The country’s nursing fraternity has spent the past few weeks absorbing the Rudd Government’s Federal Budget, which promises a patient care revolution. And nurses are expected to play a big part in the change. Nina Hendy reports.

Prime Minister Kevin Rudd has sent a loud and clear message to the country’s nursing workforce via the Federal Budget, voicing expectations that nurses will step up and play a greater role in the healthcare revolution.

The recently released Budget includes a funding allocation to encourage nurses to step up to the frontline of primary health care in a change that appears to have been reasonably well received by the workforce.

The budget, which outlines $7 billion of expenditure on the healthcare system, includes an allocation for nurses employed by doctors’ surgeries to undertake work traditionally seen to by doctors, including pap smears, test blood sugar and coordinating patient follow-ups.

The budget includes a payment of up to $25,000 for every general practice in the country to employ a registered nurse to free up GPs in what is Rudd’s answer to overcrowded clinics.

The payment will see a three-doctor practice with a payment of up to $75,000 to employ a full-time nurse, while a six-doctor practice will receive up to $150,000 to fund two full-time nurse positions.

These nurses will educate patients with chronic illnesses like diabetes and heart disease, about how to better manage their illness. Nurses will also make home visits, be responsible for dressing wounds, will carry out asthma tests and also administer vaccinations. They will also help chronically ill patients make appointments with specialists when ongoing care is needed.

In a speech delivered to the Australian Practice Nurses Association (APNA) in early May, Minister for Health and Ageing Nicola Roxon said practice nurses play a key role in government reforms. “We already know you are a profession that is going from strength to strength – with your numbers increasing by 15 per cent in the latest practice survey from 7,728 to 8,914.

“What we also know is that there is so much more to harness for the benefit of the community if we can lift some of those barriers that prevent many of you from working to your full scope of practice. We are committed to working with you to make this happen,” Roxon said.

APNA said it had long been arguing that current funding of nurses in general practice has restricted patient access to the wide range of services nurses are able to provide. Anne Matyear, president, APNA, said nurses are among the most trusted professionals in Australia.

“Replacing the current funding process with block grant payments will enable practices to tailor the nursing contribution to patient care to their particular community needs and to make the most effective use of nurse skills. We know that other health systems with block grant funding for nurses overseas have experienced a revolution in the patient experience in primary care,” Matyear said.

But the Queensland Nurses Union (QNU holds concerns that the government’s cash splash on registered nurses in general practice will exacerbate the existing statewide nursing shortage. Gay Hawksworth, secretary, QNU, feared that the budget could demand at least another 4,000 nurses, despite an existing nurse shortage in the Sunshine State.

The QNU believes that at least another 14,000 nurses will be required across Queensland to meet demand for public and private care by 2014.

But this issue could be alleviated if the government also increases the number of available nurse training places at universities.

However it appears that some nurses are already undertaking the work of doctors in general practice. If this is widespread, it could ultimately spell a gross overspend by the Rudd Government.

Comments on a newspaper website from a Gold Coast nurse calling herself Helleen paints the picture. “I have been employed as a practice nurse for the past five years and we are already doing most of the procedures that have been discussed so far. The doctors receive this incentive to employ a nurse in their practice, but even though the nurse does all this work, the amount is not passed onto the nurse,” the comments read.

“We are one of the lowest paid (nursing workforce) in the nation, and as a consequence we are always short-staffed. Why does the government think that by paying the doctors more to employ a nurse they will actually be able to attract nurses to work for them? Maybe if the government gave the incentive straight to the nurse, not the doctor, more (nurses) would want to do the work,” it continued.

But the decisions have already been made and the budget put in motion, with Roxon telling the APNA that the Rudd Government has committed to taking full funding responsibility for all primary health care and GP services.

“Too many patients find themselves shunted from one part of the health system to another, with no assistance, little consistency and constant duplication.”