Midwife and nurse practitioner boost

MIDWIVES and nurse practitioners will spearhead Canberra's ambitious health workforce reforms, winning the right to both prescribe subsidised drugs and to bill their services to Medicare.

 The announcement goes further and faster towards breaking down doctor-nurse boundaries than the Government's health reform adviser has recommended, by taking the changes national from November next year.

The National Health and Hospital Reform Commission's interim report this year backed access to the taxpayer-funded health schemes for nurse practitioners and other allied health workers, but angered nurses by proposing the reforms start in country Australia, where doctors are always in short supply.

Last night, Health Minister Nicola Roxon set aside $126million over four years in a tight budget to fund the sweeping changes, which will apply in cities as well as the bush.

Doctors have traditionally served as gatekeepers to Medicare and the Pharmaceutical Benefits Scheme, which they argue allows them to substantially lower the cost of consultations and medicines for their patients.

Nurse practitioners and midwives in state hospitals have diminished rights to the commonwealth subsidies, while those in independent practice have none.

The changes are part of a wider $120.5 million package aimed at giving mothers more choice.

The package provides professional indemnity insurance for many of the independent midwives who have lacked cover since the HIH collapse.

Home births, widely considered risky, are believed to be excluded.

The new funding for midwives has been made possible by the Government's planned cuts to "excessive fees" charged by private obstetricians, which will raise $351.3 million over four years.

Under those cuts, expectant women who once received an 80per cent rebate for all obstetric costs incurred once they reached the Medicare safety net threshold will have those benefits capped, costing them thousands of dollars.

Women who undergo IVF will also see their rebates dramatically curtailed, in a move fiercely opposed by infertility groups.