Harry Jenkins (Scullin, Australian Labor Party) Share this | Hansard source

I support the motion moved by the member for Hindmarsh and congratulate him on bringing this important area of public policy up for discussion today in private members’ business. Those that have spoken on behalf of the government have tended to look at the figures and resources that they claim are being put into health and claim that the adequacy is just on the basis of quantum. I think the real problem is that you need to analyse where these funds are going, the misdirection of funds and the fact that, in toto, these funds do not effectively look at the long-term best interests of the Australian healthcare system. If we continue to have a system that is based on secondary and tertiary health care and do not really look at the role of primary health care, the role of general practice, the role of community health centres and at what is happening in the day-to-day lives of people, we are going to completely miss the point.

The member for Werriwa talked about the outer western suburbs of Sydney; I will talk about the outer northern suburbs of Melbourne, where the population growth is great. One municipality that I represent is having eight new residents a day moving in. That is at least two households a day. When you look at some of the new suburbs you see that there are no general practitioners or neighbourly family medicos living in those areas because the needs are being outstripped by the growth. These are the problems that we confront. The member for Werriwa indicated that the ideal ratio of population and general practice is 1,200 to one. In the electorate of Scullin the actual ratio is about 1,500 to one, and the shortage is getting even more stressful because of the population growth and the ageing of the health workforce. General practitioners are ageing and they are not being replaced.

A number of the programs that the Howard government has had in place have missed the mark. The outer northern suburbs of Melbourne have fallen through the cracks. It is all right to talk about regional Australia—meaning rural regional Australia—but in the regions of our major cities there is no direct assistance in combating the types of shortages and disproportionate ratios that are seen in electorates like Scullin.

The shortage of nurses is chronic. It is a shortfall of something like 31,000 nationally and it is growing every year. There are plenty of statistics that show that the average age of nurses is increasing. There are not enough new nurses coming on stream to replace those that are leaving the profession, so we need to look at the ways in which we can assist people to get into training and make it more attractive for trained nurses to be retained in the workforce. The government at one stage, in the run-up to an election, indicated that they would lessen the HECS burden for those who go into nursing. What have we seen? What has been the outcome? Of course it is the reverse. The HECS burden for a nursing course is nearly 40 per cent more than the minimum HECS contribution. This is despite the government indicating that they would assist and understand that this is a burden on a special skills shortage in the Australian population.

The other thing that we need to look at is the amount of work that is done in outer urban areas—areas that might be seen as being on the wrong side of the Yarra. Traditionally one of the workforce issues in Australia has been that we cannot get medicos spread across the metropolis as we would like. It has always been places like the northern and western suburbs of Melbourne and the western suburbs of Sydney that have had these shortfalls. But the general practitioners that actually operate in, say, places like the Northern Division of General Practice in Melbourne consult something like 5.7 locally per head of population; nationally that ratio is 4.7. So it is not as if they are not doing the work and putting in the effort. But why should general practitioners in electorates like Scullin have to work harder? We need to address these shortages.

These shortages exist because not enough people are going into university courses to meet the shortfalls. Members of the government say that the number of places has opened up but it is still behind the eight ball. We need to have concrete ideas that will see that these types of workforce shortages are addressed. It is in the long-term benefit of our health system that general practitioners can play their important role in primary health care throughout Australia. 

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