Nurses slam Labor over policy shift

Nurses have accused the Rudd government of caving in to doctors' demands over a plan to give nurse practitioners and midwives greater power to prescribe drugs and order tests.

Federal Health Minister Nicola Roxon this week announced nurses and midwives would only have access to the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS) if they worked "in a collaborative arrangement" with a doctor.

The policy shift was seen as a backdown on Labor's original plan to give nurses and midwives a more significant role in delivering health care, particularly in rural and remote regions where doctors are thin on the ground.

The Royal College of Nursing Australia says it "emphatically opposes" Ms Roxon's change of heart.

It believes requiring collaboration will make nurses beholden to doctors, with patients the biggest losers.

"The government is responding to pressure from the doctors' lobby, who don't want to relinquish what is essentially a monopoly on the patient dollar," the college's acting chief executive, Kathleen McLaughlin, said in a statement.

"The public will ultimately lose out if this arrangement is to go ahead.

"These changes will ensure that lack of access to timely and affordable care remains an ongoing issue for many people around Australia."

People in rural and remote areas would be hardest hit, including disadvantaged indigenous communities, Ms McLaughlin said.

"If nurse practitioners are bound to doctors, what happens to communities in places where doctors are scarce or where there are no doctors at all?"

However, doctors argue they need to be present when drugs are prescribed and tests ordered.

The Australian Medical Association believes imposing a legal requirement for collaboration will protect patients.

"These changes create a framework of quality primary care delivery that supports team-based care and ensures that the role of medical practitioners, particularly the patient's usual general practitioner, is not undermined," AMA president Andrew Pesce said on Thursday when the changes were announced.

Without that requirement there'd be no safeguards to ensure "continuity of patient care" and protect against "the fragmentation of patient care", Dr Pesce said.