New data underscores the need for significant primary health care reform, with the burden of chronic disease continuing to grow while Australians are delaying or skipping GP visits due to cost.
"Nurses must be granted access to primary care funding they are currently locked out of," said Australian College of Nursing Chief Executive Officer, Adjunct Professor Kathryn Zeitz FACN. "We have the evidence to show nursing care in the community prevents expensive hospitalisations and re-hospitalisations. But we are blocking our largest, most trusted and most widespread workforce – nurses – from delivering it."
Australian Institute of Health and Welfare figures show three in five Australians now live with at least one chronic condition, and two in five with two or more.
Overweight and obesity have overtaken tobacco as the leading drivers of disease burden. Chronic conditions now cost the health system $98 billion a year – more than half of all disease spending, with almost two-thirds of that consumed by hospitals rather than the community care that could prevent admissions.
At the same time, the share of people needing a GP delaying or skipping a visit because of cost has nearly doubled in a decade, from 4.1% to 7.7%. People with chronic conditions are more likely to forgo care due to cost than those without (9.2% compared with 5.5%).
"The sickest Australians are the ones being priced out of primary care, which ends up shifting the cost onto our expensive hospital system," said Adjunct Professor Zeitz. "Nurse practitioners and nurse-led clinics deliver safe, high-quality chronic disease care – monitoring, prescribing, wound care, health checks, prevention – at lower cost and closer to home. But they battle for funding in a system that treats the GP as virtually the only primary health care provider."
"General practitioners are core to primary health care – but we need to reorient the system to recognise that not every primary health care encounter requires a medical practitioner, and reduce pressure on hospitals."
"Failing to do so means that people simply go without, or end up in an emergency department, with one in five ED patients there because a GP wasn't available in time."
With the National Health Reform Agreement 2026–2031 committing governments to strengthen primary care from 1 July 2026, ACN is calling for funding reform that:
- Establishes the Baseline Practice Payment and extends the Workforce Incentive Payment (Practice Stream) to nurse-led services accredited under the ACSQHC National Safety and Quality Primary and Community Healthcare Standards;
- Removes MyMedicare barriers so independent nurse practitioner- and registered nurse-led clinics can register and access core MBS items, incentives and telehealth – and extends the MBS 75% rebate rule to nurse practitioners;
- Scales designated registered nurse prescribing through scholarships for 2,500 nurses a year with Commonwealth Supported Place eligibility, and provides a funding mechanism and pathology-testing access via a Nurse Payment Administrator;
- Counts nursing activity and outcomes in the new National Primary Health Care Data Collection, making the contribution – and the unmet demand – visible to funders.
"Around one-third of Australia's disease burden is preventable. Keeping a person with diabetes, heart disease or kidney disease well managed in the community saves many times what that care costs by preventing hospitalisation," said Adjunct Professor Zeitz. "Funding reform that unlocks nurse-led care is the key to delivering high-quality care, efficiently."
