The Australian College of Nursing is calling on the federal government to make urgent changes to ensure equitable access to primary care for the millions of Australians living outside major cities.
In a submission to the Senate Standing Committee on Rural and Regional Affairs and Transport, ACN argues that Medicare's current structure is not fit for purpose in rural and remote Australia – and that recent policy changes are making things worse.
"Medicare settings have not kept pace with the changing structure of the health workforce or the evolving needs of rural populations," said ACN Chief Executive Officer, Adjunct Professor Kathryn Zeitz FACN.
Telehealth rule changes introduced on 1 November 2025 have had a disproportionate impact on nurse practitioners (NPs) and the communities they serve. NPs are now subject to the same face-to-face consultation requirements as GPs, but without equivalent access to Medicare Benefits Schedule item numbers – including exemptions that apply to mental health and eating disorder services.
Further, NPs remain ineligible to participate in MyMedicare – the program that exempts enrolled patients from face-to-face requirements – unless they are affiliated with an RACGP-accredited general practice.
"In many rural and remote areas, GP wait times exceed three months, or there is no GP service at all," said Adjunct Professor Zeitz. "Evidence shows underfunding nurse-led care has stark consequences – including avoidable hospital presentations."
Given the evidence supporting nurse-led models, they should be eligible for Medicare funding, instead of having to operate through block funding, government incentives, or private billing. Further, the exclusion of NPs from aged care and after-hours incentives available to GPs, further restricts access in residential aged care settings.
"In rural and remote Australia, where demand far exceeds supply, this gap is devastating," said Adjunct Professor Kathryn Zeitz. "The current system is failing the communities that need it most."
"Every day, nurses and nurse practitioners are providing the only available primary care in communities across rural and remote Australia. Their work should not be structurally excluded from public funding. We need reforms that reflect the workforce we have, not the workforce we had."
