Wilson Tuckey (O'Connor, Liberal Party) Share this | Hansard source

How do we look it up? We have not got the delegated legislation. It raises a rather interesting point as far as I am concerned. Frequently this House transfers huge amounts of power to the Public Service in terms of delegated legislation—which I presume the member for Makin understands is tabled in these two houses; I wonder when he last looked at any of it—and it becomes law, with all the meanings of the law, notwithstanding that it can only be stopped by a disallowance motion in either this House or the Senate.

The financial impact statement is very brief. It says:

The Bill delivers on the 2009-10 Budget commitment to introduce the Continence Aids Payment Scheme.

Funds for the CAPS payments from 1 July 2010 are included in the Department’s Forward Estimates.

As I recollect, the purpose of bringing in a financial impact statement was to tell the House how much something is going to cost, not to send us off on some wild goose chase hunting through the budget for amounts of this denomination. I smell a trick. I will not be voting against the legislation; I just hope that this is not another Ruddism, where promises are invariably broken.

It is all in black and white there. I have only read from the description given to this legislation by the clerks, and I draw the House’s attention to the fact of its brevity. None of the details which people would like to know for overcoming the financial aspects of their difficulty in the future are provided to the House. That is all left for another day and, if history repeats itself, maybe never, because this legislation quite obviously overrides the present scheme. A lot of people took this government on trust three years ago. The evidence is arising that they are very disillusioned by the outcomes.

As this is a health measure, it allows me to address some other health matters, as the member for Makin did a moment ago when he started talking about superclinics. There are serious matters arising in my electorate of O’Connor and, I am sure, in many country regions throughout Australia relating to the availability of general practitioners. There are constant allegations as to who created the shortage and who reduced the number of undergraduate courses. There may be blame laid on both sides of the House, but I can assure the House that the first attempt followed the bulk-billing initiatives of the Hawke government.

Why was the number of undergraduates cut back by, as I recollect, about 4,000? We had the appearance of Dr Edelsten. Remember the bloke who bought the Sydney Swans because he was making so much money out of bulk-billing? There was panic within the Hawke government that all these graduates were coming out, going to highly populated parts of the major capital cities, hanging out their shingles and then freeloaders, if you like, or less needy people were turning up to get prescriptions, in some cases for a packet of aspirin. The money was flowing out of the federal coffers as a consequence. The response of the Hawke government was to cut back on the number of undergraduate places, for the purpose of reducing the number of people who could get on the bulk-billing bandwagon. As I warned the shadow minister for health in that period, when the government becomes the sole customer of the medical profession, the profession will eventually get squeezed, as of course materialised on a number of occasions. Many more doctors today are abandoning bulk-billing, more so in country areas, where it is virtually impossible to run a practice on the rebate.

Let me draw to the attention of the House the fact that last week local government representatives around Australia turned up here for their annual conference. Numerous members arrived from my electorate and each and every one of them had been contacting me regarding their problems in ensuring their community had an adequate GP service. They have been doing it in Western Australian rural areas for years, gradually consuming up to half their rate base on subsidising a GP to stay in their town—up to $500,000. That was even a shock to me, as someone who has been watching this process get worse and worse over the 30 years I have been representing O’Connor; getting worse, getting worse, getting worse. If I had been asked what the typical contribution was from a local authority, outside of the capital commitments they have made in housing, doctors’ surgeries and things of that nature, I would have thought something under $100,000. These are small communities desperate to get a doctor.

The response to that payment, we are told, is: ‘It’s a federal responsibility.’ We know it is a state responsibility and state governments around Australia are refusing to put salaried doctors into the hospitals that exist on the grounds that they are not allowed to claim Medicare rebates if they are a salaried doctor. Too bad for the community. That is the way they deal with it. I know of nothing in this new, you-beaut deal, which seems to be falling apart every day in recent times, that would compensate those councils for this cost, would guarantee that the states provide salaried medical practitioners under the state-Commonwealth agreements. I bet that was not discussed during all the bullying that went on to achieve the loss in every state bar Western Australia of their GST share, attributable, if you like, to health. That was to be brought back here to government, which, under Keating, sold the six repatriation hospitals at a saving to our revenue of $1 billion. Fortunately, in Western Australia, it was taken over by Ramsay Health Care, who, according to the RSL and others over there, has given them a vastly improved service.

But the reality is that, amongst others, a company called Meridian commenced assisting these local government authorities by arranging the importation of doctors and allocating them in various areas on a sort of package with an obligation to provide locum services and at least give these one item GPs the opportunity for leave and have some family time or whatever else. That in itself has become a problem. A retired GP living in the town of Albany was in my office last Friday explaining how, since he retired, he has never worked so hard in his life, trying to fill as many locum positions as he can when his preference would be to be holidaying in Europe or something like that—a responsible man who is seriously concerned about the circumstances that exist in the electorates and in particular the electorate of O’Connor.

Meridian was supplying a doctor in Southern Cross, a town in the district of about 1,500 people, and Lake Grace, I guess of similar size—not huge but it is a long way between stops—and of course others. They have just advised that they are discontinuing this service, not because they have not been remunerated, not because they think they might do something else but because they can no longer get accreditation for the doctors available to come from various parts of the world to service these particular communities. Why is that? Because over the life of the Rudd government there has been an ever-tightening of the accreditation requirements, so much so that this doctor, who continues to work in his retirement to aid the community, openly admitted that he could not pass these exams either. Examinations of that nature are for the young and they are necessary to prove they have learned their lessons. As time goes by, they accumulate huge amounts of experience but, as those of us who have been around a while know, answering the sorts of questions that arise in these accreditation examinations is very, very difficult. Others have said to me that doctors previously admitted and accepted as giving good and reliable service in many communities also could not have succeeded in passing this examination. But it goes one step further: if you are willing to give it a go, you cannot get a slot to undertake the examination. It is a bit like the old French non-tariff barriers: if you did not want a certain product to come into your country, you never put a ban on it; you had one officer throughout the nation sitting in some obscure locality to whom you must apply for an import licence. That is what has happened, and who has lost out? Rural areas.

The member for Makin says we are going to have these wonders called superclinics. The minister wrote to me and said I could have one in my electorate. I said, ‘Thanks, but no thanks.’ The last thing I want is some nationalised facility with extensive government funding that sucks the last of my individual GPs out of their towns for the easy life of having a nice regulated nine-to-five job or whatever—fixed hours and the weekends off or two days off during the week. I endorse entirely the opposition’s view that these are an unnecessary proposal when the real problem is the availability of doctors. Yes, you might be able to fill up the superclinics with doctors, whatever they will be paid, but somewhere else people will lose them.

It is another one of those promises to which I have just referred. There were 36 to be built in their first term of office, along with millions of computers for school kids, and now we have got ministers pointing fingers at us saying, ‘If you cut back on the funding, people will not get these things.’ They are supposed to be there—not three but 36. If we add another 28, goodness knows when they are going to turn up. But there are opportunities and it was suggested to me by this GP who visited that we should just bring these doctors in, particularly from the UK and other places, and have a mentor here to look after them. (Time expired)

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