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Legislative Assembly for the ACT: 2002 Week 11 Hansard (25 September) . . Page.. 3197 ..

MS DUNDAS (continuing):

Mr Speaker, this motion calls on the ACT government to accelerate the accreditation of nurse practitioners to help address Canberra's growing GP shortage and to tackle the problem of nurses leaving the profession due to limited career paths and a lack of recognition of their skills.

I have received many letters from Canberrans highlighting the general practitioner shortage in Canberra, especially in Belconnen and Tuggeranong, as I am sure have other members of this Assembly. After-hours access to GPs is a particular problem.

The Minister for Health has been making sympathetic noises about the GP shortage but has claimed that the problem is in the hands of the federal government. To date, neither the ACT government nor the federal government has put forward any proposals that satisfy me that this problem is being adequately addressed.

I have been discussing possible solutions to our GP shortage with members of the health profession. I have been told that doctors' time is often consumed by tasks that university-trained nurses are well skilled to perform, and nurses are insulted that they are not being recognised as able to perform these roles.

In our hospitals nurses already make recommendations about changes to drug dosages, but a doctor's sign-off is required before changes can be made. Nurses often take pathology samples, but a fiction is maintained that these samples are taken under the supervision of a doctor, even when the doctor may be less knowledgeable about best-practice sampling procedures. To remove unnecessary supervision from highly qualified nurses would free up doctors' time in all parts of our health system.

There has been a great deal of discussion in the national media in recent times about a national and even international nurse shortage. Most reports have identified that the problem is not that we have insufficient trained nurses but that nurses are leaving the health system to work in other areas. The national review of nursing education released last week found that nurses were leaving the profession in droves because they feel their knowledge and skills are not respected, that their career paths are limited and that they are not paid a wage in line with their skills. Increasing the number of nurses being trained is not going to fix the nurse shortage unless retention is also improved dramatically.

Nurse practitioner programs have the potential to provide a more rewarding career path for nurses and to provide the recognition nurses are looking for. The New South Wales government has gone ahead with a system to accredit highly qualified and experienced nurses as nurse practitioners who have referral and prescribing rights in their areas of speciality, to do away with some of the fictions that exist in our medical system. Victoria has moved in the same direction, by establishing accreditation of nurse practitioners to take pathology samples. With the ACT still at a nurse practitioner trial stage, it appears that we have fallen behind.

A trial of nurse practitioners began under the last government, and very positive progress reports have come out of it, but we still await the final report and the government has not yet declared whether it will support a full accreditation program. I hope they will today.

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