NDIA Accountability Project

Submission 52 — Family Paediatrics Nurse Practitioners Pty Ltd — Inquiry into the Thriving Kids initiative

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Thriving Kids Parliamentary Enquiry

Briefing Note / Summary

Key Problems

Australia lacks a nationally consistent, evidence-based approach to identifying and supporting children with mild-to-moderate developmental delay.

  • Services are fragmented across states and territories.
  • Inequities persist for First Nations, CALD, and rural/remote families.
  • Parents reliably attend immunisation appointments, but far fewer access developmental checks.
  • This results in missed opportunities for early identification and intervention.

Key Recommendations

A national Healthy Child ‘Thriving Kids’ framework should adopt changes, stratified into:

Community

  • Place-based Child & Family Hubs co-located in childcare centres, schools, libraries.
  • Prioritise delivery by not-for-profit and community organisations.

Universal

  • Co-located Maternal & Child Health Nurses in Early Childhood Education and Care (ECEC) settings (similar to school health nurse model).
  • Integration of immunisation and developmental checks to leverage high parental attendance.
  • National qualification requirements for Maternal & Child Health nurses.
  • Dedicated funding to enable not-for-profits/community organisations to employ nurses and Nurse Practitioners (NPs).

Targeted

  • Expand nurse-led developmental intervention groups (e.g. Family Paediatrics Play & Thrive).
  • Wraparound parental supports (mental health, health literacy).
  • Clear triage pathways from universal checks into targeted supports.

Specialist

  • Build a Child Health Nurse Practitioner workforce to manage developmental and behavioural assessments in the community.
  • Adjust Medicare item numbers to include developmental health checks, mental health care plans and short-term intervention for NP’s
  • Reduce paediatrician waitlists by shifting routine assessments from tertiary hospitals to Nurse Practitioners.
  • Expand Allied health assistant roles under supervision to extend reach and reduce delays.

Benefits

  • Earlier identification and intervention for children with developmental delay.
  • Increased parental engagement through integration with immunisation (high attendance rates).
  • Reduced pressure on hospital child assessment units and paediatricians.
  • Equity of access for First Nations, CALD, and rural/remote families.
  • Workforce sustainability through training, national standards, and expanded Nurse Practitioner roles.

Conclusion

This Inquiry is an opportunity to establish a nationally consistent system of child health and developmental support.

By embedding Child & Family Health Nurses and Nurse Practitioners into community and ECEC settings, Australia can deliver timely, equitable, and sustainable support for all children to thrive, while alleviating pressure on tertiary systems.

Thriving Kids Parliamentary Enquiry Full Submission

Opening Statement

Australia has an opportunity to fundamentally reshape how we identify and support children with developmental needs in the early years. Despite decades of evidence that the first five years are critical to long-term outcomes, child health and development services remain fragmented, inequitable, and inconsistently delivered across jurisdictions. Families frequently miss out on timely support because maternal and child health services have shifted away from community-based delivery, workforce standards vary nationally, and access to specialist services is defined more by waiting lists than by children’s needs.

A new approach is required, one that re-establishes place-based services in the community, integrates developmental checks with immunisation schedules, and creates a clear progression from universal screening to targeted interventions and specialist care. Nurse Practitioners and Child & Family Health Nurses are ideally positioned to deliver these services in childcare centres, kindergartens, and schools, building relationships with parents, supporting educators, and reducing unnecessary referrals to overburdened hospital systems.

To make this shift sustainable, policy reform is needed. General Practices and large not-for- profit and community organisations should be supported to employ child and family health nurses. National standards must be set for workforce qualifications. Medicare must evolve to recognise developmental health checks as claimable items and to enable Nurse Practitioners to initiate short-term developmental interventions and mental health care plans. These reforms would create accessible, cost-effective, and timely supports for families, while reducing pressure on tertiary paediatric services.

By embedding a nationally consistent, community-led model, the Thriving Kids agenda can deliver earlier identification, stronger parental engagement, and equitable access for all children; including First Nations, CALD, and rural families. This is not just a policy option; it is an essential investment in the future health, wellbeing, and educational outcomes of Australia’s children.

Thriving Kids – Problems and Recommendations

Community / Place-Based Services

Problems / Risks

  • Services are fragmented across states/territories, with poor coordination between Health, Early Childhood Education and Care (ECEC), Private providers and Community organisations.
  • Maternal and child health services have shifted away from place-based delivery to clinic- only models, creating barriers for families.
  • Home visiting is valuable but too resource-intensive to deliver at scale.
  • ECEC staff are increasingly relied upon to identify developmental issues but are not trained or authorised to complete health assessments.
  • Therapy delivered by Allied Health directly in childcare and school often excludes parents, despite evidence that parental involvement is the most influential factor in early development.
  • Non-government and not-for-profit providers remain under-utilised, despite being well placed to deliver trusted, community-based care.

Recommendations & Proposed Model

  • Re-establish place-based child health and development services, consistent with the National Framework for Universal Child and Family Health Services ( Australian Population Health Development Principal Committee of the Australian Health Ministers’ Conference (AHMC), National Child Health and Wellbeing subcommittee, 2011).
  • Prioritise not-for-profit and community organisations as trusted providers.
  • Deploy Child & Family Health Nurses and Nurse Practitioners into childcare centres, kindergartens, and schools.
  • Formalise partnerships with ECEC to support educators.
  • Mandate a level of parental inclusion in therapy, ensuring skills are modelled and reinforced at home.
  • Fund child and family hubs and nurse-led developmental group interventions.

Universal (Immunisation + Developmental Checks)

Problems / Risks

  • Developmental checks are inconsistently delivered and often not aligned with the National Framework.
  • Health checks completed at General Practices are completed by Practice nurses with no developmental knowledge.
  • Uptake of health checks drop off after 6 months and then spike at the 4-year-old check because it is tied to Centrelink Family Tax Benefit eligibility.
  • Maternal and child health services vary significantly across states and engagement often stops after infancy.
  • No national requirement for postgraduate qualifications for nurses (e.g., Graduate Certificate in Child & Family Health), leaving many nurses under-prepared to identify developmental concerns.
  • Rigid, government-only service models exclude community and not-for-profit providers.
  • Lack of Medicare funding streams prevents General Practices and large community providers from employing Child Health Nurses.

Recommendations & Proposed Model

  • Co-locate Maternal & Child Health Nurses within ECEC settings, adopting a model similar to school health nurses.
  • Enable nurses to provide face-to-face parent contact and ECEC educator mentoring.
  • Integrate developmental checks with immunisations, leveraging high attendance rates.
  • Adopt annual children’s health checks with FTB part A.
  • Implement a nationally consistent schedule of developmental checks, with adherence across jurisdictions.
  • Establish minimum qualification requirements (e.g., Graduate Certificate in Child and Family Health).
  • Provide funding for not-for-profits/community organisations to employ Child & Family Health Nurses and Nurse Practitioners.
  • Develop ECEC-based health clinics as standard practice.
  • Medicare reforms:
  • Create a claimable Medicare item for Child Health/Practice Nurses to perform developmental health checks (modelled on MBS Item 715).
    • Allow Nurse Practitioners to initiate short-term developmental interventions (similar to Chronic Disease Management plans), and Mental Health care plans for family members, ensuring affordable access for families unable to meet NDIS gaps.

Targeted Interventions

Problems / Risks

  • Targeted interventions are inequitable, short-term, and often inaccessible.
  • Families face barriers such as cost, transport, and low parental engagement.

Recommendations & Proposed Model

  • Expand nurse-led targeted intervention groups (e.g., Family Paediatrics Play & Thrive).
  • Provide wraparound parental supports, including mental health and health literacy.
  • Establish clear triage pathways from universal checks into targeted services.

Specialist (Developmental & Allied Health Services)

Problems / Risks

  • Families must attend clinic appointments, requiring time off work and transport.
  • Nurses with limited training often provide referrals only to GPs or public services, leading to delays.
  • Tertiary child assessment units have 18-month to 3-year waits, leaving children with little intervention in the meantime.
  • Assessments in tertiary units are often conducted by paediatric registrars under consultant supervision, these are assessments that trained Nurse Practitioners could perform in the community, and in our model already do.
  • Child and Family Health Nurse Practitioners often have decades of experience performing developmental assessments but are underutilised due to barriers in workforce support and employment across all services, in all jurisdictions.
  • Many GPs are not confident managing developmental or behavioural concerns, leading to high referral volumes. (Hiscock, 2025)
  • Private paediatricians often have 12–18 month waitlists or are closed to new referrals. Most referred patients have no intervention while awaiting Paediatrician review.

Recommendations & Proposed Model

  • Build a Child Health Nurse Practitioner (NP) workforce within community child health teams.

  • Enable Nurse Practitioners and Maternal & Child Health Nurses to deliver group education and intervention.

  • NPs to initiate early investigations (e.g., hearing tests, diagnostics, allied health referrals) and provide timely parental education.

  • Embed NPs in teams for ongoing, family-centred, contextual assessments, aligned with the Bronfenbrenner’s Bioecological model.

  • Reduce hospital burden and paediatric waitlists by reserving paediatricians for complex cases. Paediatricians can provide regular support to Community practitioners via dedicated pathways, or phone lines similar to the GP Psychiatry Support line (ProCare Mental Health Services, 2025)

  • Expand Allied health assistant roles under supervision for group-based developmental support.

  • Medicare reforms:

    • Allow Nurse Practitioners to write Mental Health Care Plans for parents and children, giving timely access to private counselling and psychological supports.
    • Extend NP referral powers to include referrals for short-term, community-based developmental and behavioural interventions, creating faster and more cost- effective access to allied health supports.

Cross-Cutting Issues

Problems / Risks

  • National inconsistency in service delivery and workforce standards.
  • Workforce shortages.
  • Fragmented data and monitoring systems.
  • Persistent inequities for First Nations, CALD, and rural/remote families.

Recommendations & Proposed Model

  • Adopt a national Healthy Child Thriving Kids framework.
  • Introduce micro-credential training to standardise workforce capability.
  • Implement a national developmental health record to improve continuity across services.
  • Co-design services with First Nations and CALD communities to ensure cultural safety and accessibility.

Closing Statement

The Thriving Kids agenda offers a chance to correct long-standing inequities in Australia’s child health and development system. At present, too many families face barriers to accessing timely, high-quality support, while overburdened paediatric services are consumed by cases that could be managed earlier and more effectively in the community.

By strengthening the role of Child & Family Health Nurses and Nurse Practitioners, embedding services within trusted community and early childhood settings, and modernising Medicare to reflect the needs of children and families, we can create a system that is both sustainable and transformative. This model ensures families engage where they already are, provides early intervention at the point of need, and frees paediatricians to focus on children with the most complex medical needs.

The reforms proposed here are practical, evidence-based, and achievable. With national leadership, consistent standards, and investment in community and not-for-profit providers, Australia can deliver on the promise that every child will have the best possible start in life — to thrive, not just survive.

Ariane Plowright

Registered Nurse, Graduate Certificate Child, Adolescent and Family Health Nursing, Nurse Practitioner, International Board Certified Lactation Consultant, Senior Lecturer Adelaide University, Director Family Paediatrics Nurse Practitioners

References

Australian Population Health Development Principal Committee of the Australian Health Ministers’ Conference (AHMC), National Child Health and Wellbeing subcommittee. (2011). TheNationalFrameworkforUniversalChildandFamilyHealthServices. Adelaide, South Australia: Australian Health Ministers’ Advisory Council.

Hiscock, H. K. (2025). Paediatric Care in general practice: Case mix, referral patterns and healthcare costs. TheRoyalAustralianJournalofGeneralPracticeVol54, 347-355.

ProCare Mental Health Services. (2025). GPPsychiatrySupportLine. Retrieved from GP Support: https://www.gpsupport.org.au/