The Canberra Times
6/09/2009 10:35:00 AM

ONCE again it seems the jostling for position in the medical practitioner field is getting nasty.
Doctors, some 420 of them, have signed a letter opposing legislation which would enable qualified nurse practitioners to perform general practice services independently.

It is an ongoing debate, one which has been heard across a nation with increasing doctor shortages, the acceleration of emergency department waiting times and the general malaise of a health system groaning under the weight of overwork.

In Canberra alone, there has been a record demand for public hospital services, putting pressure on elective surgeries and creating longer waiting times. The ACT Government has put out a request to the public to try and avoid using hospitals for minor ailments, and during the next three months will be working with private hospitals to negotiate buying more beds, reducing elective surgery and spreading care across private hospitals in Canberra.

On the general practice front, an exclusive report in April by The Sunday Canberra Times revealed half of Canberra's general practices had closed their books to new patients, and a significant number had very long waiting times.

So how, then, to alleviate these problems?

A Bill before the Senate would enable nurse practitioner patients to claim rebates from Medicare and the Pharmaceutical Benefits Scheme for services undertaken and medicines prescribed by such practitioners. At present, the absence of such rebates is an obvious disincentive for patients who, put simply, have to pay more.

During recent years, a number of studies have shown that the use of nurse practitioners has made significant inroads into health care availability (the ACT's Aged Care Nurse Practitioner Pilot Project, or a recent study by Melbourne's Alfred Hospital of nurse practitioners operating out of the emergency department bears this out).

So why the problem?

Nurse practitioners are registered nurses with at least five years in their chosen area of practice post-registration and at least seven to nine years study, including masters-level university qualification. There is no doubting their competency.

There are about 260 in Australia and they work primarily in illness prevention, chronic disease management, aged care, emergency care, wound care, diabetes education, sexual health and rural health.

To suggest they should be excluded from a rebates system for services they can already provide is a backwards step.

While not all doctors oppose the measure, and many have been vocal in support, this latest petition can only suggest a sour-grape mentality by those keen to maintain a monopoly on public health.