Lisa Chesters (Bendigo, Australian Labor Party) Share this | Hansard source

The Health Workforce Australia (Abolition) Bill 2014 before the House seeks to repeal the Health Workforce Australia Act 2009 and to absorb this agency and its functions into the Department of Health. We will see the important work done by this agency transferred. My concern about this bill is simple: it seeks to water down the important role that the Australian government plays in national health workforce planning. This bill seeks to undo the good work that has been done by the previous government in tackling this important area.

This agency is an independent body and it works collaboratively with a number of agencies, stakeholders, and has direct links with states and territories, which is vital. We on this side of the parliament acknowledge that states, territories and the federal government are in partnership when it comes to meeting the health needs of our community. National health workforce planning is critical to addressing the looming crisis that we have not just within our cities but within our country when it comes to having the workforce we need to ensure that we are meeting the health needs of people wherever they live.

That is why it is so important that we have a national plan. We need to acknowledge that the training that is done of these health professionals is largely the responsibility of our national federal government. Yet where these people work is in the states. That is why it is so important that we have an independent body to bring those stakeholders together, to bring levels of government together and to ensure that we have the workforce in training and ready to meet the health needs of our future.

In the past, the result of the reactive approach to medical and nursing training, immigration and workforce overseas recruitment was a metro-dominated distribution of health professionals. This has affected regional areas like mine in ensuring that we have the health professionals to meet the health concerns of people in our region. We still have health workforce challenges, particularly in country areas. Workforce recruitment is tough. It is more expensive than in metropolitan cities. Retention remains one of the key issues and a major challenge and it is another reason why it is so important that we have a strong long-term plan and an agency to do that work.

Whilst it is important that we acknowledge that recruitment is an issue, it is just as important that we have a strong plan to retain health professionals in rural and remote areas. As the distance from metropolitan areas increases, the retention of rural health professionals becomes more problematic. Rural communities are currently unable to recruit and retain the health professionals that they need and, as a result, we are seeing access to health services as a problem. We are seeing poorer health standards in our regional communities. One measure that speaks to this problem so loudly and so clearly is the lower life expectancy of people living in rural and particularly remote areas. As my friend the member for Mallee quite often states in the media publicly—and on any occasion that he can—people living in regional Victoria have a life expectancy of 4.7 years less than people living in major cities. One reason is not being able to access affordable and available health care and having their health professionals in their town and communities when they need them.

If we focus specifically on medical practitioners, GPs and specialists: is there a shortage in regional areas? The answer is yes. Quite often, when I am out in the smaller towns in central Victoria I talk to people and they tell me stories about how the books of their doctor—for example, in Heathcote—are full. They cannot get into the books. They have to travel to Bendigo to visit a GP.

The difference between the number of specialists in the city and country is also a major issue. Data released by the National Rural Health Alliance speaks to this difference. In major cities there are roughly 134 specialists per 100,000 population. Yet compare that to inner regional areas where there are 63 per 100,000 and, in outer regional areas, 43 per 100,000 population. It is a huge difference. Then we compound that by the distances in our remote and regional areas and the travel that is required.

Only on the weekend was I speaking to people, talking about how they constantly travel to Melbourne and about the associated out-of-pocket costs for people living in Bendigo and further out from Bendigo by having to travel to Melbourne to see their specialist. That is because we do not have enough specialists in the regions. It is important that we tackle these issues. That is another reason why we need one agency that is independent nationally, such as Health Workforce Australia, addressing these issues.

In the cities there are ample opportunities for GPs and specialists to work in private practice, to work in corporate practices, to be salaried in hospital positions or work in bulk-billing medical services. In the bush there are not the same opportunities for doctors and this is one of the reasons why we believe we have such an issue when it comes to retaining and recruiting doctors. Our doctors just do not have the same opportunities. There is also more expected of them, which again makes it harder to recruit people to the area. Take, for example, our small hospitals in my electorate. In Castlemaine, Heathcote and Kyneton, local GPs are expected to be on the on-call roster for their local hospital. In Castlemaine and Heathcote it works quite well. However, there is currently a problem in Kyneton, a dispute which has meant that the current hospital does not have local GPs on the roster in rotation. Again, what we need is workforce planning not just at a state level but at a federal level to ensure that we have enough doctors in the places that need them. Understanding planning for the health workforce is vital if as a nation we are going to resolve and solve the ongoing GP issues across regional Australia. It sounds like a task for a health agency that is an independent body that works collaboratively with a number of key stakeholders and has direct links with states and territories, just like the agency that this bill seeks to abolish.

It is not just with GPs where we have a critical area to look at, it is also allied health professionals. Many regional and rural communities, including my own, struggle to attract the staff that they need for allied health. A study by Monash University made a number of significant findings in this particular area. Annual turnover in regional areas for allied health professionals was on average 35 per cent whilst in the city it was only 28 per cent. Retention rates were also an issue: on average in the city 12 months after starting it was 82 per cent, yet in some of our most remote areas retention rates were as low as 64 per cent. The study also finds that the cost associated with recruiting allied health professionals to the regions was much higher. In the city it was roughly $26,000 whereas in the country it was $45,000. It is a study that speaks to policy needing to address directly not only recruitment but that funding to those agencies, those hospitals, needs to be increased to recruit. It highlights again the need to have a national framework and a national agency. It is another task for a national agency focused on health workforce planning.

The other problem with this bill is that it does not say anywhere that the agency is not working. We know from our previous speakers that Health Workforce Australia is working. During the last four years there are many examples of how it is working. It has established the National Medical Training Advisory Network. It has examined the barriers and the enablers to entering the workforce. It has investigated the increasing need for self-sufficiency within the medical workforce. So if the Health Workforce Australia agency is working and there is still a need for workforce planning, as I have demonstrated, particularly in regional areas, why is the government seeking to abolish this very important organisation? It can only be described as pure Liberal ideology, an ideology and an attitude that is against universal health care and against ensuring that we have equity that takes into account where you live.

This attack on universal health care is no clearer than in the moves the government made on budget night. It was not just about the abolition of this institution but also about the cruel health cuts and funding cuts to the regional areas and the new GP tax. In my electorate the hits on budget night were huge, with nearly $29 million cut from Bendigo electorate hospitals over the next five years. Bendigo Health takes the largest whack, which is $25 million to be stripped from now up to 2018. There is almost $1 million from Kyneton District Health, which is one of our small hospitals. Today Kyneton District Health will get a visit from the state Liberal Premier, although we do not know how long he will be the Premier, and he is staging a photo op at the Kyneton hospital. He is doing the first sod turn for the Kyneton ambulatory care centre. I mention this because this centre was first funded by the federal Labor government budget in 2011, yet it has taken three years for the state Liberal government to finish the planning and to get on with the job of building. Why has it taken this government so long? If it has taken three years to do the sod turn, how long till we expect the centre to be open? This delay smacks of a deliberate political decision to give the Premier an opportunity to stand in front of a project with his candidates in an election year. We are months away from an election and its speaks volumes about the politics of the Liberals and the politics of our state government and our federal government. It is politics before the health of central Victorians, it is politics and ideology before the health workforce of central Victorians.

Having worked closely with paramedics and nurses in central Victoria, I know the commitment that they make to our region. Currently in regional Victoria we are in the midst of an ambos crisis. We do not have enough paramedics working in the area. This is another area where we need workforce planning. When you talk to nurses at the Bendigo Health or at our small hospitals, they speak of the worry that when they retire there are not enough younger nurses coming into the hospitals to replace them. This is another area where we need workforce planning. When you look at the people who are taking up the specialist nursing courses, like midwifery and so on, it is again another area where we need workforce planning. I suppose you do not want to do the planning if you know fewer people will be going into those training courses, because of the exorbitant fees they will have to pay to complete their courses.

In conclusion, what we have seen is the good work being done by Health Workforce Australia. It is improving our services. We are seeing that it is tackling the issues in our regional areas. We are seeing that it is ensuring that students have the best possible training and that models of care are being delivered in the most appropriate ways. This is an agency with purpose. It is an agency achieving its goals, yet this bill seeks to abolish it. This bill speaks as another example of Liberal ideology; it is another cruel cut from budget night that will not only put the health of all Australians at risk but also make it harder for people in regional Victoria to seek the professional help, the medical help, that they need and when they need it.

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