Jill White. Nurse Led Clinics for NSW.

Luke Foley – great!

Congratulations on committing to nurse led clinics as part of to a primary health care strategy to increase access to community based health care. The four nurse led clinics promised last week are a welcome adjunct to the current but often overstretched GP services.

The ACT has led the way in nurse led clinics with the first, based in an emergency department, being evaluated as providing high quality safe and appropriate care; however where there was also easy access to medical care there was the risk of over-servicing lessening the cost effectiveness.  So with lesson learned the two new ACT services are in underserviced areas and are providing high quality care to a population which otherwise would have had difficulty in quick and affordable access to health care. Information on these services is available through ACT Health. It is a success story, ask the people of Belconnen and Tuggeranong.

Our current NSW Minister for Health, Jillian Skinner, also has a public track record of commitment to improving community based services. So come on Jillian, match this promise and let’s not let party politics and election posturing get in the way of a really good idea for the health of the public.

The past few weeks has clearly demonstrated that we are heartily sick of party based oppositional politics and if NSW does not want to risk going down the same path as Queensland or suffering the public disenchantment experienced by the Prime Minister this is the moment and this is the issue to demonstrate that the health of the public is a genuine bipartisan concern and that this is an excellent strategy. Let’s make these clinics a reality irrespective of any election and have a public commitment from both sides of politics NOW.

I can’t let this topic go however without addressing Saxon Smith’s comment on behalf of the AMA in the SMH yesterday. He is quoted as saying “There is actually evidence suggesting nurse-led clinics can make the quality of the care worse”. What research? Conducted how and where and published in what peer reviewed journal? It is a glib and easy thing to say but where is the evidence? How does it stack up against the 20 years of rigorous, published, Australian based research which clearly demonstrates the safety and quality of the work of Nurse Practitioners?

It’s always worth reminding ourselves  that the AMA is not only a professional body but it is also the doctor’s union and protecting income and turf is its job. We have 25 years of documented AMA opposition and scare tactics about nurses being able to work to their full scope of practice and making a broader contribution to community health.

The vast majority of doctors in practice with whom I speak fully support an extension of the role of nurses in primary health care/ community care. They particularly understand the need to provide better access to underserved communities. This is work nurses want to do, are educated to do, and have the skills to do. Luke and Jillian please bring it on, make the commitment and don’t let better healthcare become a political football.

Jill White was formerly the Dean of the Faculty of Nursing and Midwifery at Sydney University. 


John Laurence Menadue is the publisher of Pearls & Irritations. He has had a distinguished career both in the private sector and in the Public Service.

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1 Response to Jill White. Nurse Led Clinics for NSW.

  1. Avatar John Dwyer says:

    Jill White and Mary Chiarella know that, as is true of most experienced clinicians trying to restructure Primary Care, I am fully supportive of nurses expanding their clinical roles. Much has been achieved in hospital care where clinical nurse specialists, consultants and nurse practitioners are playing vital roles. These unique nursing skills must be available to improve Primary Care. However international and some local experience tells us that the last thing we need is a perpetuation and even expansion of the “Silo” approach to health care delivery, an approach which has blighted Primary Care for so long. Cost effective, patient focused care is integrated care. There is abundant evidence to demonstrate the benefits of doctors , nurses and allied health professionals working in the one practice where the professionals act on “first among equals” basis with the unique contributions each can provide appreciated and utilised to offer truly patient focused care. Clearly NSW Labor has not got the message about the need for Primary Care to evolve into “Integrated Primary Care” IPC, to create “Medical Homes”, a concept much explored in “Pearls and Irritations” in recent months. Far better to use the money proposed for stand alone nursing clinics to establish some “proof of concept” IPC practices where the full range of nursing skills are best utilised.

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