First it was nurses, midwives and nurse practitioners being excluded from the federal government’s two key health reform groups, now mental health nurses have also been overlooked.

Mental health nurses, the largest part of the health care workforce, have been left off the Mental Health Expert Reference Group (ERG) advising the government on its response to the National Mental Health Commission’s recent review of mental health programs and services.

Australian College of Mental Health Nurses (ACMHN) chief executive officer Adjunct Associate Professor Kim Ryan said the 13-member group is top heavy with psychiatrists despite the review not including any specific psychiatric program or service.

“I don’t have any problem with the people that are on the Mental Health ERG but I cannot understand why there’s six psychiatrists on it,” she said.

“It’s a review of services and programs none of which are psychiatry-led so why is the review then predominantly looked at through the lens of psychiatry?

“Nurses are there 24 hours a day, 365 days of the year, across all areas, across all of the country in all sorts of service provision.

“I’m not saying there needs to be a member of my college on there,” she added.

“I’m saying there are nurses out there that can contribute to this and I don’t understand why, when there’s about 300,000 nurses that they couldn’t find one and they found six psychiatrists.”

Ms Ryan, who recently raised concerns that the voice of nursing is being left out of the crucial conversation around the nation’s health reforms, said nurses are continuing to be overlooked.

“I don’t think it’s a deliberate tactic to not include nurses,” she said.

“I’m just worried that they don’t see nurses as being people who can contribute to things at that level.

“They just see them as being the health care providers that are out there doing the work and not think about the fact that they actually are the people that run the system.

“Nurses are the people that manage the crisis, they are the people that work across state and territories, Commonwealth, private and public, rural and remote regions, they’re everywhere.”

The review called for an end to the freeze of the unique Mental Health Nurse Incentive Program (MHNIP), an increase in funding from $41.7 million to $72 million a year, and an extension of MHNIP eligibility to residential aged care facilities and multipurpose services.

It also recommended examining the cost effectiveness of extending the Better Access to mental health nurses with a postgraduate qualification in mental health nursing.

“The Mental Health Nurse Incentive Program is the only program that’s funded and structured the way that it is so I’m not sure how they will review that through the lens of the committee that’s there,” Ms Ryan said.

“There’s nurses out there that work in policy, there’s nurses out there that work in administration, management, in research - I’m not sure why they don’t look at a better mix of people that work in the health profession on the ERGs.”

Ms Ryan will write to Health Minister Sussan Ley to express her concerns at the ERG.

“I’m concerned that we’ve got an imbalance of the voice of the health profession more broadly,” she said.

“I think it’s important that nurses need to be included in every single conversation we have around the delivery of health care or the reform of health care.

“We are the largest group of people that provide health care in Australia. That voice has to be at the table.”

The comments come after the Australian Nursing and Midwifery Federation (ANMF), Australian College of Nurse Practitioners (ACNP), the Australian College of Nursing (ACN) and the Australian College of Midwives (ACM) questioned the government over its decision to exclude nurses and midwives from the Medicare Benefits Schedule Review Taskforce and the Primary Health Care Advisory Group.

The organisations said the government included just one primary health care nursing representative on the expert primary health care group, leaving the majority of the nursing profession and midwives without representation in the two key groups charged with embarking on the nation’s health reforms.

In a statement, Minister Ley said the ERG will conduct workshops in the lead up to the final implementation action plan and nurses will be invited to contribute.

“This process brings together a broad range of perspectives from across the health system and will provide evidence-based advice,” she said. 

“The whole of the mental health sector has a role to play as we move through this process together to ensure Australian mental health patients receive the right care, in the right place, at the right time.”