Anne Webster

I move:

(1) Schedule 1, page 12 (after line 4), at the end of the Schedule, add:

37 Application of amendments

(1) The amendments made by this Schedule apply only if a declaration under subitem (2) is in force.

(2) The Minister may, by notifiable instrument, declare that the amendments made by this Schedule apply on and after a day, or throughout a period, specified in the declaration.

(3) However, the Minister may make a declaration under subitem (2) only if:

(a) a trial of nurse prescriber treatments (within the meaning of the National Health Act 1953) is conducted in at least one State or Territory; and

(b) after the end of the trial, the Nursing and Midwifery Board of Australia conducts a review of the trial; and

(c) the review demonstrates a suitably supportive evidence base for the safety and effectiveness of the amendments made by this Schedule.

I rise to speak to the amendment circulated in my name to the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. This bill seeks to enable eligibility for PBS rebates for medications prescribed by a new category of prescribers, 'authorised registered nurse prescribers'. It acknowledges the essential role nurses play in our health system, especially in the regions, and the important work they do. It also acknowledges that nurses are the largest component of the health system and the most well-distributed workforce in regional Australia.

The Nationals want to see improved access to health care and progress for the nursing profession and for multidisciplinary care more generally. However, I am moving an amendment because implementation of new policy must have appropriate testing to ensure it is safe, effective and won't have unintended consequences. The Nationals have two key concerns. The bill is not evidence based, as it fails to follow normal processes where testing of any new model of care occurs in a state or territory in Australia prior to the application of PBS rebates, and this bill does not have a funding model to enable registered nurse prescribers to work in primary care as no funding model or structure has been developed. It is important to differentiate the new RN prescriber model from existing master's qualified nurse practitioners who are autonomous prescribers.

My amendment is that this legislation should not be enacted until there has been a trial or pilot of this new model of nurse prescribing in a state or territory which is then reviewed by the Nursing and Midwifery Board of Australia to ensure suitability and a supportive evidence base for safety and effectiveness of the model. This is about following due process, ensuring accountability and transparency for Australian consumers and making good use of Commonwealth funds. There must be clear evidence that any new model of nurse prescribing will improve access to high-quality care, especially in the regions, and will not have negative unintended consequences for patient safety or continuity of care. RN nurse prescribers will still require an autonomous prescriber in primary care, such as a GP or a nurse practitioner, to oversee that prescriber. The problem is that there are not enough GPs or nurse practitioners in the regions now. How is this going to work?

The process of a nurse practitioner gaining PBS access was debated in the late 2000s, and nurse practitioners had already been prescribing under state and territory law for many years from the mid- to late-1990s. Governments, therefore, had real world prescribing data, independent evaluations, patient outcome studies and safety audits. These formed the evidence base for Commonwealth reform which enabled PBS access to commence from 2010, though restricted. Major reforms to PBS access for nurse practitioners have occurred only very recently. PBS access for nurse practitioners was based on extensive safety and effectiveness evidence in states and territories. That evidence was synthesised nationally. It directly informed the Commonwealth's decision to grant PBS access in 2010. PBS access was therefore an evidence based policy decision, not simply a political concession. While it arguably took many years too long, PBS access for nurse practitioners was a thoroughly evidence based policy decision, and this amendment seeks that the same evidence base be produced before implementation of the bill currently under consideration. I urge the House to support this amendment.

Mark Butler

As I indicated, we won't be supporting this amendment. The effect of the amendment would really be to ensure that this particular group of registered nurses, who are now able to seek this endorsement through changes made by the board and will now be able to prescribe as state and territory parliaments change their legislation, which they have all committed to, will not be able to access the PBS. It would effectively make medicines more expensive for patients who had those medicines prescribed under changes that have already been decided on by the board and that are in the process of being made by state and territory parliaments. This legislation will simply ensure that those patients are able to pay PBS prices, not the market prices that the National Party would have them pay under their amendment.

I also indicate—and I think I said it in my summing up—that this has been the subject of almost a decade of consultation and modelling by the nurses' board. All the doctors' groups were involved in this as well as, obviously, a range of other groups. The member said that there was no funding available for this. As the member well knows—I know she's very familiar with primary care—the workforce incentive payment already supports the employment of registered nurses in primary care settings. This will simply ensure that they're able to do some more work subject, obviously, to the oversight of medical practitioners working in those practices. Importantly, this will also enable registered nurses, subject to the endorsement of the board, to play a prescribing role, in the appropriate way, in other settings such as: aged-care settings; hospital settings, including for discharge; mental health settings; and others. For those reasons, we will not be supporting the amendment.

Milton Dick

The question is that the amendment moved by the honourable member for Mallee be agreed to.

Andrew Wilkie

I seek leave to move the motion as circulated.

Leave granted.

I thank the government and the minister for granting leave. There is clearly an urgent need to address this motion, because there is an urgent need to give all members of this House a free vote so that they can use their own judgement, informed by their own constituents, on whether or not there should be a three-year phase-out of advertising on gambling, which, as the motion makes clear, was the flagship recommendation of the Murphy report, brought down almost 2½ years ago.

The importance of addressing this urgently cannot be stated enough, because this is a very, very real issue that needs to be tackled quickly. Not only is the community broadly—clearly, the majority—sick to death of the endless gambling advertising; the community is also sick to death of the way that advertising is normalising gambling. The community is sick to death of the way that advertising is effectively grooming children to start gambling as soon as they can.

That's not an exaggeration. When you look at the evidence prepared by the Australia Institute, they found that last year almost one million young people aged between 12 and 19 gambled. That's all the evidence you need to make absolutely clear that all of this advertising is grooming young people to gamble as quickly as it can.

This isn't some esoteric argument.

Terry Young

Order! I need you to move the motion. You asked leave; if you could move the motion, that would be great.

Andrew Wilkie

I move:

That the House:

(1) notes that the report of the inquiry into online gambling and its impacts on those experiencing gambling harm, 'You win some, you lose more', also known as the Murphy Report, was handed down two years and five months ago;

(2) further notes that the cross-party Standing Committee on Social Policy and Legal Affairs unanimously endorsed the 31 recommendations contained in the report, including the flagship recommendation to implement a three-year phase out of gambling advertising; and

(3) calls on the Prime Minister and Leader of the Opposition to grant their party members a free vote on the implementation of this flagship recommendation.

Deputy Speaker Young, there's been a little bit of confusion on the clock there on account of that. Am I right to assume that my 10 minutes starts now?

Terry Young

Yes.

Andrew Wilkie

But, mercifully, I will not speak for 10 minutes, because I would like to leave at least five minutes for the member for Curtin to make a contribution to this debate. As members would be well aware, the member for Curtin has done as much—or more—as anyone in this House when it comes to gambling reform.

I make the point again—and I'm pleased to make the point again—that there is an urgent need for this parliament to decide on whether or not to allow individual members to exercise their personal judgement, informed by their communities, on the matter of whether or not there be a phase-out of gambling advertising in this country. The reason we need to go to a free vote is that this place is currently absolutely paralysed on this issue, which beggars belief because there is clearly a strong majority of members in the House of Representatives who want to see a phased ban on gambling advertising. How we could have a clear majority of members want a ban yet the place paralysed—honestly, it beggars belief.

We have to crack this open. We have to end this impasse. That's what the community wants. That's what the community is calling out for because the community is sick to death of the endless ads. The community is sick to death of the way the endless ads are normalising gambling. The community is sick to death of the way the endless ads are grooming children to become gamblers as soon as they can.

It's no wonder the Australia Institute found that last year almost one million people aged between 12 and 19 gambled. It's not because it's in their DNA or because they just had a bright idea one day—'I'm going to start gambling'. It's because every time they look at their phone, their iPad, their laptop, the TV and, I would add, the newspapers, even if they're not looking at an ad directly—they're looking at, say, the cricket ground during the first Ashes test, the ball is racing towards the boundary, and there are bet365 ads on the rope. You can't escape it. Just going through the day, people in the community encounter literally hundreds of ads for gambling.

And let's not forget that this isn't some esoteric debate we're having in here. This is a very real matter affecting people every day. Remember that, as we encourage gambling, more and more people will become addicted to gambling. With addiction to gambling, we see countless people going broke, losing more money than they can afford. It destroys relationships. It affects mental health. It leads to homelessness. It leads to violence in the home. It leads to an elevated rate of suicide in the community.

I make the point again that this isn't some academic argument we're having here. This is about whether or not we in this place do what the community want, and whether or not the government does what the majority of members want, and implement the very well researched flagship recommendation of the Murphy report to ban gambling advertising—and not straightaway. The Murphy committee recommended three years to phase it out, giving more than enough time to change the landscape and to allow the gambling companies, the media companies and the major sporting codes to transition.

And, yes, that might take a little bit of government financial help, but when you consider the billions of dollars that are at stake here, with money lost and the countless cost to the community of gambling addiction, a little bit of government assistance is more than justified, particularly to wean the media companies and the sporting codes off—I'll say it clearly—this blood money, this money that is harvested from people who are often the most disadvantaged and most vulnerable people in the community. They should be weaned off that blood money, and the government has the means not just to pass the legislation to do so in this place; it has the financial resources to make that transition workable for all of the people involved.

I'll end it there because I am keen for the member for Curtin to have her say. I just say to the government and the opposition: do the right thing by the backbenchers, who are just having to suck this up. They get confronted every day with constituents who say, 'Why won't you ban the advertising?' I feel for the backbenchers. You've been handed a sour lemon to suck on. I don't think it's fair on them.

Terry Young

Is there a seconder for the motion?

Rebekha Sharkie

It's a privilege to second this motion from the member for Clark. I've stood in this place for nearly a decade and talked about the harms of gambling. I've stood in this place for nearly a decade and talked about the families that have been torn apart and the people who have taken their lives. We are in this last week of parliament. Surely now is the time to do something right by the Australian people, so I urge the government to look at this motion, to follow this motion and to simply just allow a free vote on an issue that your government presented a unanimous report in support of—the ending of gambling advertising.

It's not saying: 'Ban gambling.' We know that's not going to happen in this nation. We know that this is a legal thing to do. It's like what we did with smoking. Decades ago we banned advertising because we recognised that there were inherent harms in smoking. It's a legal product, but there are inherent harms, and gambling is exactly the same.

It has been 29 months since the Murphy report, called You win some, you lose more, was released. Every day, when I walk into this place, I go through the House of Reps gardens. There is a bank of roses, and those roses, which have plaques in front of them, are for members who passed away while they were in this place. And Peta Murphy's name is there on that plaque. I often stop and look at the roses—they're all in bloom at the moment—and I think about Peta Murphy. I think about her courage and I think about how she gave so much of her last months of life to this place and, in particular, to this report. She wanted to make sure that she finished this report to the absolute best that she possibly could, and there are recommendations from that report that the government hasn't even bothered to formally respond to. One of the most important recommendations on there was to ban gambling advertising, because it is pernicious, it is saturated, and it is everywhere. There is not a young person in Australia, I would say, that hasn't seen that advertising. We're banning social media because we recognise that, for under-16s, there is an inherent harm there. But, once you're 18, it's open slather. You can be targeted with advertising from Sportsbet, BetStop, Ladbrokes and the whole list. You can't even watch a game—you can't go to a game—without seeing it everywhere. We have normalised this so much in Australia.

I would say to the Prime Minister—really, I plead with the Prime Minister. You love your Rabbitohs, and you love a sports game. Think of what it was like when you were 20 and you were going and watching your beloved Rabbitohs or think of what it was like when you were watching them on television—you were not bombarded like a 20-year-old is bombarded today. They can't get away from it. This advertising is being targeted particularly at young men. We know that, between now and Christmas, there are going to be people who can't escape the advertising, who are so triggered by the advertising, who feel that there is no hope in their lives and who will not be here at Christmas. How awful is that! We have the power in this place to do something about it, yet, here we are, nearly 900 days later, and the government is really saying: 'This is not an issue for us. This is not a priority for us.'

I've stood here, I've given speeches before, and I've been really cranky; now, I'm heartbroken. I'm heartbroken that we are doing nothing about something that is affecting so many young people in our nation. It's our last sitting week of the year, and we could do so much better. We could do so much more. So, please, Prime Minister, allow a free vote for your backbench. They desperately want this leadership from you.

Matt Keogh

I move:

That the debate be adjourned.

Terry Young

The question is that the debate be adjourned.

Long debate text truncated.

Milton Dick

I have received a letter from the honourable member for Goldstein proposing that a definite matter of public importance be submitted to the House for discussion, namely:

The need for transparency and accountability in the Government's failed Administration of the CFMEU and the consequences for housing affordability.

I call upon those honourable members who approve of the proposed discussion to rise in their places.

More than the number of members required by the standing orders having risen in their places—

Tim Wilson

I know the government is going to do everything it has tried to do at every single point throughout the past two weeks to shut down a conversation about the corruption within the CFMEU and its direct connection back to this government. More important than that is we have a minister who is running interference and simply does not want to have accountability in the context of administration oversight.

So we are proud to stand up right now and speak out about the challenging problems of CFMEU corruption in Australia. We know the reality that is being faced. Fifteen months ago the CFMEU was put under administration by this government because there were systemic issues of corruption, including those revealed on television programs like 60 Minutes. Organised crime, criminal gangs and bikie gangs were infiltrating public projects and receiving cartel kickbacks that were going into the hands of those organised groups. They were being paid for by taxpayers. They were being paid for by mums and dads. They were being paid for by first home buyers, through the increased costs of housing, and by taxpayers and through debt, inflation and the high interest rates that Australians are experiencing right now. It led the Labor Party to, after letting the CFMEU off the leash, eventually accept administration.

It should never have come to this in the first place. The Labor Party should never have abolished the Australian Building and Construction Commission and removed the leash on the CFMEU to allow the corruption that has pervaded across the Australian community. But, once they did—once they accepted that they had become the enabler of corruption across Australian building sites, construction sites and public projects—they were shamed and embarrassed by the media into eventually taking action. What was that action? They appointed administration designed to break the back of the corrupt culture that sits at the heart of the CFMEU.

Well, 15 months later, we now have a report card from whistleblowers. It's not the opinion of the opposition. It's certainly not the opinion of the government, who have the view to see no evil, hear no evil and speak no evil in the context of CFMEU corruption—and they certainly don't want to hear about CFMEU corruption. From whistleblowers through to the Nine press and of course 60 Minutes, people have been saying explicitly that the problems of CFMEU corruption are now worse, 15 months on, than they were beforehand. This is a scandal and a disgrace. When we have asked basic questions in this parliament we have gotten no answers. Yesterday the Prime Minister shut down question time rather than have a question asked of him about CFMEU corruption. And it looks like the Leader of the House is going to do exactly the same thing right now.

Sharon Claydon

The Leader of the House?

Tony Burke

First of all, on a point of order, I was listed to follow him—and I was really looking forward to it! But in effectively missing that opportunity for myself, I move:

That the business of the day be called on.

Milton Dick

The question is that the business of the day be called on.

Milton Dick

The question is that the motion be agreed to.

Tony Burke

I move:

That so much of the standing and sessional orders be suspended as would prevent the following from occurring in relation to proceedings on the Environment Protection Reform Bill 2025, National Environmental Protection Agency Bill 2025, Environment Information Australia Bill 2025, Environment Protection and Biodiversity Conservation (Customs Charges Imposition) Bill 2025, Environment Protection and Biodiversity Conservation (Excise Charges Imposition) Bill 2025, Environment Protection and Biodiversity Conservation (General Charges Imposition) Bill 2025 and the Environment Protection and Biodiversity Conservation (Restoration Charge Imposition) Bill 2025:

(1) on Thursday, 6 November when the order of the day for the resumption of debate on each bill is called on:

(a) questions being put immediately on any amendments moved to the motion for the second reading and on the second reading of the bill;

(b) if required, a consideration in detail stage of the bill occurring, with:

(i) no longer than five minutes of debate on each set of amendments moved, unless a Minister specifies an extended time for debate; and

(ii) the question that the bill [as amended] be agreed to being put immediately after all amendments have been resolved; and

(c) the question being put immediately on the third reading of the bill; and

(2) any variation to this arrangement being made only on a motion moved by a Minister.

I move:

That the question be now put.

Milton Dick

The question is that the question be put.

Tony Burke

Just to clarify, as a point of order, I understand this is one of the bills that we've just had an entire cognate debate on, this whole week in the parliament. I move:

That the question be now put.

Milton Dick

The question is that the question be put.

Michelle Rowland

by leave—I move:

That this bill be now read a third time.

Milton Dick

The question is the bill be read a third time.

Milton Dick

The question now is that this bill, as amended, be agreed to.

Milton Dick

The member for Fisher is seeking a point of order, but the House has just resolved to pass a resolution, so I've got to put the question. The question is that the motion be agreed to.