Craig Thomson (Dobell, Australian Labor Party) Share this | Hansard source

Before I start, I have been asked by Luch, who looks after us so well here with water and so forth, to acknowledge that his daughter and her class members from Mary MacKillop high school are here in Canberra today watching us. On behalf of a very proud father: Jessica, welcome to you and your schoolmates. I hope you enjoy today’s proceedings.

Health reform is well and truly one of the most important issues of our time. I am delighted to say this government is providing the leadership that is needed on health reform. Leadership, especially in the area of health, is a concept that was obviously absent when those on the other side were in government. When the current Leader of the Opposition was Minister for Health and Ageing he ripped a billion dollars out of the health system, seeing that as some kind of reform. Clearly, we take a very different approach on this side of the parliament.

I rise to support the Health Practitioner Regulation (Consequential Amendments) Bill 2010. The bill supports the implementation of the National Registration and Accreditation Scheme for health professionals. This will mean that, for the first time, there will be a national system for registration and accreditation in 10 health professions, bringing consistency and uniform standards to our health workforce. Queensland, New South Wales and Victoria have already passed bills which will put in place the national system. The ACT and the Northern Territory have introduced their bills, and South Australia, Tasmania and Western Australia are well advanced in their planning.

National registration has been a very long time coming. Under the previous government, the current Leader of the Opposition as the Minister for Health and Ageing identified this as a goal and then decided to sit on his hands. After years of blaming the states and territories for all the problems in the health system, he was unable to work with them to deliver this key health reform. On the other hand, this government is delivering this key health reform. Just as the opposition leader sat on the sidelines while 60 per cent of Australians suffered from a shortage of doctors, he dithered on this important health workforce reform. The Rudd government recognized that this goal was one that had stalled and needed to be pursued. We immediately got to work with the states and territories and, in March 2008, signed an intergovernmental agreement to progress the national scheme. We know that a national scheme will reduce red tape, increase standards and improve safety for the Australian community. We also know that a national scheme will improve the mobility of the health workforce. It will stop health professionals from having to reregister every time they step across a state border, saving time, money and inconvenience. This will, for example, help boost locum support for rural doctors as doctors become freer to work across state boundaries.

As I have said, the health reforms that this government are committed to constitute one of the most important issues of our time and of our generation. In my area of New South Wales—the Central Coast—health reform is an issue we do not take lightly. I have been campaigning strongly for the Central Coast to have its own truly local area health network. Currently we are part of a larger Northern Sydney system, which is clearly not suitable for our region. We need to have a health system that caters to the Central Coast’s people rather than one that is spread out over such a large geographical area. The priorities of our health system need to be in our region and not elsewhere—a system that is funded federally but run locally.

The government is delivering a GP superclinic in the northern area of my electorate of Dobell, which has the full support of not only the local community but also the Division of General Practice, the University of Newcastle, the area health services and doctors generally in the area. It also has the support of high schools. I mention this because MacKillop College, a college of the same name as that of the students who are here in parliament today, is in my electorate. It is next to this college that the GP superclinic is to be built. It is planned that this superclinic will have high standards of training. Students from the school and others in the area will be able to participate in training at the superclinic. Once the new superclinic is fully operational in the Warnervale area, it will employ more than 100 health professionals. It will take demand off the emergency department at Wyong Hospital, which is now the fourth busiest in the state. Already there are nearly 2,000 patients on the books of the temporary GP superclinic, which reflects the need for additional doctors in our areas, particularly in this area, where there is a growing number of new families moving to the Central Coast.

To further alleviate the pressure on emergency departments, including the one at Wyong, the budget outlined by the Treasurer last night, as we now know, allocates new money towards limiting the time in which patients will be seen to in an emergency department to only four hours. This will be done by increasing the capacity of the emergency departments. Through the budget, the government is acting to ensure that more Australians can more easily access appropriate health care by making a strategic investment to support and recognise the work of practice nurses. As part of the government’s nursing package, $390.3 million will be provided to better support practice nurses and for the first time provide funding to GPs in urban areas to help employ practice nurses. Annual incentive payments of $25,000 per full-time GP for a registered nurse and $12,500 per full-time GP for an enrolled nurse will be made available to eligible accredited general practices.

The government will transform the way Australians with long-term illnesses are treated, starting with improving health outcomes for the nearly one million Australians living with diabetes, too many of whom end up being treated in hospitals unnecessarily. The government is committing $449.2 million to improve care for people with diabetes. For the first time, Australians with diabetes will have the option of signing up with a GP practice. The practice will be responsible for managing all aspects of their care and will be paid, in part, for keeping patients healthy and out of the hospital system.

Through these key reforms, this government is committed to delivering better health outcomes for all Australians. The 2010-11 budget will deliver a massive $1.2 billion boost to GP and primary health care, including $355.2 million to build and upgrade GP superclinics. This will honour the Rudd government’s commitment to deliver real improvements in front-line health services for patients across Australia. The Rudd government will upgrade around 425 primary care facilities and GP superclinics and construct around 23 new dedicated GP superclinics. This strengthens the Rudd government’s $275.2 million GP superclinic program, which is delivering 36 GP superclinics across the country, including in my electorate. As I have mentioned, GP superclinics take pressure off public hospitals, provide better integrated and more accessible care, help attract health professionals to areas of need and give health professionals the option of more training in these particular facilities. Of the new GP superclinics, around nine will be large clinics where doctors, nurses and allied health professionals will be supplemented by more specialised services such as renal dialysis, minor surgical procedures, rehabilitation services and radiology. The remaining new GP superclinics will be built along the lines of the 36 clinics already under construction. By providing patients with more convenient one-stop shops, the government will help and encourage patients to get the primary care they need to stay fit and well, particularly if they suffer from chronic illnesses.

Three types of funding will be available to help existing general practices expanded their facilities, with grants of up to $500,000. These larger grants will be available to those practices that also establish teaching facilities. Additional services will be made available as a result of the infrastructure investment, with space made available in GP clinics for allied health services; group education, such as diabetes management; counselling; and community health promotion. This injection into GP superclinics builds on the additional primary care being committed to by the Rudd government, including funding for a record number of GPs, more support and training for around 4,600 practice nurses and a new innovative approach to improving the treatment of diabetes in GP practices. These infrastructure investments are part of the government’s move to take over full funding of and policy responsibility for primary care. Through the National Health and Hospitals Network, the Australian government is taking full responsibility for funding all general practice and primary healthcare services. The Commonwealth government will continue discussions with the states and territories to finalise the scope of services included in the takeover by the end of 2010.

Our region—the Central Coast—is ideal for a Local Hospital Network which will be run locally and funded federally. I will continue to fight for that outcome. My constituents take their health very seriously. That is why there is a rising tide of community opposition to plans for a large longwall coalmine in the valleys of Wyong Shire in my electorate. People not only know that there is a major risk to the region’s water supply because of the planned mine’s location in relation to the water catchment but also are worried about potential health risks. The proposed coal loader for the mine is to be located in one of the fastest growing areas of my electorate, which is popular with young families moving to the coast for the clean air and outdoor lifestyle. I am fighting against the coalmine because of the ongoing concerns about health outcomes linked to coalmining in general and, in particular, the problems they have experienced in the Hunter, just north of me. They did not move to these areas of the Central Coast to have their health and their children’s health affected by coal dust from thousands of tonnes of coal moving through their neighbourhoods. I am determined to stop that coalmine.

The bill I am speaking on today is an important part of the government’s major agenda of health reforms. On 3 November 2009 the Queensland Health Practitioner Regulation National Law Act 2009 received royal assent. The national law sets out the framework for the scheme covering the registration of health practitioners and accreditation of health education and training, complaints, privacy and information sharing, and transitional arrangements. The Commonwealth does not need to apply the act for national law; however, consequential and transitional amendments are required to the Health Insurance Act 1973 to ensure that medical practitioners continue to retain the same Medicare billing eligibility from 1 July 2010. It also streamlines the extensive systems involved in registration and recognition of medical practitioners for Medicare purposes, ensuring the reduction of red tape, and helps to maintain the currency of the Health Insurance Act 1973 regulations and adequate access to Medicare rebates and retention of practitioners in Australia.

The current pathways to specialist, consultant physician and GP recognition in the Health Insurance Act 1973 necessitate communication exchange between Medicare Australia and relevant organisations, such as medical colleges, to ascertain Medicare eligibility. These arrangements have been put in place because previously there were variations across states and territories for the recognition of specialist qualifications and general practice qualifications in the registration process.

The national registration and accreditation scheme provides a nationally consistent means of identifying both specialists and GPs. The mandatory requirement for continuing professional development in the scheme means that Medicare Australia is no longer required to monitor whether practitioners providing a Medicare rebateable service are meeting continuing professional development requirements. It is essential that the extensive systems involved in registration and recognition of doctors for Medicare purposes are streamlined to ensure the reduction of red tape, the currency of the health insurance regulations and efficient access to Medicare rebates, as we have noted before.

The Health Insurance Act 1973 provides various pathways for recognising specialists, consultant physicians and general practitioners for Medicare purposes. This bill provides an opportunity to streamline current specialist recognition processes under Commonwealth legislation. This includes removing the current Vocational Register of General Practitioners, particularly now that the Medical Board of Australia has recommended that health ministers endorse general practice as a specialty for the medical profession.

This bill will not disadvantage medical practitioners who are currently registered in states and territories. In particular, it will not disadvantage any GPs who are currently on the vocational register whether or not they have a fellowship of the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine. Streamlining specialist recognition will also facilitate workforce mobility and access to Medicare for international medical graduates.

The National Registration and Accreditation Scheme for the Health Professions will modernise the regulation of health professionals by creating a single regulatory environment. By ending the duplication of effort, multiple standards and red tape caused by separate systems in each state and territory we will have a more workable registration scheme for Australian patients and practitioners that also contributes to improving the safety of our health system for all Australians. It provides the community with reassurance that health professionals across Australia will meet a common set of standards. Our health workforce will also benefit from the improved mobility the national scheme will offer.

It is important to note that much effort has gone into where we are today with this bill. Much credit should go to all of the professional groups who have constructively engaged in an incredibly complex task over the last four years. This includes the current state and territory health professional boards, which have faced enormous change. We should also recognise the expertise and hard work of the officials who have undertaken the work that is making national registration a reality.

We should also thank the state and territory governments around the country, who are all committed to a national scheme for the registration of health professionals and have put the national interest first in supporting this change. We now look forward to the national law being adopted in the remaining jurisdictions over the coming months and the implementation of the national registration and accreditation scheme for the first time in Australia. I commend this bill to the House.

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