Ken Ticehurst (Dobell, Liberal Party) Share this | Hansard source

The Health Insurance Amendment (Provider Number Review) Bill 2007 proposes an amendment to the Health Insurance Act 1973, relating to arrangements for reviewing the operations of sections 19AA, 3GA and 3GC of the act, collectively known as the Medicare provider number legislation. This amendment is the result of comments submitted to and deliberations undertaken at the most recent biennial review process in 2005. The amendment aims to change the frequency of the review from two to five years, with the next review to commence in 2010. The biennial review undertaken in 2005 reported that there continued to be overwhelming agreement with the objective of the legislation and reported it was agreed that the legislation was having, in particular, a positive impact on raising the quality of general practice services to the community. There was also broad agreement that the operation of section 19AA of the act has not exacerbated any medical workforce shortages. The bill is therefore a relatively straightforward proposal to retain the review process but change the review interval from two to five years, with the next review report to be tabled in parliament no later than 31 December 2010.

To provide some background on the issue, in 1996 the Australian government introduced major changes to accessing Medicare provider numbers for new medical practitioners. Under section 19AA of the act, newly graduated doctors were required to obtain postgraduate qualifications before they were able to access the Medicare Benefits Schedule. Exceptions were made for those doctors who were enrolled in approved training or workforce schemes. These changes had the effect of encouraging young doctors to work towards fellowship of a recognised medical college, including recognition of general practice as a distinct medical discipline. For general practitioners, the intention of limiting Medicare provider numbers to only those doctors who have received vocational training was to ensure that all medical practitioners are appropriately skilled to enter into unsupervised general practice.

At the time the legislation was introduced, there was a view in the medical workforce and by the doctors in training that it would significantly restrict access to training places by junior doctors. There were strong concerns that junior doctors would be forced to spend years working in salaried positions in hospitals or that, due to the lack of training positions, large numbers of doctors would be unemployed. But this has not occurred. The concern that the legislation would negatively impact on the availability of training places has not eventuated.

During the consultation process, noting the wide acceptance of the legislation by relevant national health organisations, the frequency of the review process was discussed with a view to extending the period between reviews. The review process takes nine months to complete and requires significant staffing resources from the Department of Health and Ageing. With continuing wide acceptance of the legislation, the need to conduct a review on a biennial basis is no longer critical.

My electorate of Dobell on the Central Coast is classified as an area of workforce shortage. Access to quality health care is so important to the Central Coast community that I am always working to attract more doctors to our region. By working with the community over the last 12 to 18 months, we have been able to secure 13 new doctors for Dobell. The Australian government is committed to improving access to GPs in regional areas like the Central Coast.

The 2006-07 federal budget contained some important measures to address this aim, including $241 million to train more doctors and nurses in our system. With the Central Coast rapidly growing in population, this sort of commitment is vital. It is creating 400 new places for medical students and 1,000 extra higher education places for nurses each year. Essentially, this means that more students are having the opportunity to get into medicine if they spend part of their training period in a regional area, and it may encourage them to continue in a regional practice.

Hundreds of patients visiting GPs in Dobell are benefiting from higher bulk-billing incentives. There are higher rebates for GPs in eligible areas who bulk-bill Commonwealth concession card holders and children under 16 years. This initiative has been welcomed by families with children under 16 and many of the Central Coast’s seniors. The Australian government’s Medicare initiatives are attracting more and more doctors to the Central Coast. In fact, the bulk-billing rate in Dobell has increased by around seven per cent to just under 80 per cent.

The opening of two medical centres in the northern area of the Central Coast in the last two years is greatly improving the level of health care available in the rapidly growing area of Warnervale. I secured $523,000 toward the establishment of the North Wyong Primary Health Care Centre. It is a fantastic initiative that is working towards attracting more GPs to the area, especially those with a strong interest in research. I am now working with the Central Coast Division of General Practice to secure additional funding for the centre in recognition of the innovative model of health care that the new centre is trialling and the urgent need in the Wyong community for primary health care services. The Minister for Health and Ageing, Tony Abbott, visited the centre and met with several Central Coast doctors and definitely understands the medical needs of our area.

To conclude, this is a very straightforward bill that will not have any impact on any other act or on access to medical training placements. As I mentioned earlier, all previous reviews have found the legislation to be well accepted. The government recognises the need to maintain a monitoring process but does not see a need for a review to take place every two years.

I reiterate that the Howard government is committed to improving and strengthening Medicare and the medical workforce to ensure that all Australians, including the people of the Central Coast, have access to quality, affordable medical care. Sadly, thanks to a New South Wales Labor government that is out of touch with the needs of our local community, the situation in our local hospitals leaves a lot to be desired. Of course, the operation and management of these hospitals is a state government responsibility.

These comments are no reflection on the fantastic, skilled, though underresourced, staff that I have the pleasure of working with on many occasions. Figures for December 2006 show that, of all hospitals in New South Wales, Gosford Hospital had the second highest number of people waiting for surgery, behind Newcastle’s John Hunter Hospital, and that 19 per cent of patients who went through the Wyong Hospital emergency department triage system in December 2006 waited much longer than they should have for treatment. People stuck in emergency departments included very sick patients who needed to be admitted to hospital, and I know that the staff in the emergency department would have done all they could to help them.

The problem is not that we do not have qualified people in New South Wales but that the Labor government, unlike the Howard government, simply does not understand the needs of local communities. Despite the record funding New South Wales receives under the GST, it is failing to provide the necessary funding to assist these dedicated professionals to do their jobs as they would prefer to do them.

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