

“However, the legislation the government has put in place has laid down a framework to build on.

“For many years, our union has been calling for RNs in nursing homes 24/7 – we have now got that.

“We’ve got a law that mandates minimum care hours. It’s not perfect, but it has given us a starting point and we have started to build on it.

“We’ve also got a commitment from the government to fund the outcomes of the current work value case.

“We’ve already got a stage 1 decision to award a 15 per cent increase to award rates – that’s a great start.

“It is likely to lead to really meaningful wage increases for aged care staff, who are some of the lowest paid workers in the country.” n

Biggest change in generations –Grattan Institute

The Strengthening Medicare Taskforce recommendations “amount to the biggest change to general practice in generations” says the Grattan Institute, a leading public policy think tank.

The Institute’s director for health and aged care, Peter Breadon, said Australians have got older and sicker since Medicare was designed 40 years ago.

“Many of us require longer consultations (and) there is strong evidence that people will be healthier and live longer if they have ongoing relationships with their care team, not just one-off visits.

“Today, we have a fee-for-service model that rewards doctors for seeing lots of patients for short, one-off visits.

“There are many primary care workforces, such as nurses and allied health workers, whose training means they can help GPs manage a growing and more complex caseload.

“But as it stands, our rules, regulations and funding model limit the help they can provide.”