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  1. 1

    Puff, the Magic Dragon.

    Well that is one argument guaranteed to set the cat amongst the pigeons. There is great merit in the idea. It is the nurses who spend most time with the people, they go where doctors do not and they deliver the health programs which save countless lives and prevents or mediates disability from health conditions. They are no longer doctors’ ‘go-fors’.

  2. 2

    ron batagol

    All of that makes sense- greater use of nurses in primary care (provided they concentrate on triaging and don’t drift into medical differential diagnosis, for which only doctors are specifically trained!).

    Also, given that a 2009 NPS Literature Report( showed that hospital admissions associated with ADEs (adverse drug events) ranged from 5.6% of admissions in the general population to 30.4% of admissions in the elderly, and paediatric ED attendances reported to be associated with ADEs 3.3% of the time, better utilisation of the skills and expertise of pharmacists, who are the acknowledged experts in optimum medication use, drug side effects, drug interactions etc., would help to lower the rate of expensive and life-threatening hospital admissions in the at-risk groups.

  3. 3

    Doctor Whom

    There is no argument that makes any one profession automatically better at “leading the health system” (whatever that means) than another.

    How about Epidemiologists, Population Health Practitioners, a Politician?

  4. 4

    Jenny Haines

    Truth is nurses already run the health system. They are there at work 24/7/365. Doctors can work around the clock too, but this is usually in their first years of practice, then as they move on into their professional lives they largely become day workers. But it is nurses who are the patient’s bedside for 8 to 12 hours per shift, day and night, in hospitals, and up to hours at a time when the patient is in the community. Doctors visit, but largely do not provide nursing care. So if you view the health system from the point of view of the 24 hour clock and presence at the patient’s side providing care, it is nurses who are always there.
    In terms of advanced practice, nurse practitioners have been highly successful in providing safe and competent patient care in hospitals, homes, and community services. They are well educated, clinically competent, aware of their boundaries, and willing to work collaboratively with other health professions including doctors and do so very successfully. As nurse practitioners numbers grow steadily in Australia, I am not aware of any cases questioning a nurse practitioners practice by any registering authority in this country.

  5. 5

    Professor Mary Chiarella

    I had the pleasure of putting together a compendium of nurse-led primary health care models for WHO about two years ago -it is available at
    What was pretty obvious about that study was that nurses and midwives were already leading a lot of PHC services in both developing and developed countries – they just weren’t getting the direct funding or the kudos and they seemed to have to spend a lot of time fundraising. But the message to me from those nurses and midwives was that, if we really want a sustainable health system into the future, the people who need to lead our health systems are the public themselves. They are the most important component of the health workforce and they already do most of the health work – as carers, parents or through their own self management.


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