Emma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | Hansard source

[by video link] I join my colleagues in speaking in support of the Dental Benefits Amendment Bill 2021 and the amendment moved by the member for Ballarat. Labor is proud of its record in health care. It was Labor that introduced Medicare, as my colleague the member for Adelaide just mentioned, and it was Labor that introduced the Dental Health Reform package in August 2012. A key part was the child dental benefits scheme, delivering financial support for children between two and 17 so they could access dental care, many for the first time. Families receiving benefits such as family tax benefit part A, parenting payment and carer payment are eligible for the child dental benefit, which provides over $1,000 to families over a two-year period so they can cover routine check-ups, dental cleaning, dental fillings and root canals.

Thanks to this program, we know that over three million children across Australia have avoided the painful side effects of untreated dental conditions, impacts that are both physical and mental. This has had significant flow-on benefits to household budgets and to the government's bottom line because it helps people to avoid downstream medical costs. This is a Labor legacy, and it's a demonstration of what government can achieve when it's focused on the day-to-day lives of all Australians, especially young people.

This bill now extends the coverage of the dental benefits schedule for children from birth to the age of 17, removing the lower age limit on eligibility. As a result of this change, it's estimated a further 300,000 children from nought to two will become eligible for the dental benefits schedule every year. It's well known that good dental care from a young age will mean avoiding serious problems in the future. From 1 January 2022, it's estimated that 15 per cent of children in this age group will become eligible for the program. That's 45,000 Aussie kids with better oral care, better physical health and better mental health. It means up to 45,000 families won't need to worry about being able to pay for the dental care their kids need. Labor supports this bill, which builds on Labor's legacy in health care.

I'd like to turn now to the proposed amendment to this bill and the issue of GP shortages and sustainability in rural and regional areas across Australia, including in my community on the Central Coast of New South Wales, where I join you from today. The lack of doctors in rural and regional Australia is not a new issue. It's a longstanding problem. But it is one that has gone on for far too long. People often say that Australia has universal health care, but we don't. We're increasingly seeing a two-tiered healthcare system in Australia, where access to care is increasingly determined by where you live and how much you earn, and communities outside big cities are finding it harder and harder to see a GP, to get the primary health care that they need close to home. We know from Institute of Health and Welfare reports and others that people living outside big cities often have poorer health, which is made worse by longer waiting times, higher out-of-pocket costs and a shortage of healthcare workers.

As a pharmacist and local MP I know that, if people delay care, their condition will only get worse, and these people will end up in emergency departments, clogging up what is already an overwhelmed hospital system, when a trip to the GP could have helped them sooner and avoided these problems. People in my community on the Central Coast have been battling an acute shortage of GPs for a long time now. Practices are being forced to close their books as GPs move away or retire. They're being overwhelmed by lengthy cancellation lists and they can't get access to more GPs to help ease the pressure. That means some locals have to wait up to three weeks for routine appointments; for some, the wait is even longer.

This is in large part because the government refuses to recognise the northern end of the Central Coast as a priority. It's not a distribution priority area, according to this government. I've been calling on the government to make the coast a DPA for a long time now. Changing our classification would allow local practices to recruit and retain more GPs from a wider pool of doctors, and help people in my community get access to health care more quickly—quality care close to home, which is what every Australian deserves, especially in a global pandemic. Fortunately, Wyoming-Ourimbah, which is part of my community, now has DPA status, as of 1 July. This means practices in this area should be able to access more GPs. The northern end of the Central Coast was completely ignored, and much of it remains non-DPA, despite ongoing calls from patients, from GPs, from our community.

I keep hearing stories from locals about how they're struggling to see a GP, and that's in the middle of a pandemic, when it's more important than ever to talk to your GP, to get trusted advice, to have the reassurance you need, especially when it comes to getting the vaccine. People in my community are desperate to get vaccinated. They want to book an appointment with a GP so they can seek medical advice and they can get the jab. But they can't. In the middle of this global pandemic, in the middle of COVID-19, people shouldn't have to worry about getting access to primary health care. They should be able to book in to see a GP straightaway when they need that care and advice.

There are people like David. David lives in Wyong on the Central Coast, in my home town, but he used to live in the Hawkesbury. He told me that he needs to make an appointment at least a week in advance if he wants to see a doctor on the coast, but that not the case further south. He said: 'I'm better off making the trip down to the Hawkesbury. I can get in within an hour down there.' David and others shouldn't have to drive down to the Hawkesbury, or wherever else they've lived before, to see their former GP to get a doctor's appointment, especially in the middle of lockdown. Locals should have timely access to health care close to home in their own community.

Leonie from Toukley told me a similar story. Her husband tried to get in to see a GP in their local area when he became unwell. Every single practice told him they couldn't take on new patients, and they were forced to send him away. He then had to make a half-hour trip to San Remo, where he could get in to see his old GP, only to be told that he was in the middle of a cardiac event. To make matters worse, he had to take his children with him because his wife, Leonie, an aged-care worker, was working at the time. This just shouldn't have happened. If Leonie's husband had been able to get in to see a GP close to home he would have known what was happening sooner and he could have been taken to hospital for the treatment that he needed urgently. Incidents like this are completely avoidable. They're preventable, but they're still happening and that's all because there aren't enough GPs in our community to keep up with the demand.

Then there's Kristy from Wyee Point, just outside my electorate. Kristy is a young mum who became very concerned when her young son fell ill. She tried to take him to a GP, but she was forced to wait days before she could get an appointment. During this time, her son's condition, sadly, got worse. He had a high temperature, he started vomiting and he was having convulsions. He ended up in ICU in Westmead children's hospital in Sydney with a collapsed lung, a chest strain and 40 millilitres of fluid on his lungs. He was 16 months of age at the time. Thankfully, he's now fully recovered, but this should never have happened. This toddler should have been able to see a GP and get care close to home sooner.

As a young mum, Kristy said it was a frightening experience for her. She said, 'Kids should never end up in ICU for something that should and could have been treated earlier.' She said that she developed such bad anxiety from that experience that every time her kids get sick now she gets anxious. But that's not all. Kristy's two-year-old daughter had an incident of her own. Recently, she started having an asthma attack and went into respiratory distress. Kristy took her to the hospital, where she had to wait four hours to be seen by triage. She said: 'Is she meant to be unconscious before someone can give her medical attention? I had to drive back home and call an ambulance.'

This not only is just not good enough; it's risky. It's unsafe for local people in our community, and it's not just good enough. People in my community are suffering because they can't get timely access to medical care close to home. As I mentioned, local practices are being completely overwhelmed and are being forced to close their books because they don't have enough GPs to take on new patients. I was speaking to a senior GP yesterday who was just exasperated. Two GPs from his practice are moving interstate, and he can't replace them. The several thousand patients that they see currently now no longer have a GP. They can't absorb them within that practice and they have had to let them know that they can't provide them with ongoing care.

This is a long-running issue on the coast, which all local MPs are aware of. That's why I was frustrated to see claims recently that 33 new GP registrars were set to start work in our region this month. It's just simply not true that 33 new GP registrars will start work this month. I've spoken to local health professionals in my area, as a pharmacist myself. These registrars already exist and work on a rotational basis. They're not new GPs for our community. We have a major shortage of GPs on our hands and we need to do something to fix this.

Unfortunately, a shortage of GPs isn't the only problem. Affordability is also a major concern. The cost of seeing a GP is at an all-time high, and practices that until recently bulk-billed have now stopped doing so during the pandemic. Across Australia, the average out-of-pocket cost to see a doctor has increased by 37 per cent over the last eight years. On the north end of the Central Coast, in the community I represent, the average out-of-pocket fee is $33, and that's before you go to the pharmacy and fill the prescription that you need for the medicine for your treatment. That amounts to a 31 per cent increase since this government was elected, and it's a direct result of the government's Medicare freeze. But that's not all. The cost of seeing a specialist is even higher, and waiting times are growing. The average out-of-pocket cost is over $85, up over 50 per cent. This increase is felt by many people in regional communities, especially those who can least afford it.

It's well past time that something was done to fix this critical issue in my community and in other regional communities across Australia. That's why my Labor colleagues and I decided to take action. We pushed for a Senate inquiry to investigate the lack of doctors in regional areas right across Australia, including the Central Coast. That inquiry has now been established, and it will be able to investigate the provision of GPs in outer metropolitan, rural and regional areas; reforms to the DPA classification system; GP training; the Medicare rebate freeze; and the impact of COVID-19 on GP shortages. It will also be able to consider the role of allied health professionals, such as pharmacists, dietitians and physiotherapists, in providing quality health care in outer metropolitan, regional and rural communities so patients can get access to coordinated multidisciplinary care leading to better health outcomes, especially for those living in rural and remote Australia. This inquiry is also taking submissions from locals who have been affected by GP shortages in their communities. This is an opportunity for them to have their voices heard, because clearly the government hasn't been listening so far.

I am optimistic about this inquiry. We need practical solutions to help areas like the Central Coast of New South Wales that I represent so that we can get more GPs in our community. People in my community, as I've said, deserve timely access to quality health care close to home that they can afford, and this is no more important than in the middle of a global pandemic.

This has been going on for far too long not just in my community on the Central Coast of New South Wales but in outer suburbs and regions across Australia. We are at a crisis point. Local GPs have told me that their practices may no longer be viable. A practice recently closed because it wasn't able to recruit or retain a GP. This is something that is happening increasingly in the outer suburbs and regions across all of Australia. We're in the middle of a global pandemic, so access to GPs and health care is more important than ever, especially for the most vulnerable in our communities. For too long we've seen cuts to health care under this government. For too long we've seen rural and regional Australians overlooked. It needs to stop. We need to make access to GPs a priority. Every Australian counts.

See this speech in context