Reform tracker · Australia
Nurse practitioners and midwives: doctor collaboration requirement removed
Since November 2024, nurse practitioners and endorsed midwives can bill Medicare and prescribe PBS medicines without a formal collaborative arrangement with a doctor.
The stated rationale
The Department of Health said the requirement was introduced "for the purposes of access to the MBS and PBS" and that "It's never been, or was intended to be, a safety and quality mechanism". The Government said removing it would improve access, especially in rural and remote areas.
What changed
Nurse practitioners and endorsed midwives previously needed a formal “collaborative arrangement” with a medical practitioner to access Medicare and the PBS. That requirement was removed on 1 November 2024.
Why it matters
In our view, the government’s rationale is an unusually explicit example of right-touch reasoning: a requirement that was not designed as a safety mechanism should not be kept as one. Related change: a new Designated Registered Nurse Prescriber endorsement took effect from 30 September 2025, with prescribing also subject to each state’s and territory’s medicines and poisons laws.
Who supports it
- Australian College of Midwives
- Australian College of Nursing
Who has raised concerns
- RACGP (long-standing opposition)
Sources
- Aged Care Insite: Collaborative arrangement laws abolished (Nov 2024)
- newsGP: Nurse practitioner collaborative arrangement changes
- NMBA: Endorsement for scheduled medicines, designated registered nurse prescriber
- Minister Kearney: Making it easier to get top quality care from a nurse practitioner and midwife
- Department of Health: Collaborative arrangements Q&A (April 2024)