David Gillespie (Lyne, National Party) Share this | Hansard source

I support the Health Insurance Amendment (Continuing the Office of the National Rural Health Commissioner) Bill 2020 that we are debating tonight, which provides for continuing the Office of the National Rural Health Commissioner. I'd like to personally commend and congratulate Emeritus Professor Paul Worley, who is about to complete his term. His was the inaugural appointment, and I was very pleased to make that appointment when I was the Assistant Minister for Rural Health. I'm pleased to see that the Office of the National Rural Health Commissioner is being continued and will become a permanent fixture, rather than being temporary. It will continue for another five years before it's reviewed again. I'd like to congratulate Minister Greg Hunt and the Minister for Regional Health, Regional Communications and Local Government, the member for Parkes, on the decision to continue this wonderful initiative.

I would also like to congratulate Professor Worley on his achievements in getting the two general practice specialist colleges to agree, in the Collingrove Agreement, on the national framework for developing a national rural generalist pathway, which is no mean feat. I'm pleased to say that over $62 million has been appropriated to deliver that. He's also worked with the two colleges to get a pathway for subspecialty recognition for rural generalist practitioners. He's also advised on rural allied health reform and helped the set-up of GP-led respiratory clinics during the COVID crisis, and he's been instrumental in implementing the $550 million Stronger Rural Health Strategy. The Workforce Incentive Program has been reformed during Professor Worley's time into support for Doctor Stream and for medical practices themselves.

A lot has been said about rural bulk-billing. The rural bulk-billing incentive program is continued, but they have focused it by aligning it with areas that are rural, because there were some areas which were actually metropolitan centres which, by a freak of old classification systems, were still getting a rural bulk-billing incentive that is meant for rural, regional and remote Australia.

I'm really pleased that, at the last election, we as a coalition government made other announcements to strengthen rural health. One of the big issues facing rural Australia is the disproportionate shortage of professionals, and it's no more acute than in the health field with medical specialists and specialist rural generalist GPs, and that's what Professor Worley and the Office of the National Rural Health Commissioner have been particularly focused on. I'm pleased to say there is a growing realisation of how valuable a highly trained rural generalist practitioner can be. One of the markers of good health outcomes is timely access to medical care. That is so important. So we are really committed to getting improved access for the people of rural Australia. They have more diabetes, more heart disease and more cancer, and they get worse outcomes. We can fix it, but it takes a long time.

I'd like to run through the focus on rural health reform and the incentives. In my area of Lyne, we successfully argued for and got a commitment to a headspace centre in the town of Taree. We have got an MRI license to re-expand Manning Base Hospital, and we've got a commitment to rolling out radiotherapy in the Taree-Manning region. These are no small achievements. Over the last 10 or 15 years, a lot of the services at the Manning Base Hospital have wound back, but we're in the middle of winding them back up again. The Manning Base Hospital look after about 90,000 people, and it's important they get the support that we from the federal government can give them. The state government is committed to the already-announced expansion of that facility, and I'm really pleased to be supporting the state member in getting a hospital for Forster-Tuncurry as well.

There are many other rural incentives that we have put out to increase rural workforce retention, and I'll just elucidate some of them. It's not just about doctors in rural health; we need more pharmacists in rural health. We've just concluded a very successful seventh Community Pharmacy Agreement. Because the rural and remote pharmacists do so much more, that is a really sensible outcome, and I know a lot of my pharmacy colleagues are really pleased with the outcome.

I might mention that I actually don't just talk about it, like many of the people who've spoken tonight; I actually practised medicine for 33 years, and 22 years of that was in a regional town called Port Macquarie. When I went there, there were five medical specialists, but there are probably now almost 20. There's been an expansion of surgeons, anaesthetists—all sorts of subspecialties. And one of the biggest drivers has been the rural clinical school of the University of New South Wales at Port Macquarie Base Hospital.

One of the big initiatives driving workforce development not just for medical specialists but for GPs and rural generalists is the expanded Murray-Darling Medical Schools Network. Around the country, 12 centres in these rural clinical schools and schools of rural health are being expanded so that they have end-to-end med school teaching. That's also part of the Rural Health Multidisciplinary Training Program, where we expanded the amount of training for physiotherapists, occupational therapists and all the multidisciplinary care that you need for proper healthcare delivery.

We've developed the regional training hubs to grow that secondary degree training program. What most people don't realise is you have to do several degrees. The first one is awarded by a university and the next one by a college, and with the second medical degree you get your vocational training and recognition and your speciality status as a specialist GP, a rural generalist, a surgeon or a psychiatrist. That is going ahead full steam, with many regional training hubs now in existence.

We've got the junior doctor training initiative, allowing young doctors to work in general practice so that they get exposed to general practice before they get buried into a hospital pathway. We've also supported an increase in the Specialist Training Program, which co-funds the employment of trainee specialist registrars, and we've weighted that towards regional areas. If you get a registrar in a regional area when they're settling down and doing their second, college, degree, that's the time when they're starting families and getting their networks. It's probably one of the best initiatives that we've got.

I'm really pleased to see also that the More Doctors for Rural Australia Program is delivering dividends already. We have 291 participants. I'm really pleased the office of the Rural Health Commissioner is going to get deputy rural health commissioners to focus on allied health, nursing and Indigenous health. We also expanded funding to the Royal Flying Doctor Service. They not only fly people around but actually deliver clinics as well. We funded a project which is dear to my heart and that is the Heart of Australia bus in rural and remote Queensland. So there are many things that we have done, but I'm really pleased that the Minister for Health and the minister for rural health have supported making this office permanent. I wholeheartedly support this bill in the House.

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