This bill became law on May 31st, 2024.
Health, care & disability
Nurse practitioners and eligible midwives can access MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care. and PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. without first having a formal collaboration deal with a doctor.
The law left nurse practitioners and eligible midwives needing a formal collaboration deal with a doctor before they could provide MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care.-funded care or prescribe PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. medicines, creating barriers especially in rural and remote areas. This bill removes that requirement so they can work within their scope and patients can access care and medicines more easily.
Before this bill, nurse practitioners and eligible midwives needed a formal collaborative arrangementA formal agreement with a doctor that, under the old law, was required before some nurse practitioners and midwives could use Medicare or prescribe PBS medicines. with a doctor before they could provide MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care.-funded services or prescribe PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. medicines, a rule the government said created unnecessary barriers and could leave rural and remote communities without practical access to care when no doctor was available. The bill responded by removing that legal requirement so they could work within their scope more directly, and after Parliament passed it in May 2024 it received Royal AssentThe final step that turns a bill passed by Parliament into an Act of law. on 31 May 2024.
The main criticism was that removing collaborative arrangementA formal agreement with a doctor that, under the old law, was required before some nurse practitioners and midwives could use Medicare or prescribe PBS medicines. rules will not fix the deeper shortage of doctors and other primary care workers, and could become a partial substitute for proper specialist access in rural areas. That concern was limited rather than broad: the Coalition still backed the bill while calling for wider workforce reform, and Pauline Hanson's One Nation raised the clearest warning against replacing doctors.
Ged Kearney MP introduced this bill. It passed on the voices.
Did it become law?
Yes
Became law 31 May 2024
Final passage
Passed without a counted vote
1 recorded amendment or procedural vote was found, but no counted vote on the bill itself was recorded.
Passage speed
72 days
From introduction to the latest recorded parliamentary step
Meaning
Nurse practitioners and eligible midwives can access MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care. and PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. without first having a formal collaboration deal with a doctor.
Eligible midwives will no longer need a formal doctor collaboration arrangement before they can provide MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care.-funded services.
Nurse practitioners will no longer need a formal doctor collaboration arrangement before they can provide MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care.-funded services.
Authorised midwives and authorised nurse practitioners can prescribe PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. medicines without first having a formal collaboration arrangement with a doctor.
Australians, especially in rural and remote areas, should find it easier to get primary care because fewer legal barriers will hold back nurse practitioners and midwives.
The Bill will amend the National Health Act 1953 and Health Insurance Act 1973 to remove the legislated requirement for a collaborative arrangement between a eligible nurse practitioner or eligible midwife, and a medical practitioner, in order for that eligible midwife or eligible nurse practitioner to prescribe Pharmaceutical Benefits Scheme (PBS) medicines or provide services under Medicare.Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) explanatory memorandum
This item amends the definition of “participating midwife” in subsection 3(1) by omitting all the words after paragraph (b) of the definition, which will remove the requirement for a participating midwife to be in a collaborative arrangement in order to deliver Medicare services.Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) explanatory memorandum
This item will omit all the words after paragraph (b) of the definition of “participating nurse practitioner” in subsection 3(1) of the HIA. Similarly to item 2, this will remove the requirement for a participating nurse practitioner to be in a collaborative arrangement of a kind specified in regulations in order to deliver Medicare services.Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) explanatory memorandum
This item will omit all the words after “84AAJ” in the definition of an “authorised nurse practitioner” in section 84 of the NHA. Similarly to item 5, this will remove the requirement for an authorised nurse practitioner to be in a collaborative arrangement in order to prescribe PBS medications.Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) explanatory memorandum
The Bill will remove barriers to primary care for Australians, particularly in rural and remote areas. It will support more effective use of the existing health workforce recommended by the Strengthening Medicare Taskforce Report and Nurse Practitioner Workforce Plan.Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) explanatory memorandum
Context
Before this bill, nurse practitioners and eligible midwives needed a formal collaborative arrangementA formal agreement with a doctor that, under the old law, was required before some nurse practitioners and midwives could use Medicare or prescribe PBS medicines. with a doctor before they could provide MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care.-funded services or prescribe PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. medicines, a rule the government said created unnecessary barriers and could leave rural and remote communities without practical access to care when no doctor was available. The bill responded by removing that legal requirement so they could work within their scope more directly, and after Parliament passed it in May 2024 it received Royal AssentThe final step that turns a bill passed by Parliament into an Act of law. on 31 May 2024.
Existing collaboration rule is described as a barrier to care
In the second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. speech, the government said nurse practitioners and endorsed midwives still needed a formal arrangement with a doctor to access MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care. and PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through., which could block care in rural towns if no doctor was available.
Second reading speech ↗Bill is introduced to remove the collaboration requirement
The government introduced the bill to scrap the legislated doctor collaboration requirement for MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care.-funded services and PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. prescribing by eligible midwives and nurse practitioners.
Parliamentary timeline ↗Parliament passes the bill
Both houses passed the bill, clearing the way for the collaboration requirement to be removed from the Health Insurance Act and National Health Act.
Parliamentary timeline ↗Collaboration requirement ends for MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care. and PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. access
Schedule 1 commenced on 1 November 2024, removing the formal doctor collaboration arrangement requirement for eligible midwives and nurse practitioners to use the relevant MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care. and PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through. pathways.
Parliamentary timeline ↗Legislative route
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Introduced and read a first time
A minister or sponsoring member moved the second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., opening the main debate on the bill's purpose and principles.
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. moved
The bill reached this recorded parliamentary step.
The bill reached this recorded parliamentary step.
Referred to Federation Chamber
The bill reached this recorded parliamentary step.
The chamber agreed to the bill at second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., meaning it accepted the bill in principle and allowed it to continue.
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. agreed to
The bill reached this recorded parliamentary step.
Reported from Federation Chamber
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Third reading agreed to
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Introduced and read a first time
A minister or sponsoring member moved the second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., opening the main debate on the bill's purpose and principles.
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. moved
The bill reached this recorded parliamentary step.
The chamber agreed to the bill at second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., meaning it accepted the bill in principle and allowed it to continue.
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. agreed to
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Third reading agreed to
Both houses passed the bill in the same form, completing parliamentary passage.
Finally passed both Houses
The Governor-General gave Royal AssentThe final step that turns a bill passed by Parliament into an Act of law., turning the bill into an Act.
Key criticism
The main criticism was that removing collaborative arrangementA formal agreement with a doctor that, under the old law, was required before some nurse practitioners and midwives could use Medicare or prescribe PBS medicines. rules will not fix the deeper shortage of doctors and other primary care workers, and could become a partial substitute for proper specialist access in rural areas. That concern was limited rather than broad: the Coalition still backed the bill while calling for wider workforce reform, and Pauline Hanson's One Nation raised the clearest warning against replacing doctors.
No party represented in the debate opposed the bill itself, but some support came with broader workforce reservations.
Does not solve wider workforce shortages
Critics argued the bill removes one barrier but does not by itself fix the larger shortage of GPs, specialists and other health workers, so patients may still struggle to get care unless broader workforce and scope-of-practice reforms follow.
Should not replace doctor and specialist access
A narrower objection was that expanding nurse practitionerAn advanced-practice nurse with extra qualifications who can diagnose and treat within a defined clinical scope. and midwife roles in rural areas should not be treated as a replacement for recruiting more doctors or improving specialist and telehealth access.
Further sources
Votes
The bill passed both chambers on the voices. The counted divisions below were about amendments or procedure, not final passage.
House agreed to the bill's third reading on the voices, so there is no list of individual Aye and No votes for final passage in that chamber.
Passed on the voices
In a voice vote, members call out Aye or No and the presiding officer judges which side has it. Individual names are only recorded if a formal division is called.
Senate agreed to the bill's third reading on the voices, so there is no list of individual Aye and No votes for final passage in that chamber.
Passed on the voices
In a voice vote, members call out Aye or No and the presiding officer judges which side has it. Individual names are only recorded if a formal division is called.
Amendments grouped by chamber. These cards include amendment outcomes recorded without a counted division.
Senate
Defeated 11 to 35. Support came from Greens. Opposition came from Labor, Liberal Party, Nationals, One Nation, and minor parties and independents.
The request was defeated 11 to 35, so the bill continued without the Greens prisoner MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care.-benefit proposal.
The Senate rejected this second-reading proposal, which called on the Government to work with state and territory governments to let nurse practitioners and midwives work to their full scope and reduce limits in each jurisdiction.
Defeated on voices
The chamber decided this amendment without a counted division, so there is no list of individual Aye and No votes.
The Senate rejected this second-reading proposal, which said expanding nurse and midwife roles in rural areas should not replace more specialist doctors and urged more doctor recruitment and better telehealth links.
Defeated on voices
The chamber decided this amendment without a counted division, so there is no list of individual Aye and No votes.
The Senate Journal records this amendment outcome as carried on voices. The collected source does not identify it as a counted division.
Carried on voices
The chamber decided this amendment without a counted division, so there is no list of individual Aye and No votes.
The Senate Journal records this amendment outcome as defeated on voices. The collected source does not identify it as a counted division.
Defeated on voices
The chamber decided this amendment without a counted division, so there is no list of individual Aye and No votes.
These are amendment votes, not the final passage vote on the bill itself. The bill passed both chambers on the voices.
Parliamentary debate
Start here — lead voices
Ged Kearney strongly supports the bill, saying it will remove an unnecessary collaborative arrangementA formal agreement with a doctor that, under the old law, was required before some nurse practitioners and midwives could use Medicare or prescribe PBS medicines. requirement that limits nurse practitioners and endorsed midwives and creates barriers to care, especially in rural and remote areas.
Read in Hansard ↗Haines supports the bill and says it should pass because it removes an unnecessary collaborative-agreement hurdle for nurse practitioners and endorsed midwives, letting them provide MedicareAustralia's public health insurance scheme; on this page it means the services these practitioners can bill so patients can get subsidised care. and PBSThe government program that subsidises many prescription medicines; on this page it is the system these practitioners can prescribe through.-funded care to more patients.
Read in Hansard ↗Ayres strongly supports the bill, saying it will remove an unnecessary collaborative arrangementA formal agreement with a doctor that, under the old law, was required before some nurse practitioners and midwives could use Medicare or prescribe PBS medicines. requirement that limits nurse practitioners and endorsed midwives and creates barriers to care.
Read in Hansard ↗Phillips supports the bill and says it will remove barriers that stop nurse practitioners and eligible midwives from fully using their skills, especially in rural and remote areas.
Read in Hansard ↗All speeches by bloc
5 speakers · 6 contributions · 5 support
“This Bill will finally remove the legislated arrangement known as a 'collaborative arrangement' between a nurse practitioner or endorsed midwife, and a doctor . This will in turn assist in removing barriers to accessing primary care for Australians, particularly in rural and remote areas, where a general practitioner can be hard to come by.”Read the full speech in Hansard ↗
Hansard records 2 separate contributions by Ged Kearney, including an amendment-moving contribution. They are grouped here so the speaker is listed once.
Moved amendment
Ged Kearney strongly supports the bill, saying it will remove an unnecessary collaborative arrangementA formal agreement with a doctor that, under the old law, was required before some nurse practitioners and midwives could use Medicare or prescribe PBS medicines. requirement that limits nurse practitioners and endorsed midwives and creates barriers to care, especially in rural and remote areas.
“This bill will finally remove the legislated arrangement—known as a 'collaborative arrangement'—between a nurse practitioner, or endorsed midwife, and a doctor . This will, in turn, assist in removing barriers to accessing primary care for Australians, particularly in rural and remote areas where a general practitioner can be hard to come by.”Read this contribution in Hansard ↗
Second reading speech
Ged Kearney supports the bill, saying it will remove an unnecessary doctor sign-off requirement for nurse practitioners and endorsed midwives so they can work to the full extent of their training. She argues it will improve access to care, especially in rural and remote areas, without undermining clinical collaboration.
“This bill recognises that nurse practitioners and endorsed midwives are autonomous professionals who can deliver high-quality care to patients within their scope of practice.”Read this contribution in Hansard ↗
“The Albanese Labor government has no higher priority than strengthening Medicare to make it easier and cheaper for Australians to get the health care they need when they need it. By removing the legislative requirement for collaborative arrangements, we will make it easier and cheaper for Australians to access health care. We will also unlock the full potential of our wonderful nurses and midwives. I commend this bill to the House.”Read the full speech in Hansard ↗
“We said that we would strengthen Medicare and that's exactly what we're doing with bills like this one before the House today. I get great pleasure in commending this bill to the House.”Read the full speech in Hansard ↗
“Today's bill, therefore, is good news for all Australians, but especially for our nurse practitioners and midwives, as it further empowers them. Supporting these workers means that more may be encouraged to take up the professions and, in doing so, address some of the nation's workforce issues.”Read the full speech in Hansard ↗
2 speakers · 2 support
“So, we will support this bill. However, I will put on the record that the coalition will continue to call on the government to implement an urgent and comprehensive national workforce strategy until they start taking real action on this critical issue.”Read the full speech in Hansard ↗
“As I said, the coalition will not stand in the way of this legislation. We will support it because it removes a barrier to Australians accessing primary care. But we would also like to put on the record that we believe that there is an absolute necessity for us to address, with a greater level of urgency, the issues around workforce. That's why the coalition will be moving an amendment that calls on the government to work with the states and territories to ensure nurse practitioners and midwives can work to their full scope of practice and to reduce any restrictions on their scope of practice at the state and territory level.”Read the full speech in Hansard ↗
1 speaker · 1 support
“With the mandated collaborative arrangements currently in place, women are bearing the financial burden due to increased travel time and the cost of finding a GP who will provide a referral for midwifery care. This is even more problematic in rural and regional areas, where access to care is already limited. Removing these mandated collaborative arrangements is a very positive change for women's access to maternity care, sexual and reproductive health care and nurse led care. It's one that the Greens have supported for many years, and we're thrilled to see this legislation come to the chamber today. These are particularly important changes for women in rural and remote areas. We support this bill.”Read the full speech in Hansard ↗
1 speaker · 1 support
“In closing, this legislation is important and necessary, and the time has come for it to be passed. I want to thank Assistant Minister Kearney for all the work she has done on this; it's substantial, important and right, and I look forward to further work around the health professional scope of practice. I commend this bill to the House with great joy.”Read the full speech in Hansard ↗
Record
House · Introduced and read a first time
Introduced
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
House · Second reading moved
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. opened
A minister or sponsoring member moved the second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., opening the main debate on the bill's purpose and principles.
House · Second reading debate
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. debate
The bill reached this recorded parliamentary step.
House · Referred to Federation Chamber
Referred to Federation Chamber
The bill reached this recorded parliamentary step.
House · Second reading debate
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. debate
The bill reached this recorded parliamentary step.
House · Second reading agreed to
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. agreed
The chamber agreed to the bill at second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., meaning it accepted the bill in principle and allowed it to continue.
House · Reported from Federation Chamber
Reported from Federation Chamber
The bill reached this recorded parliamentary step.
House · Third reading agreed to
Third reading agreed
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Senate · Introduced and read a first time
Introduced
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Senate · Second reading moved
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. opened
A minister or sponsoring member moved the second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., opening the main debate on the bill's purpose and principles.
Senate · Second reading debate
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. debate
The bill reached this recorded parliamentary step.
Senate · Second reading agreed to
Second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments. agreed
The chamber agreed to the bill at second readingThe parliamentary stage where members debate the purpose of a bill before later votes and amendments., meaning it accepted the bill in principle and allowed it to continue.
Senate · Third reading agreed to
Third reading agreed
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Parliament · Finally passed both Houses
Passed both houses
Both houses passed the bill in the same form, completing parliamentary passage.
Assent · Assent
Assent
The Governor-General gave Royal AssentThe final step that turns a bill passed by Parliament into an Act of law., turning the bill into an Act.
