Nurses Could Ease Australia's Chronic Disease Crisis, College Argues

Australia's health system is caught in a widening squeeze. Three in five Australians now live with at least one chronic condition. Two in five carry two or more. The diseases that drive this burden—diabetes, heart disease, kidney disease—are expensive to manage once they spiral into crisis. Yet the system that should prevent that spiral is increasingly out of reach for the people who need it most.

The numbers tell the story plainly. Chronic conditions now consume $98 billion annually from the health budget, more than half of all disease spending. But here is the peculiar cruelty: nearly two-thirds of that money flows to hospitals rather than to the community services that could keep people out of hospitals in the first place. Meanwhile, the share of Australians who delay or skip a GP visit because of cost has nearly doubled in a decade, climbing from 4.1 percent to 7.7 percent. Among those with chronic conditions, the figure is even starker—9.2 percent forgo care due to expense, compared with 5.5 percent among the healthy.

The sickest people, in other words, are being priced out of the very care that could prevent them from becoming sicker still. One in five emergency department patients arrive there because a GP was not available in time. The system has created a perverse incentive: skip the affordable prevention, pay for the expensive crisis.

Into this gap steps an argument from the Australian College of Nursing. The workforce exists to change this trajectory. Nurse practitioners and nurse-led clinics deliver chronic disease management—monitoring, prescribing, wound care, health checks, prevention—at lower cost and closer to home than general practitioners can. The evidence supports this. The trust is there; nurses are Australia's most widespread and most trusted primary health care workforce. Yet the funding architecture locks them out. The system treats the GP as virtually the only legitimate primary care provider, leaving nurse-led services to battle for scraps.

Adjunct Professor Kathryn Zeitz, Chief Executive Officer of the Australian College of Nursing, frames the problem as a choice. "Nurses must be granted access to primary care funding they are currently locked out of," she said. The college has evidence that nursing care in the community prevents expensive hospitalizations and re-hospitalizations. But the system refuses to deploy it. "We are blocking our largest, most trusted and most widespread workforce—nurses—from delivering it."

The timing matters. A new National Health Reform Agreement covering 2026 to 2031 commits governments to strengthen primary care beginning July 1, 2026. The college is using that window to push for specific reforms: extending baseline practice payments and workforce incentive payments to accredited nurse-led services; removing barriers that prevent independent nurse practitioners from accessing Medicare items and telehealth; scaling nurse prescribing through scholarships for 2,500 nurses annually; and making nursing activity visible in national data collection so the contribution—and the unmet demand—becomes impossible to ignore.

The case is fundamentally about prevention. 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 costs a fraction of what hospitalization costs. The math is not complicated. The barrier is not evidence or capacity. It is funding structure and professional gatekeeping. The question now is whether the reform window will open wide enough to let the largest available workforce through.