Key points

•       The purpose of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 (the Bill) is to amend the National Health Act 1953 and the Health Insurance Act 1973 to enable registered nurse prescribers, who meet specified criteria, to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme (PBS).

•       The Bill seeks to implement reforms identified by the Strengthening Medicare Taskforce and the subsequent Scope of Practice Review. The proposed amendments aim to empower nurses to work to their full scope of practice in primary care and, in doing so, ease workforce pressures and provide more equitable access to treatment for people living in rural and remote areas of Australia.

•       While concerns have been raised by stakeholders regarding the types of medicines that can be prescribed by registered nurse prescribers, these matters fall outside the scope of this Bill and instead be determined by the Minister by disallowable legislative instrument.

•       The Bill has been referred to the Senate Community Affairs Legislation Committee for inquiry and report by 26 February 2026.

•       At the time of writing, the Bill had not been reported on by any parliamentary committees.

Introductory Info

Date of introduction: 26 November 2025
House introduced in: House of Representatives
Portfolio: Health, Disability and Ageing
Commencement: The day after Royal Assent. However, a person will not be able to apply for approval as an authorised nurse prescriber, or prescribe pharmaceutical benefits under the PBS, until various pieces of delegated legislation are made or amended.

Purpose of the Bill

The purpose of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 (the Bill) is to amend the National Health Act 1953 (NH Act) and the Health Insurance Act 1973 (HI Act), to enable nurse prescribers to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme (PBS).

As outlined in the Explanatory Memorandum (EM), the Bill will amend the NH Act to:

The HI Act will be amended to enable the Professional Services Review (PSR) to review the PBS prescribing of authorised nurse prescribers, ensuring that they are subject to the same oversight as other PBS prescribers.

Background

Prescribing of medicines

In Australia, only authorised health practitioners can prescribe medicines. Prescribing is primarily undertaken by medical practitioners (general practitioners and medical specialists); however, other health practitioners, including dentists, optometrists, nurse practitioners and midwives may also prescribe medicines within their scope of practice. For health professionals, the scope of practice is the ‘professional activities that a health professional is educated (skill and knowledge), competent and authorised to perform, and for which they are accountable.’ (p. 7)

To prescribe medicines, health practitioners must:

The regulation of prescribing is shared between the Commonwealth and state and territory governments. Legislation governing ‘which health practitioners are authorised to administer, obtain, possess, prescribe, sell, supply, or use scheduled medicines’ is enacted at the state and territory level, while approval to prescribe PBS medicines and monitoring of appropriate PBS prescribing is enacted by federal legislation. (p. 9)

Workforce shortages and scope of practice

Workforce shortages

Health workforce shortages have been a cause for concern in Australia for over 20 years, with shortages experienced across a range of health professions. Workforce shortages are more pronounced in regional, rural and remote areas of Australia, with data from the Australian Institute of Health and Welfare showing that ‘people living in rural and remote areas have … poorer access to, and use of, primary health care services, than people living in Major cities’.

There are several factors that contribute to workforce shortages including increased demand from an ageing population, rising levels of chronic disease, barriers to education and training and barriers preventing health professionals working to their full scope of practice. (p. 12)

Scope of practice

In May 2022, the Labor Opposition announced that, if elected, it would establish a Strengthening Medicare Taskforce to provide advice to the government on ‘the best ways to boost affordability, improve access, and better support patients with ongoing and chronic illness’ in primary care. Following the May 2022 election, the new Labor Government established the Strengthening Medicare Taskforce, with a final report provided to government in December 2022. The report stated that:

Funding and regulatory arrangements should support all parts of the primary care workforce to work to their full scope of practice and to collaborate across the health and other care systems, optimising the use of our most vital workforce resources, and supporting the delivery of person-centred outcomes. All governments must play their part to back in these reforms, working together to enable the legislative and regulatory barriers to full scope of practice to be reviewed and addressed (p. 6).

Following National Cabinet endorsement of the Strengthening Medicare Taskforce recommendations in April 2023, funding was provided in the 2023–24 Budget to undertake a scope of practice review to examine current models of primary care (p. 150). The scope of practice review was led by an independent reviewer and included extensive consultation. The final report, Unleashing the Potential of our Health Workforce, released in October 2024, proposed 18 recommendations across 4 themes.

As outlined in the Minister’s second reading speech, this Bill seeks to implement reforms identified by the Strengthening Medicare Taskforce and the subsequent scope of practice review. The proposed amendments aim to empower nurses to work to their full scope of practice in primary care and, in doing so, ease workforce pressures and provide more equitable access to treatment for people living in rural and remote areas of Australia:

This change empowers nurses to provide safe, high-quality care directly to people in the community, reducing the need for GP visits or long waits in overcrowded hospital emergency departments.

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This reform aligns with the government's commitment to cheaper medicines, and with the National Medicines Policy. It promotes equitable, affordable, and timely access to high-quality medicines and services.

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Designated registered nurse prescribing strengthens the health system by easing workforce pressures and building long-term capacity and sustainability.

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This reform allows people, especially those in rural and regional areas, to receive affordable treatment with greater equity.

History of nurse prescribing in Australia

Regulation of the health workforce and the Nursing and Midwifery Board of Australia

In 2008, the Council of Australian Governments (COAG) agreed to establish a single national scheme for registered health practitioners, the National Registration and Accreditation Scheme (NRAS). The NRAS ‘ensures that all regulated health professionals are registered against consistent, high quality, national professional standards’ and can practice across state and territory borders without having to re‑register in each jurisdiction. The NRAS commenced in 2010 and currently covers 16 professions practicing under protected titles.

Each health profession that is part of the NRAS is represented by a National Board – for nurses this is the Nursing and Midwifery Board of Australia (NMBA).

Under section 94 of the Health Practitioner Regulation National Law Act 2009 (Qld) (the National Law) as in force in each state and territory, National Boards may ‘endorse the registration of a registered health practitioner registered in a health profession for which the Board is established, as being qualified to administer, obtain, possess, prescribe, sell, supply or use a scheduled medicine or class of scheduled medicines’. Under the National Law, the NMBA has developed registration standards for nurse prescribing.

Current prescribing situation

Limited nurse prescribing has been permitted in Australia since 2001, following the introduction of the nurse practitioner role. Nurse practitioners are registered nurses (RNs) who have undertaken additional training and are authorised to function autonomously and collaboratively in an advanced and extended clinical role, which includes prescribing medications in line with state and territory poisons legislation.

Prior to 2023, RNs with an endorsement by the NMBA for scheduled medicines in rural and isolated practice were able to prescribe medicines under a structured prescribing arrangement (p. 12). RNs with this endorsement were able to obtain, supply, and administer schedule 2, 3, 4 and 8 medicines.[1] The endorsement was retired in 2023, with states and territories now regulating prescribing by RNs in rural and isolated practices through state and territory legislation alone (p. 12).

Discussion and consultation for the most recent endorsement for nurse prescribing began in 2016. The Decision regulation impact statement was prepared by the NMBA to support the proposed ‘Registration standard: Endorsement for scheduled medicines − designated registered nurse prescriber’ and outlined the background to these reforms:

In 2016, the former Australian Health Ministers’ Advisory Council’s Health Workforce Principal Committee (HWPC) requested that the Nursing and Midwifery Board of Australia (NMBA) work with the Australian and New Zealand Council of Chief Nursing and Midwifery Officers (ANZCCNMO) to explore potential models of prescribing by RNs. Since 2017, the NMBA and ANZCCNMO have undertaken extensive research and consultation with governments, key nursing and medical stakeholders, RNs and consumers about the potential for RNs to contribute to improving health outcomes for the Australian community by working to their full scope of practice.

The reform is driven by the Australian government’s commitment to ensuring that all Australians, including those who live in rural, regional, and remote parts of Australia and those in aged care and disadvantaged communities, can access timely, safe and effective healthcare and health service. (p. 6)

The NMBA and the Australian and New Zealand Council of Chief Nursing and Midwifery Officers (ANZCCNMO) developed 4 options for registered nurse prescribing models to align with the key healthcare strategies of the Australian Government. The preferred option was to ‘enable RNs to prescribe scheduled 2, 3, 4 and 8 medicines under supervision, in accordance with governance frameworks and prescribing agreements.’ (p. 7)

At the December 2024 Health Ministers Meeting, Commonwealth, state and territory Health Ministers approved a new registration standard for nurse prescribing, the Endorsement for Scheduled Medicines - Designated Registered Nurse Prescriber (the standard) under the Health Practitioner Regulation National Law Act 2009. The standard came into effect on 30 September 2025, and the first cohort of registered nurses is ‘expected to complete the required education and commence prescribing from July 2026.’ (p. 1).

The standard and its associated guidelines outline the requirements that registered nurses must meet to qualify for endorsement:

When applying for the endorsement for scheduled medicines − designated RN [registered nurse] prescriber, an RN must be able to demonstrate all of the following:

1. Current general registration as an RN in Australia with no conditions or undertakings relevant to this endorsement.

2. The equivalent of three years’ full-time post-initial registration clinical experience (5,000 hours) within the past six years, from the date when the complete application seeking endorsement for scheduled medicines as a designated RN prescriber is received by the NMBA.

3. Successful completion of:

a. NMBA-approved units of study leading to endorsement for scheduled medicines as a designated RN prescriber, or

b.  units of study that are equivalent to the NMBA-approved units of study leading to endorsement for scheduled medicines as a designated RN prescriber. (p. 2)

A key requirement under the endorsement is that designated nurse prescribers must only prescribe in partnership with an ‘authorised health practitioner’, defined in the guidelines as ‘a registered health practitioner who is an authorised autonomous prescriber for example a medical practitioner or a nurse practitioner’ (p. 1). Further, once endorsed, the nurse prescriber will be required to complete a six-month ‘period of clinical mentorship with an authorised health practitioner.’ (p. 2)

 Stakeholder response

The Australian College of Nursing (ACN) supported the changes, stating:

This milestone aligns Australian nursing with international best practice, following successful implementation in countries such as New Zealand, the UK, Ireland, and the Netherlands. Research consistently shows non-medical prescribing is safe, effective, and increases job satisfaction among nurses.

While legislative changes are still required across some jurisdictions before implementation begins, today represents the culmination of extraordinary professional collaboration led by the Chief Nursing and Midwifery Officers (CNMOs) across the country. We congratulate the Nursing and Midwifery Board of Australia (NMBA) for their unwavering commitment to driving this change, our CNMOs for their leadership and support, and the Australian Nursing and Midwifery Accreditation Council for developing the accreditation standards and accrediting the programs to ensure quality education for RN prescribers.

ACN looks forward to supporting our colleagues along the journey towards registered nurse prescribing, one that, in advancing nursing, will shape the health of our nation.

The ACN also noted that it was important for the healthcare sector to work together to ensure the standard is ‘implemented smoothly and consistently across all jurisdictions’.

The president of the Australian Medical Association (AMA), Danielle McMullen, stated that she was ‘broadly supportive of the new initiative’ but highlighted that the AMA will lobby for more restrictions around prescribing Schedule 8 medicines, such as morphine and other opiates. In an article published on the AMA website, the AMA highlighted the impact of its advocacy relating to the standard and its ongoing concerns, stating:

… we secured several key safeguards to ensure this change supports — rather than undermines — doctor-led, team-based models of care that are vital to our health system.

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We advocated that any RN prescribing of Schedule 2, 3, and 4 medications must occur within medically-led, delegated team environments — and only under an active prescribing agreement with a medical practitioner.

While not all our concerns were addressed, the NMBA has incorporated several important safeguards.

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Despite improvements, concerns remain. For example, there is ambiguity around the definition of “authorised health practitioner”.

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We also continue to oppose the decision to include Schedule 8 medicines in the standard. We do not consider that medical practitioners will feel comfortable delegating the responsibility of S8 prescribing. It is important to remember this is not a requirement, and individual doctors retain control of their delegations.

The Royal Australian College of General Practitioners (RACGP) had previously expressed concerns about the change:

The RACGP previously expressed concerns about the move, particularly surrounding the prescribing of Schedule 8 medicines, warning that expanding RNs’ scope in this way could lead to increased risks and more fragmented care.

‘Patient safety is paramount and best protected where multidisciplinary teams which include a GP, are working together to provide coordinated, collaborative and continuous patient care,’ the college said in a 2023 submission to the NMBA.

Instead, the college proposed allowing RNs to expand their scope of practice with endorsement to prescribe only Schedule 2, 3, and 4 medicines under designation or supervision ‘in areas of identified need’.

Policy position of non-government parties/independents

At the time of writing, no comments by non-government parties or independents specifically relating to the Bill had been identified.

Key issues and provisions

Several amendments relate to updating definitions within the HI Act and NH Act, reflecting the inclusion of authorised nurse prescribers as a new PBS prescriber type.

Health Insurance Act 1973

Part VAA of the HI Act establishes the PSR Scheme. The PSR Scheme ‘enables the review and investigation of the provision of services by certain kinds of practitioners to determine whether they have engaged in inappropriate practice’ including when prescribing PBS medicines (EM, p. 4).

Items 1–6 of the Bill amend the HI Act to include the term ‘eligible nurse prescriber’ (as defined in the NH Act) where relevant, ensuring that registered nurse prescribing will be subject to the same oversight as other PBS prescribers.

National Health Act 1953

Item 11 inserts proposed sections 84AAM to 84AAQ into the NH Act, recognising authorised nurse prescribers as PBS prescribers under specific conditions. Proposed subsection 84AAM(1) provides that an ‘eligible nurse prescriber’ is a registered nurse who meets the requirements set out in a legislative instrument made by the Minister. These requirements may include, but are not limited to, one or more of the following:

•       a requirement to hold particular qualifications in nursing

•       a requirement to have particular experience in nursing or

•       a requirement to be endorsed by a particular body.

According to the EM, one of the requirements that will be determined by the Minister ‘is that the person’s registration as a registered nurse includes an endorsement under section 94 of the Health Practitioner Regulation National Law from the Nursing and Midwifery Board of Australia that the person can prescribe schedule medicines as a designated registered nurse prescriber.’ (p. 7)

Proposed subsection 84AAN(1) provides for an eligible nurse prescriber to be approved by the Secretary as an authorised nurse prescriber, with criteria to be determined by the Minister via a legislative instrument. Proposed subsection 84AAN(4) provides that the criteria may include, but are not limited to, one or more of the following (though the EM suggests that these will be compulsory requirements for approval (p. 7)):

•       the eligible nurse prescriber has an agreement (a nurse prescriber agreement) in place with one or more other kinds of PBS prescribers and

•       the nurse prescriber agreement must include specified features.

The requirements listed under proposed subsection 84AAN(4) ensure that authorised nurse prescribers only undertake prescribing in partnership with an authorised health practitioner, such as a general practitioner (referred to as ‘designated prescribing’). The Guidelines for registered nurses applying for and with the endorsement for scheduled medicines – designated registered nurse prescriber outline the requirements of designated prescribing, including the development of a written prescribing agreement between the registered nurse and the authorised health practitioner (pp. 2–4).

The Minister may, by legislative instrument, also impose conditions to which approvals as an authorised nurse prescriber are subject. These may include:

•       that nurse prescriber agreements are to be retained and produced to the Secretary on request and

•       that the eligible nurse prescriber does not prescribe a pharmaceutical benefit under their prescriber agreement that could not be prescribed by a PBS prescriber with whom the agreement is made.

Proposed section 84AAP provides mechanisms for the Secretary to suspend or revoke approvals for authorised nurse prescribers, while proposed section 84AAQ allows for a review of decisions relating to authorised nurse prescribers.

Item 14 inserts proposed subsection 88(1EAA) which provides authority for authorised nurse prescribers to write prescriptions for PBS medicines on or after 1 July 2026, with the Minister to determine which pharmaceutical benefits may be prescribed. Item 15 amends subsection 88(1EA) to require the Minister to give regard to advice received from the Pharmaceutical Benefits Advisory Committee when deciding which medicines can be prescribed by authorised nurse prescribers.

Concluding comments

The Bill will amend the NH Act and the HI Act to enable registered nurse prescribers, who meet specified criteria, to prescribe certain pharmaceutical benefits under the PBS. This change is in line with recommendations from recent reviews to empower health professionals to work at their full scope of practice.

The amendments will allow authorised nurse prescribers to become PBS prescribers, ensuring that when they prescribe medicines under the new standard patients will be able to access those medicines on the PBS. While concerns have been raised by stakeholders regarding the types of medicines that can be prescribed under the new standard, these matters fall outside the scope of this Bil and will instead be determined by the Minister by disallowable legislative instrument.

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