A health care policy can be best defined as the decisions, plans and actions decided and undertaken by the government to direct, improve and achieve health care goals for the population in general. It specifies goals and priorities for the future along with an action plan as well (WHO, 2020). National Medicines Policy, Australia is one such policy optimised to improve health outcomes for the population. One important aspect of the policy is the Pharmaceutical benefits scheme (PBS) which according to an amendment in 2010 makes nurse practitioners eligible for prescribing medicines as listed in the PBS (Schadewaldt et al., 2016). The National medicine policy along with its impact on nurse practitioners and their increased role in healthcare setting will be discussed in this essay.
Australia’s National Medicines Policy was launched twenty years ago with the aim of improving health outcomes for all Australians. It was developed in partnership with healthcare professionals, consumers and the pharmaceutical industry. The key parts of the policy focus on timely access to high-quality and affordable medicines and their safe and judicious use. It also supports a viable and responsible pharmaceutical industry (McLachlan 2020). It was published by the Department of health, Government of Australia.
The policy talks about improving health outcomes for the population in general with increasing accessibility of the population to medicines. The Australian Pharmaceutical Advisory Council (APAC) was formed in 1991. It presented an opportunity for all the parties interested in contributing positively on a consensus basis for the conduct and development of this policy. Several policies were developed and implemented through several years, with major reviewing in 1999. The revised policy was launched with the support of the government in 1999. The goals of the policy include provision of good quality care to all citizens of the country which is responsive to their needs and provision of incentives for maintenance of preventive health and cost-effective care. One of its goals is to also give a better value for the money of the taxpayer and define more clear roles and responsibilities. It also aims to provide the benefit of access to universal health services via Medicare (Hoebert et al., 2013).
It also came to be known as the Pharmaceutical benefits scheme(PBS). The policy envisions providing timely and adequate access to medicines for people whenever they need it, at affordable prices that can be afforded by the community and the individuals. It also envisions maintaining the standard of the medicines being provided to the people in terms of its quality, efficacy and safety. It also talks about the quality and specific use of medicines along with sustaining efforts to maintain a viable, working and responsible industry of medicines for everyone. The practicality and achievement of these goals and visions requires collaboration and coming together of a number of stakeholders and partners to help achieve them. A variety of stakeholders and partners like the government- at all levels, central, commonwealth to state and territorial along with a number of partners like health practitioners, healthcare providers, pharmaceutical industry, health educators, the community- as consumers and patients, public interest groups and the media as well play the role of working together in collaboration to achieve the goals and objectives of the policy (McLachlan 2020).
Every partner is a stakeholder and will have a more specific role to play and work at to contribute to achieving the objectives of the policy. Every stakeholder will work dedicatedly for achieving a different aim and vision under the policy. The expected priorities of the policy from the different stakeholders in trying to achieve universal access for everyone to medicines will be achieving value for money. This can be done by making sure access to medicines is provided at a price that the community is able to afford. Another expected priority is to make sure that the process of access to medicines is streamlined, so that subsidization of the medicines is done like a timely process and effective supply chain mechanisms are maintained. These priorities need work from the most important stakeholder that is the governments present at the various levels. The medicine industry and the pharmaceutical companies need to produce these medicines and help in maintaining a thriving industry of medicine which helps provide drugs and medicines to the public at a subsidized cost along with enough returns for greater research and development in the field. Also, it needs to provide complete information about the medicines and practice responsible marketing to the patients as well as the healthcare providers and health practitioners. It will help ensure more efficient use of the medicines and maintain competition in the industry as well (Ung et al., 2017).
Next most important stakeholders are the health practitioners and the health educators. Their role involves promotion of the effective and quality use of the available medicines by making sure that they make good treatment choices for the patients, provide enough information to the patients about the drugs and their effects and increase collaboration and cooperation with other practitioners as well. The practitioners will also work long with the industry to promote the quality, efficacy and safety of drugs by participating in clinical trials of the drugs and by participating in post-trial surveillance of drugs. The consumer organizations should help in promoting the effective use of medicines in the patients that is the consumers and help increase their knowledge and awareness about the correct usage of drugs and their side-effects as well.
One of the major stakeholders in the policy involve the health practitioners. Their role is most important in terms of prescribing the drugs to the patients and educating them about the same. They also help in maintaining the supply chain and administration part of drug prescription along with helping out in clinical trials of medicines and post-trial marketing as well. A change in this direction was made to the policy in 2010, which made changes in the pharmaceutical benefits scheme and made medicines and drugs accessible for the nurse practitioners for prescription and administration to patients and consumers, mostly practicing as primary health care providers. Their service has been subsidized through the pharmaceutical benefits scheme and the Medicare benefits schedule as well. This helped in expansion of their role as independent healthcare providers in the primary set up (McMillan & Emmerton 2013). The list of drugs that they can prescribe has been approved by the PBS. The nurse practitioners according to the policy can practice as primary health care providers in collaboration with the medical practitioner. Also, studies show that the role of the nurse practitioners as primary care providers evolves when the practitioners are able to collaborate more effectively with the medical practitioners (Schadewaldt et al., 2016).
The intent of including NPs in the fold of primary health care was to increase accessibility for patients to health services and to increase the number, flexibility and scope of the working force in healthcare. Although the scope of practice has increased for the nurse practitioners through the PBS and MBS scheme, they are still unable to provide complete treatment in the process to the patients. The restrictions of the NP MBS and PBS items have potentially reduced their capacity to function to their full potential of practice when they are providing subsidized care to patients (Currie at al., 2017).
It was also observed that the nurse practitioners are definitely increasing access to primary health care services for the vulnerable population in areas of less accessibility and lesser coverage. It has helped improved the uptake of chronic, long-term services as well along with primary health care. Another important perspective noted was that their primary healthcare role appears to e complementing the existing role of the community pharmacists. There exists scope to collaborate more and provide interdisciplinary care in screening and promotion of health services. Also, more clarification is required in terms of prescribing pharmacist-only drugs to the patients (McMillan & Emmerton 2013).Practical issues in the scheme still remain such as greater collaboration with the GPs, stipulated and limited times of service, limited list of drugs and subsidies on the PBS and the MBS list for the nurse practitioners, inability to refer for certain diagnostic tests amongst others. More reform in these aspects will help in increasing the scope and viability of nurse practitioners practice as healthcare providers and help improve the health workforce and provide improved positive health outcomes as well (Currie et al., 2019).
The over-all impact of the scheme and the policy on the Australian healthcare system has been increasing accessibility of medicines to the population and greater number of people being able to access health services. It has helped increase the number of people being able to afford and access medicine and help increase the reach of healthcare to people by making it affordable and subsidized for everyone. It has also helped increase the scope of health practitioners by introducing the nurse practitioners in the health workforce as primary care providers (Sweeny 2013). However, the policy has not undergone many changes and reforms since its inception in 1999 and is in need of major reforms and change. It needs to loom at the developing technology and innovation in the field of medicine and look at reviewing the policy aspects on health education and literacy, planning of the health workforce and issues of global health as well (Swannell 2019).
The national medicines policy was discussed in the essay along with its aims, goals and objectives. It envisages provision of accessibility to affordable medicine to people that the community can afford along with access to care to improve health outcomes. The role of the different stakeholders involved in making and practicing the policy were also discussed along with its impact on nursing and nurse practitioners as well. Their increase in the role as care providers and how it impacts and improves the health care system was looked at as well. However, the policy is in need of reforms according to the current times and technologies as well.
Currie, J., Chiarella, M., & Buckley, T. (2017). Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey. Australian Health Review, 41(5), 533-540.
Currie, J., Chiarella, M., & Buckley, T. (2019). Privately practising nurse practitioners’ provision of care subsidised through the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme in Australia: results from a national survey. Australian Health Review, 43(1), 55-61.
Hoebert, J. M., van Dijk, L., Mantel-Teeuwisse, A. K., Leufkens, H. G., & Laing, R. O. (2013). National medicines policies–a review of the evolution and development processes. Journal of Pharmaceutical Policy and Practice, 6(1), 5.
McLachlan, A. J., & Aslani, P. (2020). National Medicines Policy 2.0: a vision for the future. Australian Prescriber, 43(1), 24.
McMillan, S. S., & Emmerton, L. (2013). Nurse practitioners: an insight into their integration into Australian community pharmacies. Research in Social and Administrative Pharmacy, 9(6), 975-980.
Schadewaldt, V., McInnes, E., Hiller, J. E., & Gardner, A. (2016). Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia–a multiple case study using mixed methods. BMC Family Practice, 17(1), 99.
Swannell, C. (2019). National Medicines Policy: outdated and needing review. The Medical Journal of Australia, 1.
Sweeny, K. (2013). The impact of further PBS reforms: report to medicines Australia. Centre for Strategic Economic Studies, Victoria University.
Ung, C. O. L., Harnett, J., & Hu, H. (2017). Key stakeholder perspectives on the barriers and solutions to pharmacy practice towards complementary medicines: an Australian experience. BMC Complementary and Alternative Medicine, 17(1), 1-17.
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