A bigger role for nurses

Federal Health Minister Nicola Roxon says her health reforms include a bigger role for nurses and a change in priority towards prevention and primary care.

Last month, in the Ben Chifley lecture – a significant forum for ALP policy presented annually in Bathurst – Federal Health Minister Nicola Roxon outlined her vision for reforming our health system. A key priority, she says, will be to shift more responsibility from doctors to nurses.

Roxon told doctors to cooperate with reform or face a pay cut.

‘There needs to be an incentive for doctors to eschew less complex work and focus on the work that does require their high-level skills and expertise. Or, if doctors don’t want to let go of it, to accept being paid less for devoting their highly-skilled and heavily-trained selves to less complex tasks,’ she said.

The Minister said there was a financial disincentive for GPs to provide the type of longer, intensive visit that prevention demands – ‘like teaching somebody how to lose weight, keep fit, and avoid diabetes’.

‘There is a long-standing, historical anomaly here. Our health system, including funding for health services, is organised almost entirely around doctors, despite the fact that many services are now safely and ably provided by other health professionals – nurses, psychologists, physiotherapists, dieticians and others,’ she said.

Nicola Roxon said it was possible for nurses and other health professionals to take on some of those responsibilities and suggested Labor would make it attractive for them to do so.

‘In doing so, we will not only be redressing the historical bias towards medical intervention and acute care, we will be redressing the historical bias against the traditionally female nursing workforce,’ she said.

Health is crucial to tackling inequality

In her speech, the Minister claimed that all the great health initiatives in the post-war period – especially the pharmaceutical benefits scheme and universal health care – were hard-fought social gains won under a Labor government.

‘Over time [there] is a clear cycle: Labor introduces a signature health reform; it is opposed by the conservatives, and by the medical profession; as it gathers public support, the fight is won; and the Liberals are forced to accept that the reform has won community support and a firm place in Australian society,’ she said.

Despite this progress, she argued, health remains a major indicator of inequity.

‘If you want to judge how affluent a suburb is, you could check its tax returns – or you could look at its medical records. Rates of diabetes, of heart disease, early deaths, infant mortality, how many teeth a person has left – all are clear markers of socio-economic status.’

This, she said, had two lessons for health policy.

  • First, that health policy can’t exist in a vacuum. As is most clearly demonstrated by our approach to Indigenous health, we know we must simultaneously work on improving housing, education, and employment.
  • Second, that investing just in hospitals can play only a very limited role in addressing disadvantage. It can do a great deal of good, but the chance at early intervention, and a better life, has been lost.

‘There is now much to be done. If we are to tackle inequality in this country, then reshaping health is crucial. If we want our kids to live longer, not shorter lives than us, we can’t afford to rest,’ she said.