Mark Butler (Port Adelaide, Australian Labor Party, Parliamentary Secretary for Health) Share this | Hansard source

That’s right, and the member for Kennedy’s name was mentioned in vain during the very long but very important question the member for Lyne asked.

As the only city slicker, as I understand it, speaking in this debate, I hope I can do it some justice. The first ever Minister for Rural and Regional Health—and, if I can also say, the best ever, Minister for Rural and Regional Health—has indicated the importance with which the government regards these issues in a general sense. I have been asked by my minister to indicate to the member for New England, through you, Madam Acting Deputy Speaker, that a range of the matters that the member for New England raised by way of request to the government to consider will be considered by the minister, and there will be a response in due course.

It is a pity that the only way we can have a debate in this chamber around health policy is through an MPI initiated by the Independents, because, beyond this chamber and in this chamber, other than on the opposition benches, health policy is seen as one of the most significant public policy challenges confronting the country at this time. It goes without saying that this government has indicated very clearly that it is committed to reform. There are very obvious reasons for that: the ageing of the population, the growing burden of chronic disease and, as the member for New England indicated, an explosion in costs over the last decade or so which is only going to increase exponentially over the 10, 20 and more years.

We initiated the Bennett report through the Health and Hospitals Reform Commission—and a number of others as well—to talk about the ways we might deal with those trends. The Bennett report also confirmed what all of us knew, but particularly what those members who represent rural and regional Australia knew—that is, that there are glaring inequities of access to health services in Australia. You can slice and dice those inequities a number of ways—for example, you can do it by ethnicity or by income—many of which apply in metropolitan Australia. But perhaps the most glaring inequity of access is geography. The most glaring graph I remember from the Bennett report is the one that indicated that the further away you get from a central GPO, the less MBS services you access as an Australian citizen every year. I would like to think that that is because the further away you get from a GPO the healthier you are, but we know that that is not the case. In fact we know that there are, if anything, greater health challenges for Australians living in inner-regional, outer-regional, remote and very remote Australia. There is a range of very clear recommendations that the government is currently considering from the Bennett report that go specifically to that inequity of access.

The Bennett report tells us that it is all well and good to have a universal entitlement through the Medicare system, and that universal entitlement is something that Australians cherish very deeply. But, if there is no equity of access—particularly for rural and remote Australians—as well as an equity of entitlement, then the universality of entitlement is a bit of a chimera. In addition to considering the far-reaching recommendations from the Bennett report, we are already acting on some of these inequities.

There are already a range of Commonwealth-led initiatives in rural and regional Australia. The minister has talked about a number of them, as have the member for New England and the member for Lyne. The workforce challenges in rural and remote Australia are perhaps the most significant legacy from the last 10 years or so. The minister talked about them as well. GPs are so important in rural and remote Australia. We know that in addition to the primary-care services they provide throughout Australia, they are often the front-line doctors in emergency departments and they are often the front-line doctors who do shifts in the broader hospital settings.

There is a particular challenge to get GPs to rural and remote Australia and to get them to stay. We know that the previous government’s program of rural incentives was a broken program. It was operating on the basis of 16-year-old data and it simply failed. We have overhauled that program and introduced a new GP rural incentives program based on up-to-date census data. We have introduced real incentives for GPs to shift from metropolitan Australia to rural Australia. If a GP shifts from a major city like Sydney or Melbourne to very remote Australia, that GP will now receive a relocation grant of up to $120,000—a very significant increase on the previous program. If a GP moves from a smaller city like Launceston or Hobart to very remote Australia, that GP will now receive a relocation grant of up to $60,000.

As well, we have introduced a range of supports for rural GPs to help them get through the very difficult burdens that they bear—burdens that metropolitan GPs just do not experience. Metropolitan GPs work incredibly hard. They have a range of support mechanisms that rural GPs just do not have—the capacity to take leave for professional development, the capacity to take leave to have a holiday and the capacity to take time off if a family emergency arises. These are challenges day in, day out for rural GPs. We have introduced the Rural GP Locum Program to allow locums to work with GPs in rural areas, including an urban GP incentive program, which will provide professional development opportunities for urban GPs if they undertake to spend four weeks of paid time working as a locum in rural and regional Australia.

We also confronted very stark infrastructure deficits in the rural and regional health system in Australia. Notwithstanding that we have not yet made a formal response to the Bennett report, a range of programs are already underway trying to deal with that infrastructure deficit. Of the GP superclinics that are underway—and 28 of the 36 are under contract—half of the rural GP superclinics will be in rural and regional Australia.

I also want to talk about an experience I had with the member for Franklin last week when I was in Tasmania in relation to the National Rural and Remote Health Infrastructure Program, NRRHIP—a program from the 2008 budget involving $46 million over four years to build infrastructure, hard infrastructure or equipment, for communities in rural and regional Australia with fewer than 20,000 people. The member for Franklin and I visited a health service in Geeveston, which is within the Huon Valley in south-east Tasmania. Geeveston had struggled for a considerable amount of time to get a GP. With the cooperation of the Huon Valley council, they managed to upgrade the old GP office and get a range of cutting-edge equipment. Two new GPs—importantly, not just a male GP but also a female GP—were attracted to work in that area with the up-to-date equipment. They will service not only people who live in the area but also the 500,000 or so people who visit the airwalk—a major tourist attraction in Tasmania. Some occasionally fall off the airwalk and cut their heads open, as some poor tourist did when we visited the centre. These things are making real differences already in rural and regional Australia.

The regional cancer centres were mentioned by the minister—$560 million out of the health and hospitals infrastructure fund to try and close the shameful gap that Australia has in cancer outcomes between metropolitan cancer sufferers and rural and regional cancer sufferers. As members in this House know, the invitation to apply for those cancer centres closed in January this year and is now under consideration by the government, and in due course by the Health and Hospitals Fund assessment processes. These are very important things that will try and close the gap and do what I said earlier about improving the equity of access to health services.

A range of other training infrastructures are in place, and I would like to mention Charles Sturt University dental school, which has five new locations—and I have opened three of them. These schools will train rural doctors to work there, but while being trained they will also deliver up to 30,000 low-fee consultations in those areas which have gross shortages of dental procedures. There is a range of work we are already doing to try and close this gap. The gap is so significant and the challenges so immense in a country as big and diverse as Australia that we are not going to do it overnight. But we welcome the opportunity to debate these points in a constructive way through an MPI such as the one initiated by the member for Lyne and which was supported by the other Independents. This process takes resolve and the government have the resolve to do it. (Time expired)

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