The Australian College of Nursing welcomes the Australian Government's first national Menopause and Perimenopause Campaign and is calling for urgent reform to the Medicare Benefits Schedule (MBS) so that nurse practitioners can effectively and efficiently contribute to meeting the growing demand for menopause and perimenopause care.
ACN commends the Government for its response to the recommendations of the Senate Inquiry into Menopause and Perimenopause, but says the investment in menopause care would deliver even greater benefit if the barriers facing nurse practitioners were addressed.
"The campaign's success depends on women being able to access timely, expert clinical care once they decide to seek help," said Acting ACN CEO, Dr Zachary Byfield. "Nurse practitioners are a highly qualified part of the health workforce whose contribution is currently constrained by outdated Medicare settings."
Nurse practitioners are advanced practice registered nurses who can independently assess, diagnose, prescribe medications (including menopausal hormone therapy), and provide ongoing management of menopause and perimenopause within their scope of practice. They already deliver this care every day in general practice, women's health services, community clinics, and rural and remote settings.
Despite this, persistent gaps in the MBS limit their impact. Nurse practitioners have fewer billable item numbers than GPs, lower rebate levels, and restrictions on key services and referrals. These funding and policy settings restrict their ability to provide integrated, financially sustainable care, particularly in primary care and community settings, and limit the system's capacity to address workforce gaps and improve access for women seeking timely menopause support.
Outdated barriers faced by nurse practitioners include:
- Restrictions and less flexible access in practice compared with GPs; inability to always initiate full care pathways tied to MBS funding structures,
- No access to many preventive health assessment items, including the 45-49 year-old health check,
- Limited MBS support for structured risk assessment consultations,
- No dedicated MBS items for menopause assessment or management,
- Under-remuneration for long consultations relative to their complexity,
- Limited ability to bill structured review or medication management plans,
- No ability to bill equivalent GP items for staged care across initiation and review cycles,
- No access to GP Mental Health Treatment Plan items, including referrals that generate rebated psychology sessions,
- Limited access to structured mental health care planning items,
- Limited access to referrals for diagnostic imaging, such as bone densitometry.
"This campaign is an important step in recognising that women's health concerns must be taken seriously, and we commend the Government for acting on the Senate Inquiry's findings," Dr Byfield said.
"But information alone is not enough. Women also need to be able to see a clinician quickly, in their community, who has the time and expertise to listen and to walk with them through what can be a complex transition, without being hit in the hip pocket because they are choosing to see an NP instead of a GP.
"Nurse practitioners are ready and able to provide that care. What holds them back is not their skill or their scope – it is an outdated MBS structure that does not reflect contemporary models of care, or the role nurse practitioners already have in primary care and community settings."
ACN is calling on the Government to:
- Expand MBS items available to nurse practitioners so they reflect the care nurse practitioners are educated and authorised to deliver,
- Introduce dedicated MBS items for menopause and perimenopause assessment and management, accessible to both GPs and nurse practitioners,
- Provide nurse practitioners with access to preventive health assessment items (including the 45-49 year-old health check), structured care planning items, and mental health items and referrals,
- Ensure rebate levels for nurse practitioner consultations reflect the complexity and duration of the care women often require, particularly during menopause and perimenopause.
"The Senate Inquiry made it clear that women want their symptoms taken seriously and their care made easier to access," Dr Byfield said.
"Empowering the full health workforce – including nurse practitioners – is fundamental to delivering on that promise. Australia cannot afford to leave any part of its skilled workforce on the sidelines while women are waiting for care."
