Cardwell is the latest, but not the last

Time to fund nurses and allied health professionals in multidisciplinary teams 

Media Release 23 August 2023 

The Australian Primary Health Care Nurses Association (APNA) is aware of the situation in Cardwell where State and Commonwealth government intervention has been required to maintain primary health care (PHC) services to a rural community.   

This is not an isolated situation, as it is common in rural communities across Australia. Communities such as Cardwell are bearing the brunt of GP and other health workforce shortages, resulting in a lack of access to primary care. 

The intervention, announced by Queensland Minister for Health and Ambulance Services and Minister for Women, Hon Shannon Fentiman MP, and led by the Townsville Hospital and Health Service (HHS), Northern Queensland Primary Health Network (NQPHN), and Cassowary Coast Regional Council (CCRC), is a good start to responding to this urgent community need. We welcome this action from Minister Fentiman and the federal government.   

APNA wants to work alongside the Minister to make Queensland a leader in multidisciplinary models of care. At a national level, we will work with the Commonwealth on systemic change to address the core problem of Medicare funding is required to reduce the incidents like this across Australia. 

The Commonwealth Government should reduce the reliance of primary health care services on general practitioners by reforming Medicare to enable nurses, paramedics, allied health, and other health professionals to treat patients under a multidisciplinary team operating model. 


Health provision in rural communities 

Australia currently faces significant challenges in the provision of health care.  In general practice, a key part of this is the challenge in effectively using its health workforce under the current Medicare funding model.  

One of the impacts of the current funding model is that communities can be left vulnerable when general practitioners are unavailable to provide health services.  Under Medicare, general practitioners are the gatekeepers to health services.  When a general practice cannot secure a general practitioner, it also loses nurses and allied health professionals. 

 Access to health services keeps communities healthy.  Many community health needs can be provided by health professions other than doctors. There are thousands of health workers who are ready to work together to ensure rural communities have access to health services, including nurses, paramedics, midwives, pharmacists, allied health and nurse practitioners. 


Potential solutions 

Increasing the sustainability of primary health care services in Cardwell is essential:  

  • In the short term, providing for the health needs of Cardwell through multidisciplinary teams is vital. This can be delivered by nurses, paramedics, allied health, and nurse practitioners, working together in conjunction with Townsville HHS. Many primary care services around Australia are already using nurse-led models to help support people with chronic health issues. 

  • In the medium-term, reducing reliance on general practitioners by enabling multidisciplinary team funding models is essential.  This will require changes to how primary health care is funded under Medicare.  

 APNA has strong working relationships with Northern Queensland stakeholders, including NQPHN and will work with them to find short-term solutions and ultimately work with the Commonwealth Government on long-term sustainable models of care and funding. 

 Potential healthcare solutions include: 

  • Use of multidisciplinary care models: Many models for multidisciplinary care exist across Australia but are not funded under Medicare. APNA has established models of care for preventative health and chronic disease which can be implemented successfully. 

  • Better use of the non-GP workforce: Nurses are the most geographically spread of all health professions. Currently, a third of Australian PHC nurses report never or rarely being used to their full scope of practice. There are also many Nurse Practitioners in QLD who are unable to use their skills because of low MBS billing and a lack of recognition of their skills. Allied Health professionals and paramedics are also underutilised in primary health care. 

  • There is a timely opportunity for Government to intervene to support the community and build a multi-disciplinary public primary care health service for its future needs. 

Queensland has a unique opportunity to be a leader in innovative nurse-led models of care.  APNA will work with state and Commonwealth Governments to make Australia a leader in multi-disciplinary primary care nurse service delivery in Australian communities.  

The Australian Primary Health Care Nurses Association acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respects to elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.

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