Russell Broadbent (McMillan, Liberal Party) Share this | Hansard source

I rise to speak in support of the Higher Education Legislation Amendment (2006 Budget and Other Measures) Bill 2006 because of the importance of its provisions in addressing an issue of growing concern in the electorate of McMillan. Mr Deputy Speaker Haase, knowing that you serve one of the largest electorates in Australia, what I am about to say will be a matter of importance not only to you and your electors in the seat of Kalgoorlie but also to those electors in outer metropolitan parts of capital cities and in rural Australia—in your case, remote rural Australia—and particularly those in Tasmania.

The bill, as we heard from the Minister for Education, Science and Training in her second reading speech, implements commitments made in the 2006 federal budget to provide a major boost to the provision of health related university places. As I said in my opening remarks, this is an issue of growing concern particularly in rural and remote areas of this nation. Rural communities in McMillan and, I am sure, in outer metropolitan and non-metropolitan electorates are facing a critical shortage of general practitioners, nurses and allied health practitioners. This, I know, would also be close to the heart of the member for Hotham, for he was previously the Minister for Primary Industries and Energy. I remember, when I was a backbench opposition member, his support for rural Australia, the issues that affected rural Australia at the time, the decline in small communities and the leadership program that he had in place. To my memory, he was personally involved in that leadership program, which made a big difference to rural communities. I do not forget the member for Hotham’s work at that time, so he would be aware of this issue, even that long ago, and it is an issue that this nation has to again address today, of the shortage of health practitioners in rural Australia.

Issues such as population growth, the ageing of our population—including the ageing of the health service practitioners themselves—and the changing workforce patterns have all contributed to the problem we face. Recognising this, the Howard government, in partnership with states, last year commissioned a study by the Productivity Commission to examine all aspects of Australia’s health workforce. In its report, released earlier this year, the commission acknowledged that Australia was experiencing workforce shortages across a number of health professions. It said:

The shortages are even more acute in rural and remote areas ...

The report went on to say:

Though precise quantification is difficult, there are evident shortages in workforce supply—particularly in general practice, various medical specialty areas, dentistry, nursing and some key allied health areas.

In the overview of its study of Australia’s health workforce, the Productivity Commission said that Australia’s broad health outcomes compared favourably with those of other developed countries, with total spending on health care being around 10 per cent of GDP. The commission gave credit in no small measure to:

... the expertise and commitment of the health workforce and to the efforts of the health and education and training sectors more generally.

At the same time, the commission acknowledged:

... there continue to be poor health outcomes in particular regions and for particular groups.

I have just met with the AIDS task force regarding diseases within Indigenous communities and how we might address them. That is why I was reminded of the member for Hotham’s leadership program before, because we need that same leadership program at a local level with regard to Indigenous health and the health of young people, particularly with regard to sexually transmitted diseases.

The observations by the Productivity Commission reflect the reality in McMillan and other rural electorates. The McMillan electorate covers some 8,300 square kilometres, from the Great Dividing Range, or Mount Baw Baw, in the north to Wilsons Promontory in the south, and from the eastern outskirts of Melbourne, at Pakenham, to the heart of the Latrobe Valley in the east. The whole area is served by four main hospitals at Warragul, Wonthaggi, Foster and Leongatha and by smaller hospitals at Neerim South and Mirboo North. These hospitals are, in turn, supported by 16 medical practices, with around 90 GPs at any given time. More than a quarter of these are solo practices, which means that a whole community can be affected by the loss of a single doctor. As I mentioned earlier, the ageing of the population places greater demands on our health professionals.

I should explain to people who are listening that the electorate of McMillan covers from outer Melbourne to the east. It is now right on the cusp of the metropolitan growth area, which is from Berwick to Beaconsfield out to Pakenham. It also spreads out into quite small country townships, then into regional towns such as Warragul, Leongatha, Korumburra and Moe. They are the bigger centres, but we still have our Bunyips, Tynongs and Nar Nar Goons and all of those smaller places like Neerim South.

In the McMillan electorate, 15.4 per cent of the population is in the 65-years-and-over age bracket. That is higher than the average for Victorian rural electorates. Within McMillan itself, the figure varies widely, with the highest proportion of the 65-plus age group being in the South Gippsland region, where the proportion is over 16 per cent. As I mentioned earlier in my address, GPs themselves are not immune to the ageing process, and a significant proportion are in the over-55 age group and are looking to cut back on their working hours.

All of this means that these small communities are competing for a dwindling pool of GPs, nurses and other health professionals to replace doctors or nurses who retire or leave the area. In recent years, this competition has increased in intensity. These communities not only have to compete with incentive schemes being offered by governments in other states but also have to compete with outer metropolitan areas of Melbourne, which are also facing a critical shortage of doctors. All too often, this means that practices in small communities find themselves devoting far too much of their valuable time to being virtual recruiting agents, trying to find replacements for their services.

I recently received correspondence from the Foster and Toora medical centres, both of which are in my electorate. At the present time, these medical centres are facing a critical shortage of GPs. To maintain the level of cover their communities require, they need the services of nine full-time doctors. At the moment, they are down to 7½ equivalent full-time GPs. This number is expected to decline further at the end of the year to only six equivalent full-time doctors. So these rural practices are facing the prospect of trying to deliver services with a third less than the number of doctors they require. This, of course, does not include provision of sick leave, holiday leave or professional development leave, and at the Foster and Toora medical centres access to a locum service is simply nonexistent. For some time now, these practices have relied heavily on the recruitment of overseas doctors, who are required, under various schemes, to spend a number of years in rural practices. This avenue of recruitment is also becoming more and more competitive, as Australia finds itself competing on the international scene with other developed countries facing similar shortages of health professionals. All of this underlines the importance of the legislation before us.

We in McMillan are beginning to see the long-term light at the end of the tunnel in this year’s budget. The Minister for Health and Ageing outlined the government’s strategy to develop a health workforce to meet community needs. In particular, it addresses issues aimed at improving access to health services in rural and remote communities across the nation. I know there will be some members who question the description of ‘remote’ of communities in an electorate that abuts the outer fringe of metropolitan Melbourne. I would not even think to claim that any part of my electorate is remote in comparison with the electorate of the member sitting in the Speaker’s chair, the member for Kalgoorlie. He understands what ‘remote’ is all about. However, the issues can be very similar across our country electorates—certainly the feelings of our people are very similar. The lack of public transport and the time taken and the distances one needs to travel to access basic health services are very real to people in communities such as Foster, Toora and other similar communities in South Gippsland.

I was pleased to receive the news this week that the Howard government will provide $300,000 to assist the Monash Centre for Multi-Disciplinary Studies in Rural Health to become part of the university’s department of rural health program. The centre, which will be known as the Monash University Department of Rural and Indigenous Health, will be based in Moe, a robust and exciting community in my electorate of McMillan.

I also welcome the Howard government’s commitment to 600 new medical places and more than 1,000 new nursing places. Forty of those medical places will be used to establish further rural links with Gippsland with a new branch of Monash University’s medical school at the Gippsland campus. These two initiatives for Gippsland mean more students of medicine, nursing and allied health disciplines will be able to study and experience rural health practice, and it is hoped that many of them will remain in the area when they eventually enter practice. It is hoped that the Gippsland branch of Monash’s medical school and Monash Gippsland’s plans to deliver some of its nursing and teaching program at Leongatha will also help improve the take-up of tertiary education among school leavers in South Gippsland.

For many reasons that I do not have time to go into today, the group of young people coming through this year has the lowest take-up of tertiary education of any part of Victoria. I know this is an issue everywhere in remote Australia, but in Gippsland we are going to try to address that. We have some ideas that will be released later on, but at present this area has one of the lowest school leaver retention rates in Australia. Yes, it is about access, but it is also about attitude, what the school leavers’ parents did, the lead that students are given and whether they have an association with a tertiary facility prior to leaving school. So we have the standard group going off to the city to pursue their tertiary education, but they tend not to come back. They tend to meet partners and change their lifestyles to the point that they do not come back to rural areas. We have to make a bridge that goes from secondary education to tertiary education, and that is exactly what we are working on at the moment.

This is a timely piece of legislation in light of the current shortage of GPs, particularly in rural and regional areas. A white paper produced by a group of organisations involved in the recruiting and training of healthcare workers estimates Australia is short some 1,300 GPs. It estimates that, by 2013, we will need to have between 1,100 and 1,200 trained doctors entering the workforce each year. At present we have 700 Australian GP trainees and overseas trained doctors entering the workforce each year. You can see that we are going backwards a long way every year, year after year. This is a serious challenge for the Howard government, but it is one we are prepared to address.

Since 2000, the number of publicly funded students commencing medicine in Australian universities has increased by more than 30 per cent. The health minister and the cabinet have been prepared to put their money where their mouth is and address the issue of the lack of doctors in the nation, whether we are recruiting them from overseas or training them here—and I know there is a program for more mature Australians to go into medicine at a later age—

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