Tony Windsor (New England, Independent) Share this | Hansard source

I compliment the member for McMillan on a number of the comments he made in his address, obviously recognising that we do have some concerns, particularly in regional parts of Australia, about doctor numbers and allied professionals. I also compliment him for his comments on medical schools. One comment I did pick up on that I think is quite pertinent was in relation to the nursing community and the role which they can play—and I know there are a number of moves afoot—in assisting and taking the pressure off some of our general practitioners, because they are under extreme pressure in many of our communities.

I support the Higher Education Legislation Amendment (2006 Budget Measures) Bill 2006. I would like to compliment the minister and the government on a number of initiatives that have come forward in and are dealt with by this bill in a small way. It is a multifaceted piece of legislation. I guess we can always find some part of every piece of legislation that there is some fault in. We can always do better, and we can demand more and more in terms of health care et cetera—it is a never-ending journey—but no government will ever deliver the ultimate for all of us. There are a number of very positive things that this bill does address. The member for McMillan touched on a few of them, but I would like to mention a few if I could.

The initiative that the minister announced for medical schools is a very positive initiative. In one case, it has an impact on the electorate of New England. The University of New England is a great university, of which I happen to be an ex-student—probably not its greatest ex-student, but nonetheless I was an attendee—and I am very proud to have been part of that university. One of my children also attended that university. The University of New England is one of those country universities that were granted, in partnership with the University of Newcastle, the Tamworth Base Hospital and the Armidale Base Hospital in particular, 80 university places in the formation of a medical school.

I would like to particularly congratulate Professor Peter Jones, who has headed up the University Department of Rural Health which has been based in Tamworth for quite a few years now. It is his and his team’s very hard work, in my view, that has actually established that part of the world as being at the forefront of educating country students, as well as other students, in medicine. Professor Jones is originally from the University of Newcastle. The partnership between the University of Newcastle, which also has a medical school—on the coast, of course—and the University of New England, in conjunction with what used to be the New England Area Health Service and is now Hunter New England Area Health, is working.

The Minister for Health and Ageing, Tony Abbott, was in the electorate about 15 or 18 months ago to formally open some extensions to the University Department of Rural Health at the Tamworth Base Hospital. He saw the progress and enthusiasm, the results on the ground. It is obvious to all that, if you educate country students in the country—or city students in the country—they are more likely to carry out their general practice work or other work, such as hospital work, in the country, because a whole range of the fears that they may have about working in the country are removed and a lot of their social contacts are established in the country. They can see the absolute benefits of working in the country in terms of their own lifestyles and the positive interactions they have with country people.

It was a natural progression from the University Department of Rural Health’s work in Tamworth to the establishment of a full-blown medical school, which will be based on a similar model and work in conjunction with the University of Newcastle.

I also congratulate the new Vice-Chancellor of the University of New England, Alan Pettigrew, for his work and the way in which he has taken to the task of administering the university—particularly taking it to this new level, where medical and nursing places are going to be filled. It is a really positive story of addressing a problem. We can all say that it should have been addressed some years ago. It did not happen, but it is happening now, and the government needs to be congratulated for moving now—and, hopefully, moving in a similar direction in other parts of Australia as well.

The formula works. It may be running slightly against the economic rationalist thought that major centralised universities on the coast are a more cost-effective way of delivering more doctors into the community. In theory that works, but in practice it has not got doctors out into country areas. This is a positive way of bringing students through a country process to achieve their degrees, with a greater likelihood of their actually working in the country after that.

Another issue that the bill embraces is the mental health arrangements that were put in place at the Council of Australian Governments meeting earlier in the year. I congratulated the Prime Minister at the time, and I still do, for the leadership role he took on that issue. The state Labor premiers, particularly the Premier of New South Wales at the time, had also been fairly proactive. We all realise that at all levels of government not enough had been done in the mental health area. The leadership taken by the Prime Minister and the premiers on this issue could make significant differences into the future.

Let us hope that this issue does not fade as the months and years go past—that the bureaucracies and the various Commonwealth and state departments do not filter the original intent away. Mental health is an enormous problem for all of us. Most people are touched by relatives or friends who have had some degree of mental health problems as part of their lives. Mental health issues are part of our modern community and should be recognised as such. It is pleasing to see that at a government level that is happening.

At a local level, too, it is happening. In the electorate of New England the Billabong Clubhouse was the first such centre to be located in a regional part of Australia. It does a tremendous job. People with varying degrees of mental illness do not just get well overnight. It is a slow process. It does need professional people and caring people within the community to be able to stay the course with those people.

I am sure that from time to time all members of parliament have dealt in their offices with people who have had significant problems. A lot of the time they are coming to us just to talk to someone. That caring ear is very important—probably as important as being able to refer people to services in the community. Billabong Clubhouse does an extraordinary job of bringing people who have suffered a degree of illness back into the community at a pace that they feel comfortable with and with some professional backup.

Another initiative that has been undertaken in the electorate of New England in recent months is the Suicide Safety Network that has been established under the chairmanship of Mr Darren Greentree. I congratulate his committee for the work that they have done. The network is the brainchild—and the Central Coast members of this parliament would particularly know this—of a Mr Eric Trezise. Eric was very instrumental in establishing a similar network on the New South Wales Central Coast. I know he has had assistance from members of parliament from that part of the world. Eric has brought that model to our area, and under the chairmanship of Darren Greentree we are trying to re-create the successes that Eric has had on the Central Coast.

The bill does not actually deal with dental health, but it is a significant problem and most members have been fairly wide ranging in their speeches in this debate, so I hope the Deputy Speaker will allow me to talk for a moment about it. The member for McMillan spoke about the lack of doctors and the problem that we have in all of our communities. The lack of dental health and dentists—the numbers of people that we are training at our universities and the incapacity to encourage some of those who are being trained to come into country communities—is an enormous problem now and potentially a bigger problem than the lack of doctors and ancillary staff. I want to read from a letter from a Dr Christopher Cole, who is based in Armidale in my electorate and who is a dentist. He has despaired about the situation in dentistry. He said:

The number of dentists graduating 30 years ago was approximately 100 per year in NSW.

I think the proportions are similar in other states. He continued:

Now and for recent years it has been around 45-50 per year.

The population has doubled and with many more people now retaining their natural teeth into older age the workload has multiplied.

The public dental health system is in a completely dilapidated state with waiting lists of over 200,000 and still counting ...

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The country dental workforce is feeling the brunt of this in both public and private sectors. In the New England/North West over the last five years or so at least six dentists have closed their doors when they have retired. They have not even been able to give away their practices to ongoing dentists.

This has happened in Tenterfield, Scone, Bourke, Narrabri, Gunnedah, Coonamble ...

Those communities are located in the electorates of New England and what is currently Gwydir. He continued:

Narrabri for example now has one dentist for four days a week to serve approximately 13,000 people. We are supposed to be on an ideal ratio of one dentist per 2,300 people.

I will read out some of the suggestions that Chris Cole makes, because I think it is important that we recognise the problem and look to the profession to try and assist with the solution. In his letter he stated:

I suggest that we should:

• Utilise the university staff in the theory and preclinical training
• Utilise the vast knowledge of the dentists in large regional areas such as Armidale, Albury, Dubbo, Tamworth, Wagga Wagga, Wollongong, Coffs Harbour etc for the practical clinical training of the undergraduates. This could be done as type of “intern” situation where the undergraduate students would be rostered to one of these regional areas and work under the supervision of the private practitioner on the non urgent Public Patient waiting lists. This is what happens in the major teaching hospital where the undergraduates do the fillings etc on the public patients under supervision.

This would allow for:

• More students to be enrolled in the Faculty of Dentistry.
• Utilisation of undergraduates to help alleviate the growing backlog of public patients on the public lists.
• Expose more undergraduates to country areas of NSW and to the real workings of general practice. This also gives them more clinical time in which they can learn their profession
• Give local practitioners a closer connection with ongoing education activities. One of the greatest problems of country practice is the mentoring with fellow colleagues and this set up would give the country Dentists more exposure to education with the added stimulation of this expansion of the profession.
• As a side outcome I feel a lot of the country Dentists may get a little extra lease of their professional life because of this interaction and potentially stay longer in the profession.

That is a very important point. He continued:

This can’t be a bad thing for the economy because it keeps the workforce there and they also would be adding to their retirement security with added superannuation savings.

Dr Cole went on to say a number of other things. I seek leave to table the document.

Leave granted.

I have one more issue to raise in terms of dental care. I ask the government to look seriously at the way in which Medicare treats dental care. I am fully aware that the health minister partly addressed that issue some time ago, in that people with health problems related to identifiable dental health issues can seek a rebate from Medicare. That does not embrace the vast majority of people who have dental health problems. It is time that we moved away from the state-Commonwealth responsibility debate in terms of dental care. Dental care, under any definition, is part of health care and should come under the Medicare umbrella in a greater fashion than is currently the case.

There is interplay on a whole range of these issues between state and Commonwealth governments. I have been complimentary of the government today, so I may as well continue in that vein; tomorrow is another day! Real success has been achieved—and I am sure this has occurred in other parts of Australia as well—under the multipurpose service model. The member for McMillan spoke a while ago about the ageing community and people’s health generally, and particularly older people. For those who do not know about it, multipurpose services—it is a dreadful name; they are called MPSs—are a partnership between the state and the Commonwealth, with the Commonwealth providing the aged care and the state providing what we would all think of as basic hospital care. Certain economies of scale are derived through the cooperative approach of the two bodies, as there are co-location and shared staff issues.

In the smaller and medium sized communities, these have been very successful. I am told the electorate of New England has more of these, either built or currently under construction, than any other electorate in Australia. Communities are welcoming them. I know that in the Guyra community, for instance, their MPS has just been opened. The Walcha community are turning the first sods for theirs. The Bundarra community have a slightly different variation of the theme but, nonetheless, it provides the same outcomes of aged care and health care. The Emmaville community were one of the first. In fact, I believe a few women in that community changed the face of health policy in small towns by the stance that they took some years ago and the fact that both at a Commonwealth and a state level—the state minister at that time was one Craig Knowles—they were able to change the agenda from centralising health and aged care in bigger centres to a decentralised approach in smaller centres. I congratulate the government for being part of that. (Time expired)

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