‘Secretive’ plan to let registered nurses prescribe MS-2 Step slammed

The proposal takes recommendations from a federal report on reproductive health and goes further.
AMA Queensland CEO Dr Brett Dale (PhD).

A Queensland Government plan to let registered nurses prescribe MS-2 Step is another “ad-hoc and opaque” attempt to rewrite health workers’ scope of practice, doctors say. 

In a scathing response to the proposal, AMA Queensland said it risked patient safety and ignored a recent federal report on reproductive health.

The 2023 report from the Senate Community Affairs Reference Committee recommended MS-2 Step prescribing rights for registered midwives, nurse practitioners and Aboriginal Health Workers.

“It is highly concerning that Queensland Health is proposing expansion beyond that recommended by the Senate Committee,” said AMA Queensland CEO Dr Brett Dale (PhD) in a submission.

“This cannot be justified, lacks evidence and must not be further progressed.” 

The submission said the Queensland Government should wait for the results of the federal Department of Health and Aged Care’s scope of practice review, due in October 2024, before making moves.

“Amending [extended practice authorities] before these reviews are finalised risks hasty implementation and inadequate patient safety controls.”

AMA Queensland also slammed the government over its “secretive approach”. 

It said the government gave just one working week to respond to its 30-page consultation paper on amending two relevant Queensland Acts, which was only sent to “targeted government and external stakeholders”. 

“It is unacceptable that Queensland Health persists with this targeted and secretive approach to legislative amendments and does not act with transparency and accountability by publishing all such proposals,” said the AMA Queensland response.

The “extremely limited” time frame meant the submission did “not represent a fulsome and considered response”, it added.

However, GP abortion prescriber and AusDoc columnist Dr Heather McNamee said RNs were well-placed to prescribe MS-2 Step.

“Medical termination of pregnancy and the prescribing of MS-2 Step is a very safe protocol driven procedure based on years of research and best practice guidelines,” she said.

“RNs and midwives are very suitable to provide [medical abortion] especially in regional or rural areas where doctors are thin on the ground.

“Pharmacists diagnosing and treating patients with minimal clinical training and no experience in diagnostics is one thing, but this is completely different.”

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More information: AMA Queensland submission; 27 Sep 2023.