National Health (Eligible Midwives) Determination 2022

The instrument rests on a small set of interconnected statutory concepts, each drawn from either the instrument itself or other named instruments. Those concepts and their operational meanings, as provided by the instrument, are:

• Eligible midwife: The instrument states that "eligible midwife has the same meaning as in Part VII of the Act" (s 4). The determination then prescribes an additional requirement that must be satisfied for a person to be treated as an eligible midwife under Part VII: an endorsement on the midwife’s registration under the Health Practitioner Regulation National Law to deal with scheduled medicines (s 6). The instrument therefore treats eligibility under Part VII of the Act as contingent on a Health Practitioner Regulation endorsement.

• National Board: The instrument indicates that the term "National Board has the same meaning as in the Regulations" (s 4). It then clarifies that the reference to the National Board in s 6 is a reference to the Nursing and Midwifery Board of Australia (Note 1 to s 6). Operationally, the Nursing and Midwifery Board is the decision-maker that may endorse registrations under s 94 of the Health Practitioner Regulation National Law; that endorsement is a precondition for eligibility under this determination (s 6, Note 1).

• Endorsement under section 94 of the Health Practitioner Regulation National Law: Section 6 requires an endorsement under s 94 to cover the relevant scheduled medicine or class of scheduled medicines. The instrument explains the eligibility for such an endorsement: the person must hold either an approved qualification or a qualification that the National Board regards as substantially equivalent or based on similar competencies, and must comply with any approved registration standard relevant to the endorsement (Note 2 to s 6). Thus, the practical concept of endorsement is both qualification- and standards-based.

• Scheduled medicine: The term "scheduled medicine has the same meaning as in the Health Practitioner Regulation National Law" (s 4). The determination therefore links eligibility to the categories of medicines as defined in the Health Practitioner Regulation National Law rather than to some separate federal list.

• Authorisation versus qualification: The instrument draws a careful distinction between endorsement as an indication of qualification and legal authorisation to act. It states that an endorsement "indicates that the midwife is qualified to administer, obtain, possess, prescribe, sell, supply or use the scheduled medicine or class of scheduled medicines specified in the endorsement but does not authorise the midwife to do so. Such authorisation will be provided for by or under another Act of the relevant jurisdiction" (Note 3 to s 6). Therefore, the instrument’s concept of eligibility is rights-adjacent but not equivalent to legal permission to perform those regulated acts.

• Cross-instrument dependencies: The instrument explicitly operates by reference to other instruments, creating an interlock. It is made under subsection 84AAE(3) of the National Health Act 1953 (s 3); it defines "Regulations" to mean the National Health Regulation 2016 (s 4); it requires an endorsement under s 94 of the Health Practitioner Regulation National Law (s 6). These cross-references mean the instrument’s effect depends on the content and application of those other texts.

Collectively, these concepts show that the determination is a targeted, legally technical instrument: it does not create a standalone licensing regime, but instead sets a federal statutory precondition for Part VII eligibility that depends on a state-level or national-registration-level endorsement dealing with scheduled medicines. The instrument therefore creates a gate that is procedural (endorsement) and substantive (qualification and compliance with registration standards), while leaving regulatory authorisation to other Acts of the relevant jurisdiction (s 6, Notes 1-3).

The instrument primarily affects persons who are or who seek to be "eligible midwives" for the purposes of Part VII of the National Health Act 1953. It makes explicit that, for those purposes, eligibility depends on the midwife’s registration being endorsed by the Nursing and Midwifery Board of Australia under section 94 of the Health Practitioner Regulation National Law to cover scheduled medicines (s 6; Note 1). That will directly affect:

• Individual midwives: Midwives who need to be recognised as eligible under Part VII must obtain and maintain the specified endorsement on their registration. The instrument places the substantive and administrative onus on registrants to hold an "approved qualification" or an equivalent qualification and to comply with any approved registration standard relevant to the endorsement (s 6, Note 2). Midwives without the endorsement cannot, under this determination, be considered eligible midwives for Part VII purposes.

• The Nursing and Midwifery Board of Australia: The instrument places the endorsement decision with the National Board, identified as the Nursing and Midwifery Board of Australia (Note 1). The Board’s processes for assessing qualifications and registration standard compliance are therefore the decisive mechanism by which persons attain the federal status the instrument governs.

• Employers and health service providers: Organisations that employ midwives and rely on their statutory status under Part VII will need to verify that any midwife they engage holds the required endorsement. While the instrument does not specify employer duties, it establishes an eligibility threshold that employers and contracting parties must check if Part VII status matters for funding, service delivery or compliance.

• Regulators and administrators under other Acts: The instrument explicitly states that endorsement is not the same as legal authorisation to administer or supply scheduled medicines, and that authorisation will come from "another Act of the relevant jurisdiction" (Note 3). Consequently, state and territory health regulators, or other federal/state Acts that confer permissions, remain relevant decision-makers for actual clinical authorisation.

• Parties relying on Part VII of the Act: Any persons or entities that derive rights, entitlements or obligations from a midwife’s classification as an "eligible midwife" under Part VII will be affected by this instrument to the extent that the midwife’s eligibility is a precondition. The instrument itself does not list those rights or entitlements, but it explicitly sets the eligibility gate.

The instrument also has indirect administrative effects: it repeals the 2010 determination in full (Schedule 1), so any persons whose status depended on that instrument will be affected by its replacement. The commencement clause makes the new determination effective the day after registration (s 2), so affected individuals and organisations needed to take account of the timing.

Who does not appear to be directly affected, on the instrument’s face, are non-midwife health practitioners, because the text focuses on the midwifery profession and the Nursing and Midwifery Board’s endorsement (s 6, Notes 1-2). The instrument is narrowly targeted by design to the midwifery registration endorsement that interacts with Part VII of the Act.

The determination does not list criminal offences, monetary penalties or explicit ongoing duties in the instrument itself. Instead, it operates by specifying a statutory requirement that determines who qualifies as an "eligible midwife" for Part VII of the Act. From the instrument’s text the practical duties and rights that arise are the following:

Duties or preconditions that persons must satisfy to be an eligible midwife:

• Obtain the specified endorsement on registration. The core requirement is that "the registration of the person in the health profession of midwifery must be endorsed by the National Board under section 94 of the Health Practitioner Regulation National Law" to the relevant scheduled medicine or class of scheduled medicines (s 6). That endorsement is the formal precondition set by the federal determination.
• Hold the requisite qualification(s) and meet registration standards required for the endorsement. The instrument states that the National Board may endorse a registration only if the person "holds either of the following qualifications relevant to the endorsement,(i) an approved qualification; (ii) another qualification that, in the National Board’s opinion, is substantially equivalent to, or based on similar competencies to, an approved qualification; and (b) complies with any approved registration standard relevant to the endorsement" (Note 2 to s 6). These are conditions precedent to endorsement, and therefore to federal eligibility.

Rights or legal effects conferred by satisfying the requirement in this instrument:

• Federal recognition as an eligible midwife for the purposes of Part VII of the Act. The instrument binds the federal determination process: if a person satisfies the endorsement requirement, they meet the determination’s statutory condition for being an eligible midwife under Part VII (s 6). The instrument does not itself list the consequences of that status; those consequences follow from Part VII of the Act, which the instrument references by importing the meaning of "eligible midwife" from the Act (s 4).

Limitations and non-rights stated in the instrument:

• Endorsement is an indication of qualification, not legal authorisation. The instrument expressly states that an endorsement "indicates that the midwife is qualified to administer, obtain, possess, prescribe, sell, supply or use the scheduled medicine or class of scheduled medicines specified in the endorsement but does not authorise the midwife to do so. Such authorisation will be provided for by or under another Act of the relevant jurisdiction" (Note 3 to s 6). Therefore, satisfying the endorsement requirement does not automatically give the person legal permission under jurisdictional health or drugs legislation to perform those acts.
• The instrument does not itself impose obligations on employers, health facilities or insurers, nor does it create administrative fee rules or enforcement mechanisms within its text. It is a determinative instrument that creates a federal eligibility condition; enforcement, authorisation and licensing remain in other legal instruments.

Decision-makers and administrative duties:

• The National Board (Nursing and Midwifery Board of Australia) is the body empowered to grant the endorsement under the Health Practitioner Regulation National Law; its role includes assessing qualifications and registration standard compliance in relation to endorsements (s 6; Note 1; Note 2). The instrument therefore allocates administrative discretion and duty to the National Board insofar as endorsement is required for eligibility.

In summary, the determination converts administrative acts at the registration level (endorsements under s 94 of the Health Practitioner Regulation National Law) into a federal eligibility condition for Part VII treatment, thereby creating a de facto duty for midwives seeking federal recognition to satisfy registration endorsement criteria, and a corresponding right to federal recognition if they do so. The instrument deliberately separates endorsement (qualification) from statutory authorisation to act, which remains governed by other statutes (Note 3 to s 6).

The National Health (Eligible Midwives) Determination 2022 does not itself create criminal offences, civil penalties, or a specified enforcement mechanism within the text of the instrument. The instrument is a determination under subsection 84AAE(3) of the National Health Act 1953 and prescribes a requirement for a person to be an eligible midwife for Part VII purposes; it does not, in its text, attach sanctions for non-compliance (s 3; s 6). There are a number of practical points about enforcement and penalties that follow from what the instrument does include and omit:

• No penalties in the instrument: The instrument contains no section that establishes offences, fines, suspensions, or infringement notices. It focuses on defining a statutory prerequisite,endorsement under section 94 of the Health Practitioner Regulation National Law,and leaves enforcement and authorisation to other legislative instruments (s 6, Note 3).

• Enforcement by implication via administrative recognition: The primary enforcement mechanism created by the instrument is administrative. A person who does not have the required endorsement cannot be treated as an eligible midwife for the purposes of Part VII. Consequently, the immediate compliance consequence is loss of federal eligibility status where that status is relevant to entitlements, approvals or funding under the Act. The instrument does not itself say what administrative remedies follow, but the determination’s effect is to make endorsement a gate for eligibility.

• Role of the National Board and other regulators: The endorsement itself is granted under the Health Practitioner Regulation National Law by the National Board,identified for this instrument as the Nursing and Midwifery Board of Australia (Note 1 to s 6). Any disciplinary, suspension, or cancellation mechanisms in relation to registration, endorsement, or professional conduct would arise under the Health Practitioner Regulation National Law and the National Board’s powers, not under this determination. The instrument therefore relies on the enforcement architecture of the Health Practitioner Regulation National Law for regulatory control over endorsement status.

• Authorisation enforcement remains with other Acts: The instrument clarifies that endorsement does not authorise a midwife to perform the acts listed, and that such authorisation will be provided by another Act of the relevant jurisdiction (Note 3 to s 6). Any penalties for acting without legal authorisation to administer, prescribe, sell, supply or use scheduled medicines would therefore be governed by the statutes that create those legal permissions and their enforcement regimes, not by this determination.

• Repeal of prior instrument: The determination repeals the National Health (Eligible midwives) Determination 2010 in full (Schedule 1). Any enforcement regimes or transitional arrangements that were embedded in the 2010 determination are removed as of the commencement of the 2022 determination, subject to how other legislation handles transition. The instrument itself contains no transitional provisions beyond its repeal clause.

• Practical enforcement for third parties: Employers, health services and payors that depend on Part VII recognition will be responsible in practice for checking that midwives hold the required endorsement. While the instrument does not create explicit civil liabilities for employing or contracting with a midwife who lacks the endorsement, such commercial or contractual risks may arise through the interplay of the Act, funding conditions, insurer requirements, or service agreements. Those risks are not detailed in the instrument.

In short, the determination is a declaratory administrative instrument that creates a condition of federal eligibility. It does not prescribe penalties or enforcement measures itself; enforcement will instead operate through administrative recognition under the Act, the National Board’s registration and endorsement regime under the Health Practitioner Regulation National Law, and the authorising statutes of the relevant jurisdiction for matters relating to scheduled medicines (s 6, Notes 1-3).

The determination is explicitly designed to operate in concert with other statutory instruments and regulatory regimes. The instrument itself sets out its legal dependencies and cross-references, and those references determine its practical reach and limitations.

Primary cross-references and interactions:

• National Health Act 1953: The instrument is made under subsection 84AAE(3) of the National Health Act 1953 (s 3). It determines a requirement "for a person to be an eligible midwife for the purposes of Part VII of the Act" (s 6). Thus, it is subordinate to the Act and functions as an instrument that shapes which persons will be treated as "eligible midwives" under Part VII. The content and consequences of Part VII for a person classified as an eligible midwife are matters under the Act, which the instrument does not reproduce.

• Health Practitioner Regulation National Law (HPRNL): The instrument requires an endorsement under section 94 of the Health Practitioner Regulation National Law (s 6). It also declares that "scheduled medicine has the same meaning as in the Health Practitioner Regulation National Law" and that the Health Practitioner Regulation National Law has the meaning given in the Regulations (s 4). The endorsement process, criteria for approved qualifications and registration standards are determined under the HPRNL and the National Board’s rules; this determination depends on that body of law for the substantive gatekeeping it requires.

• National Health Regulation 2016: The instrument defines "Regulations" as the National Health Regulation 2016 (s 4). It also states that "National Board has the same meaning as in the Regulations" (s 4), thereby connecting the identification of the National Board to the definition in the National Health Regulation. The Regulations thus serve as a definitional bridge between the Act and the Health Practitioner Regulation National Law.

• Other Acts of the relevant jurisdiction concerning authorisation: The instrument makes explicit that endorsement "does not authorise the midwife to do so" (that is, to administer, obtain, possess, prescribe, sell, supply or use a scheduled medicine), and that "Such authorisation will be provided for by or under another Act of the relevant jurisdiction" (Note 3 to s 6). This means the instrument interacts with licensing, drugs and poisons, medicines, and health practitioner authorisation regimes enacted by state, territory or federal statutes. The instrument creates a federal recognition condition but leaves clinical legal permissions to other jurisdictions.

Consequences of these interactions:

• Dependency on multi-instrument compliance: A person who meets the endorsement requirement under the HPRNL may still lack legal permission to perform acts with scheduled medicines if the relevant jurisdictional Act does not confer authorisation or imposes separate conditions. Compliance therefore requires satisfying both the National Board endorsement and the substantive permission rules of the relevant jurisdictional statute (s 6, Note 3).

• Administrative division of labour: The determination allocates the assessment of qualifications, equivalence and registration standards to the National Board (Note 2 to s 6), while the Act supplies the federal eligibility framework and other Acts supply authorisation. Enforcement and disciplinary consequences for registration or endorsement issues are governed by the HPRNL and the National Board’s powers, not by the determination itself.

• Repeal effect on prior framework: The instrument repeals the National Health (Eligible midwives) Determination 2010 (Schedule 1). Any interlocking provisions in the 2010 instrument that previously interacted with the Act, Regulations, or HPRNL are now removed and replaced by this determination. The instrument contains no transitional text; how existing endorsements, registrations and legal permissions carry forward depends on the other instruments and administrative practice.

• Definitions and meaning transfer: By defining certain terms to have the same meaning as in other instruments (s 4), the determination imports conceptual frameworks and regulatory categories established elsewhere. For example, whether a medicine is a "scheduled medicine" is determined by reference to the HPRNL rather than by this instrument. That imports all of the HPRNL’s classification and scheduling rules into the effect of the federal eligibility determination.

Taken together, the instrument is a narrowly tailored legal link between federal eligibility under the National Health Act and registration endorsements created under the Health Practitioner Regulation National Law and associated regulatory instruments. Those cross-references determine the instrument’s practical effect, and the instrument leaves authorisation and enforcement for scheduled-medicine acts to the other legal regimes it references (s 6, Notes 1-3; s 4).

The instrument makes two important temporal or amendment-related statements in its text, and otherwise contains no record of prior amendments. The relevant textual elements and their effects are:

• Commencement: The instrument indicates that "the whole of this instrument" commences "the day after this instrument is registered" (s 2; Commencement table). The instrument further notes that the table relates only to the provisions as originally made and will not be amended in the instrument for any later amendments (s 2(1) and the accompanying note). This establishes a single commencement rule for the instrument’s initial entry into force.

• Repeal of the 2010 determination: The instrument expressly repeals the National Health (Eligible midwives) Determination 2010 in its entirety (Schedule 1, item 1). The Schedule states "The whole of the instrument" and directs "Repeal the instrument." This is an explicit legislative replacement: the 2010 instrument ceases to have effect as of the commencement of this 2022 determination.

• Notes about published versions: Section 2(2) contains a note that any information inserted in column 3 of the commencement table is not part of the instrument, and that such information may be edited in any published version. This is not an amendment record but a procedural clarification about published versions.

• No textual amendment history within the instrument: The instrument as provided contains no other amendment history, savings, transitional provisions, or grandfathering clauses. It does not record prior variations, nor does it include provisions preserving or extinguishing existing endorsements, registrations or statutory consequences from the prior instrument. The repeal of the 2010 instrument is unconditional in the Schedule; how that repeal interacts with transitional administrative decisions would be governed by the Act and the other regulatory instruments.

• Authority for future amendments: The instrument is made under subsection 84AAE(3) of the Act (s 3). While the instrument itself does not state an amendment formula, its enabling provision in the Act is the legal basis for making, varying or repealing such determinations. The instrument contains no express restrictions on future amendments.

In sum, the textual amendment history contained within the instrument is limited: it repeals the 2010 instrument in full and specifies commencement the day after registration. There are no transitional or savings clauses in the instrument itself; any transitional arrangements or effects of the repeal beyond the immediate replacement must be addressed by the Act, the Regulations, the Health Practitioner Regulation National Law, the National Board, or administrative practice.

The instrument contains no litigation history, references to judicial interpretation, or records of legal challenges. It is a short administrative determination made under subsection 84AAE(3) of the National Health Act 1953 and, as provided, includes only the operative requirement, supporting definitions and one repeal. The published text does not mention any judicial review, disputes, or case law relevant to its content.

From the instrument alone the following can be stated with confidence:

• There are no cases named or cited in the instrument.
• There is no textual record of judicial interpretation or challenges to the instrument's provisions within the instrument’s content.
• Any litigation touching the instrument would necessarily arise from either (a) disputes about whether a person satisfies the endorsement requirement in s 6, (b) disputes about the meaning or application of Part VII of the National Health Act 1953 as it interacts with this determination, (c) disputes about the National Board’s exercise of endorsement discretion under the Health Practitioner Regulation National Law, or (d) disputes about cross-jurisdictional authorisations to administer scheduled medicines under other Acts. The instrument itself does not record or comment on such litigation.

Practitioners seeking to understand litigation risks or precedents will need to consult:

• The National Health Act 1953 and Part VII for the substantive federal consequences of being an "eligible midwife".
• The Health Practitioner Regulation National Law and any cases interpreting section 94 endorsements, qualification equivalence assessments, and registration standards where available.
• State and territory statutes that authorise the administration or supply of scheduled medicines, and any case law interpreting those statutes’ interaction with national registration endorsements.

None of those materials are contained in this instrument. The instrument provides the administrative gate, not any litigation record or interpretative history.

The instrument is short but contains several items that may produce practical surprises if read superficially. The following points are factual vulnerabilities, interpretative traps, or obligations that commonly cause implementation error, each grounded in the instrument’s text:

• Endorsement is not authorisation: The most salient "gotcha" is the instrument’s explicit separation between endorsement and legal authorisation. The instrument states that an endorsement "indicates that the midwife is qualified ... but does not authorise the midwife to do so. Such authorisation will be provided for by or under another Act of the relevant jurisdiction" (Note 3 to s 6). Practically, a midwife or an employer might assume endorsement equals legal permission to administer scheduled medicines. The instrument shows that is not the case.

• Multiple statutory gates: Achieving the federal status of "eligible midwife" requires satisfying two different regimes: (1) endorsement via the Nursing and Midwifery Board under s 94 of the HPRNL, and (2) legal authorisation under another jurisdictional Act to perform the scheduled-medicine acts. Endorsement alone is necessary for the federal recognition created by this determination but not sufficient for performing regulated clinical acts.

• Qualification equivalence depends on the National Board’s opinion: The instrument allows the National Board to accept "another qualification that, in the National Board’s opinion, is substantially equivalent to, or based on similar competencies to, an approved qualification" (Note 2 to s 6). That wording gives the Board subjective evaluative space; affected persons will need to anticipate that equivalence is assessed by the Board’s judgment.

• Compliance with approved registration standards is a condition precedent: The instrument ties endorsement to compliance with "any approved registration standard relevant to the endorsement" (Note 2 to s 6). This means that staying eligible may require ongoing compliance with registration standards set by the Board. The instrument does not spell out which standards are relevant; the answer will be found in the National Board’s registration standards.

• Definitions are imported by reference: Key terms are defined by reference to other instruments: "eligible midwife" is defined in Part VII of the Act, "scheduled medicine" is defined in the Health Practitioner Regulation National Law, and "National Board" is defined in the Regulations (s 4). Reliance on imported definitions creates dependency risks if those other instruments change. Practitioners should check the current text of the referenced instruments rather than rely solely on this determination’s wording.

• Repeal with no transitional text: The instrument repeals the 2010 determination in full (Schedule 1) but contains no transitional provisions. If there were midwives or administrative processes dependent on transitional arrangements contained in the 2010 instrument, those are not preserved here. Administrators and registrants should confirm how any past endorsements are to be treated under the new instrument in practice.

• Commencement timing: The instrument commences "the day after this instrument is registered" (s 2). While this is straightforward, the instrument’s note cautions that the commencement table will not be amended to reflect later changes. Users should confirm the registration date to determine the effective date.

• The instrument does not set out fees or enforcement: Practitioners should not look for fee schedules, penalty clauses or enforcement processes in this determination. Those matters are handled under the Act, the Regulations, the HPRNL, or other jurisdictional laws. Absence of those items in the instrument means that compliance costs may be imposed elsewhere and should be ascertained from the National Board and relevant jurisdictional statutes.

• Scope limited to midwifery registration endorsement: The instrument is narrowly targeted to midwives and an endorsement under s 94; it does not speak to broader scopes of practice, delegation arrangements, or arrangements for non-midwife practitioners. Entities seeking to expand roles or create delegated arrangements must look beyond the determination.

These "gotchas" are direct readings of the instrument’s operative sections and notes (s 4; s 6; Notes 1-3; Schedule 1; s 2), and they highlight places where administrative or legal practice might diverge from a superficial reading that treats endorsement as equivalent to clinical permission or assumes continuity with the 2010 instrument.

Compliance with the National Health (Eligible Midwives) Determination 2022 requires action across registration, qualification documentation, and coordination with jurisdictional authorisation regimes. The instrument sets a clear statutory precondition: for the purposes of Part VII of the National Health Act 1953, a person must have their midwifery registration endorsed by the Nursing and Midwifery Board of Australia under section 94 of the Health Practitioner Regulation National Law to cover scheduled medicines or classes of scheduled medicines (s 6; Note 1). The instrument itself prescribes no procedural steps beyond that endorsement, but the instrument and its notes identify the specific compliance pathway and the checkpoints registrants and employers must address.

Practical compliance steps grounded in the instrument:

1. Confirm the target status and timing

• Identify whether your decision requires being an "eligible midwife" for Part VII of the Act (s 6). If so, note that the determination commenced the day after registration of this instrument (s 2).

2. Secure the necessary endorsement from the Nursing and Midwifery Board of Australia

• Apply to the National Board for an endorsement under section 94 of the Health Practitioner Regulation National Law that specifies the scheduled medicine or class required (s 6; Note 1). The endorsement is the statutory condition for federal recognition under this instrument.

3. Satisfy the Board’s qualification requirements

• Ensure you hold an "approved qualification" or a qualification that the National Board considers substantially equivalent or based on similar competencies (Note 2 to s 6). Where your qualification is not on an approved list, prepare documentary evidence to support an equivalence assessment by the Board.

4. Comply with relevant registration standards

• Identify and meet any "approved registration standard relevant to the endorsement" (Note 2 to s 6). Obtain copies of the registration standards from the Nursing and Midwifery Board of Australia and maintain compliance as a condition of endorsement.

5. Obtain legal authorisation to perform scheduled-medicine acts in the relevant jurisdiction

• Recognise that endorsement demonstrates qualification but does not itself authorise the administration, possession, prescribing, sale or supply of scheduled medicines (Note 3 to s 6). Apply for and secure any separate permissions required by state, territory, or federal statutes in the jurisdiction where you intend to practise.

6. For employers and contracting parties

• Verify a midwife’s endorsement status under s 94 by checking the National Board’s register or by requesting proof of endorsement. Confirm separately whether the midwife has the jurisdictional authorisations required to administer or supply scheduled medicines (s 6; Note 3).

7. Document and retain proof

• Maintain copies of the endorsement, qualification documents, National Board communications, and any jurisdictional authorisations. Because the instrument does not set out transition or saving clauses, records proving compliance and continuity may be important if an administrative or legal question arises.

8. Monitor changes in related instruments

• Because key definitions and standards are imported (s 4), monitor the National Health Regulation 2016, the Health Practitioner Regulation National Law, and the Nursing and Midwifery Board's registration standards for changes that may affect endorsement criteria or the meaning of "scheduled medicine".

9. If relying on equivalent qualifications

• Prepare detailed competency evidence if the applicant’s qualification is not an "approved qualification". The Board’s assessment of substantial equivalence or similar competencies is the explicit mechanism for non-standard qualifications (Note 2 to s 6).

10. Seek administrative guidance where unclear

• Where there is uncertainty about whether a particular scheduled medicine or class falls within the scope of an endorsement, or about the interaction between endorsement and jurisdictional authorisation, seek clarity from the Nursing and Midwifery Board and the relevant jurisdictional health authority. The instrument delegates those determinations externally and does not resolve scope disputes itself (Note 3 to s 6).

Costs, who decides, and likely compliance burdens (as implied by the instrument):

• Who pays: The primary compliance costs,education, credential assessment, application and administrative costs associated with endorsement and registration standard compliance,fall on the individual midwife. Employers may bear verification and employment compliance costs. The instrument itself does not set fees or indicate payment structures; those will be found in the National Board’s fee schedules and other statutes.
• Who decides: The Nursing and Midwifery Board of Australia decides whether to grant the s 94 endorsement and whether a given qualification is "substantially equivalent" or based on "similar competencies" (s 6; Note 2). Jurisdictional legislatures and regulators decide legal authorisation to perform scheduled-medicine acts (Note 3).
• Compliance burden: The instrument ties federal eligibility to the Board’s endorsement and to compliance with registration standards. The burden will include meeting education and competency thresholds and maintaining compliance with registration standards; it also includes securing any separate jurisdictional licences or permissions to perform scheduled-medicine acts.

In short, to comply with this determination a midwife must secure the prescribed registration endorsement from the Nursing and Midwifery Board of Australia and separately ensure they have any statutory authorisations required in the jurisdiction where they will practise. The instrument makes the endorsement a necessary federal gate for Part VII recognition, and implementation requires coordinated action across the National Board’s registration regime and the jurisdictional statutes governing scheduled medicines (s 6, Notes 1-3).