Australia: The Exclusion of Privately Practicing Nurse Practitioners From the COVID 19 Pandemic Vaccination Rollout

      ACNP, like many other nursing and health related organisations around the world, have being trying to support members and our community through the COVID 19 pandemic. One of the most valuable things we have done to contribute, is to remind our members to take some time out to care for themselves.
      As a professional college, we have had variable influence at a Government level in relation to both the pandemic, and the vaccination effort. We have had wins, such as the addition of Nurse Practitioners to provide federally funded Telehealth during the pandemic. We have had losses, such as the exclusion of privately practicing Nurse Practitioners (PPNP) from providing COVID vaccinations. Yes, you read that correctly!
      PPNPs in Australia were actively excluded from vaccinating in Primary Care as a specific funding instrument (Medicare) was applied for Doctors, which specifically excluded PPNPs. It is a requirement this funding instrument is applied for every COVID vaccination in primary care. In Aged Care, vaccination was provided via private contractors. Aged Care did not engage PPNPs, as there are cheaper workers out there, including health professional students. It seemed we were blocked in every way.
      Ten solid months of campaigning, some extra anti-hypertensive meds (for me), and a lot of expressions of frustration have led to the release in September 2021 of a ‘Request for Tender’ (RFT) process, that PPNPs are ‘allowed’ to participate in. Potentially this will bring PPNPs into the COVID vaccination effort in December 2021, as the RFT is a long and complex process. The RFT process is also something not for the faint-hearted, it requires a significant amount of work just to apply, a substantial business structure to qualify, and a lot of non-clinical boxes to tick. So, does it effectively ‘include’ PPNP’s then?
      We are choosing to call it a win, but now we must ask some more questions. In Australia, the response from our Federal Government has been very focussed on ‘business’. Significantly, Medical Practitioners were given exclusivity at the beginning, secondly, pharmacists were able to participate, private contractors got the work too. Now PPNP’s are included in ‘the rest’, effectively to come on board when the ship has sailed for many (Australia will be approaching 90% vaccination by the time a PPNP is able to vaccinate). At least PPNP’s will be able to access our most disadvantaged and vulnerable communities from December 2021, many of whom only ever see a PPNP, and have no other contact with health services, so they are still waiting. This is what hurts us the most.
      Of course, being a NP, I think it should have been a vaccination/health effort, and I disagree with the use of tenders for arguably the biggest health crisis we have seen in our lifetimes. So, if our government chose the business approach, was this restraint of trade? It certainly restrained my trade. At best, it was fostering a competitive approach for who can vaccinate, and who cannot. Excluding a qualified profession/business would therefore be anti-competitive. In Australia, we have the Competition and Consumer Act (2010), however this does not appear to apply to our government. Cue the anti-hypertensive dose increase again!
      We fight for quality improvements for our patients, better access to care, safety in health care, and unfortunately we also must fight competitively to be able to provide health care, even during a worldwide crisis.
      Take care everyone!