Meryl Swanson (Paterson, Australian Labor Party) Share this | Hansard source

Medicare ensures that people can access life-saving treatment when they need it. Last year around 21 million Australians accessed Medicare services, including GP visits, vital tests and scans, and hospital treatments. The unfortunate reality, despite what those opposite seem to believe, is: when Medicare loses, people in regional and rural areas in Australia lose too. My electorate is a perfect example of that. In August last year I visited Raymond Terrace Family Practice. I met with principals Chris Boyle, Damian Welbourne and Sarah Bayley—all exemplary doctors. We discussed the difficulties the practice is facing when it comes to Medicare and out-of-pocket expenses, which we know have gone up and up and up. Raymond Terrace is an area with low socioeconomic status. The unemployment rate is 9.8 per cent—well above the national average—and almost 40 per cent of the population didn't finish high school. In 2016, when the national average income was over $1,500, in Raymond Terrace it was $554. Given this, it's unsurprising that Raymond Terrace Family Practice currently bulk-bills over 70 per cent of the patients it sees. And this is a vital service.

The Department of Health's Rural, Remote and Metropolitan Areas scale, more commonly known as the RRMA scale, determines how much a doctor's practice will get in cash incentives from the government for bulk-billing. Raymond Terrace Family Practice used to be classified as regional, but after a recent review the centre was reclassified as metropolitan. The reclassification will cost the centre around $60,000 per year, or two part-time receptionists. Reclassifying the centre from regional to metropolitan has taken away their incentive to bulk-bill. There are so many things wrong with this. Firstly, Raymond Terrace, whilst it is a fantastic community, is not metro. Secondly, this medical practice is in a community that desperately needs bulk-billing. It needs good primary health care. The principals at Raymond Terrace Family Practice know that their service is essential to our community, and they do an outstanding job—so much so that they're doing everything in their power to not end bulk-billing, including cutting their own incomes. But this isn't enough. In August the centre told me they had made the difficult decision to stop bulk-billing skin cancer procedures, meaning that patients will need to go to the hospital or pay over $500 and face a wait time as long as 12 months to be seen, because we're in a regional area. Unfortunately this is not an isolated issue.

Last week I met with Dr Mark Foster. Dr Foster is from the Community Healthcare Trustees, and he came to my office to tell me about the issues they're facing with GP and primary healthcare services in Kurri Kurri, my home town—in fact, I was born in the Kurri Kurri Hospital. Community Healthcare Trustees established a not-for-profit, bulk-billing GP service across two sites, in Kurri Kurri and in nearby Cessnock, in the seat of Hunter. Recent changes implemented by this government have had a terrible impact on these practices. Similar to the Raymond Terrace Family Practice, the centre is now classified as metropolitan. It's in the same category as the city of Sydney. I have home town bias: I love Kurri Kurri. It's a top place, but it's not Sydney. It's quite the opposite. Kurri Kurri has a population of 6,000, not six million, and an unemployment rate of 8.4 per cent, also well above the national average, with youth unemployment much higher in certain cohorts. The biggest industry is coalmining, and statistically the largest occupation groups are tradies, labourers and machinery operators. We're a great community. The community health care is the only 100 per cent bulk-billing practice in our town. The reclassification from regional to metropolitan has made it difficult to maintain this vital service.

Other issues are the changes to the district of workforce shortage boundaries. It's resulted in Kurri Kurri no longer being classified as a district of workforce shortage. This is fundamentally not true. We have difficulties getting GPs, and it's really hard to retain them. It's really hard to get those people there in the first place. I've written to the minister: 'Minister Hunt, come to Kurri; come to Raymond Terrace Family Practice. We'll give you a beautiful afternoon tea. You'll get to meet some great doctors, and we can really thrash out what's going on with Medicare in my community.'

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