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Legislative Assembly for the ACT: 2002 Week 11 Hansard (25 September) . . Page.. 3201 ..

MR SMYTH (continuing):

This is an entirely appropriate motion. It is important. It refers to work we started when we were in government. Little seems to have occurred since the government changed. For the Assembly to call on the government to get on with establishing such a program is appropriate, and the Liberal Party supports the motion.

MS TUCKER (11.26): I support this motion and probably Mr Stanhope's amendment, which I have not seen. A nurse practitioner in the ACT is defined as:

a registered nurse working with a multidisciplinary team whose role includes autonomous assessment and management of clients using nursing knowledge and skills gained through advanced education and clinical experience in a specific area of nursing practice.

The role may include but is not limited to the direct referral of patients to other health care professionals, the prescribing of a designated and agreed list of medications, the ordering of designated and agreed list of diagnostic investigations.

That definition is from the ACT department of health website on the nurse practitioner trial.

In essence, nurse practitioners are specialist nurses in a particular area who are authorised to do some autonomous work in that field. Nurse practitioners' place in the health care system is alongside GPs, hospitals and community health care programs.

I understand that a New South Wales trial of a nurse practitioner working in a GP surgery found that working in this collaborative way considerably increased the health of some of the elderly patients of that practice. Nurse practitioners were able to follow up, spending more time on things like wound care, and were able to pick up through that work some issues that needed GP attention.

There has been increased interest in Australia in using nurse practitioners in the health system since the early 1990s. The trial here began in 1999. It involved training up, on the job, four nurses in specialist areas, supported, supervised and reviewed by a multi-disciplinary clinical support team. Various data were collected as they were trained and worked.

The four specialty areas were mental health support, within the context of Calvary Hospital; sexual health outreach, from hospital and at brothels and beats; military nursing; and wound care. Although the military program was stopped because of time constraints, I understand that there is strong support within the military for developing the nurse practitioner role within the services.

The sexual health outreach trial demonstrated how nurse practitioners can fill gaps, to reach groups of people who are not accessing the existing health care system. This nurse practitioner was accepted as an outreach worker in brothels and by this work was able to prevent outbreaks of sexually transmitted diseases. This group of people would not accept a GP setting up practice in their area and were not regularly accessing the preventative health care systems.

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