Rebekha Sharkie (Mayo, Centre Alliance) Share this | Hansard source

I appreciate the government's intentions in changing distribution priority areas, DPAs, to automatically include all Modified Monash Model level 2 and some level 1 areas, but the cost of this decision will be borne by the regions—rural people. People in regional Australia already have significantly worse health outcomes than people living in metropolitan areas, and it's vital to keep this in mind.

The DPA was set up as a measure of last resort to make a broader pool of doctors, including those trained overseas, eligible for Medicare in communities having difficulty attracting doctors. Overseas trained doctors may practise in these locations for a time before they receive an unrestricted Medicare provider number to practise anywhere in Australia. So now we're going to have a system where metropolitan Elizabeth, in the Playford council, with a population of approximately 100,000 people, is treated the same as remote Kangaroo Island, with a population of less than 5,000. Now capital city Hobart, with a population of near a quarter of a million, is going to be treated the same as my little town in Birdwood, population 1,200, and Milang, population 850—areas with no public transport or regular access to medical services. And what's happening now is that doctors are cancelling their contracts in remote and regional Australia, going and living in North Adelaide, and they'll drive out to Elizabeth.

The Rural Doctors Association of Australia and the Australian College of Rural and Remote Medicine have expressed concern about expanding the DPA to these centres and outer metropolitan areas, saying that it will erode already limited access to health care in rural Australia. The RDA reports that some overseas trained doctors have already resigned. They've cancelled their contracts. They've withdrawn their applications to practise in the regions as a result of these changes. The RDA president, Dr Megan Belot, has stated, 'We have already received very early indicators of how this policy change will wreak havoc in the bush.'

Our doctors are the backbone of primary health care in the regions. It's already hard enough to attract doctors, even in relatively inner regional areas in parts of my electorate. The RDA anticipate this move will further diminish the chances of regional, rural and remote communities attracting doctors if no other measures are put in place for those communities. Several of our communities in Mayo already experience severe difficulty in this regard. Last month, the only general practice in the town of Meadows closed its doors, leaving around 2,000 people looking for alternative care some distance away—and there's no public transport available. The city isn't just 20 kilometres down the road. Residents in Yankalilla, a DPA listed area located on the Fleurieu Peninsula, have lost one of their two GP clinics. The average age in Yankalilla is around 68. With the remaining clinic already at capacity, residents now need to travel further if they can find a doctor who is taking new patients. They can't get on a bus to do that. They have to rely on someone to drive them if they can't drive themselves. Closures will lead to older people in our communities, those who do not have access to transport and those who have need for chronic illness care deferring primary health care. This is going to dramatically affect their quality of life.

Equally dire is Kangaroo Island, which relies on sea and air transport to access medical support on the mainland. Chronic doctor shortages have resulted in the short-term closure of Kangaroo Island Health Service obstetric and theatre services. Expectant mothers have been asked to relocate off island for weeks around their due date. The flow-on effects on the island are huge. Pregnant women and their partners are not on island to care for their other children, run their farms and businesses and, in one case, to carry out their duties as a local GP.

I call on the government to urgently work with key groups to fix the mess that they have now created. Leeching doctors from our underserviced regional and remote areas, where we already know we have poorer health outcomes, is outrageous, just because they are a Labor seat. That is why this has happened. This is purely political. Doctors are being taken from areas that are in non-Labor seats, including in my electorate, and they're going to be going into these Labor seats. Quite frankly, it's outrageous, and it's a big problem that is the making of this new government. I have deep concerns for regional Australia.

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