Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I made an initial contribution to the debate on the report of the House of Representatives Standing Committee on Health and Ageing entitled The blame game in the House earlier today. I believe that it is such an important report that I have a need to expand on my earlier contribution. The report is aptly named The blame game because it examines issues that impinge on our health service—our services to Australian people.

I am in a unique position. I have stood in a state parliament and blamed the Commonwealth for problems that exist within our health system and I have been in this House and listened to the states being blamed for problems within our health system. The truth of the matter is that both levels of government must bear responsibility in one way or another for the problems that have existed. It is a very easy out for all levels of government to say that the problems have been caused by the Commonwealth or that the problems have been caused by the states. The issue is: how do we get the best value for our health dollars? How do the Australian people get the best outcome as far as health is concerned? Is it through each level of government?

Local government get in there and do their bit too, blaming both the state and the Commonwealth for problems. Usually their complaints are directed towards the states, but they do blame the Commonwealth as well. I note that local government, particularly in Western Australia, have some very innovative approaches and have worked to get around the health professional shortage in their areas by digging into their own funds, which are quite often limited, to ensure that there are health professionals in their area. I think that the first commitment that governments at all levels need to make is to ensure that the blame game stops. I think every member of the committee feels equally as strongly about that as I do.

There are a number of models that we can look at to end this blame game. We can look at a model where the states take full responsibility for health. We can look at a model where the Commonwealth takes full responsibility for health. I might just mention that last year the Prime Minister set up a task force, headed up by Andrew Podger, to look at this very issue. It is my understanding, from evidence that he gave to the committee, that he supports a Commonwealth-led model. Unfortunately, his report was never made public. Another model is Commonwealth-state pooled funding of the health system. There is the Scotton managed competition model. Each of these has benefits and each of them has some drawbacks. What the committee did was put the models on the drawing board so that people could look at them and then have further discussion of those issues.

One area that does lead to the blame game and arguments for cost-shifting is outlined in recommendation 16 of the report. Recommendation 13 looked at the way the health system is funded and at varying funding arrangements. Recommendation 13 talks about the utilisation of growth factors that can rise or fall in response to the actual level of services provided on the basis of clinical need and the formula that is used when funding health services. Recommendation 16 is about the GST and the impact that it has on ‘specific purpose payments’. For those members who are not so familiar with that, specific purpose payments are impacted on by the amount of funds that are in the GST pool. Basically, it has the effect of reducing the funds that can be allocated to the funding of hospitals and health. I think that that unanimous recommendation of the committee in the report will go some way towards dealing with that issue.

This morning I mentioned that there should be a national health agenda, which is recommendation 11 of the committee report. I think that too would lead to a diminution of the blame game. If all levels of government and all players in the health system can commit to a national health agenda then the health system and the people who utilise it—that is, all Australians—will benefit.

Recommendation 3, dealing with dental services, is very important, one that I believe we all felt very strongly about. As I said earlier today, the issue of dental services is one that each and every member of the public is confronted with on a daily basis. So I think it is important that we are brave and that we do address that issue.

The skills shortage in the healthcare workforce has an impact on all regions and all electorates within Australia, but it has a greater impact the further you are from the Sydney Harbour Bridge. In my area we have a chronic shortage of doctors. Although the government has put in place some initiatives to address that, I have to say a lot more needs to be done in that area. It is very important that the skills shortage is addressed. I do not think that bringing in doctors from overseas is the answer; there are some ethical issues associated with that. It is very important that the government look at the relevant recommendation in this report and strongly commit to the training of health professionals. It is important for Australia’s future. I refer people to recommendation 5, a very good recommendation, and to recommendation 4, which recommends:

The Department of Health and Ageing take a lead role to better coordinate the existing jurisdiction-based recruitment of overseas trained health professionals …

I definitely think we would benefit from the Commonwealth taking that lead role, along with ensuring that adequate numbers of health professionals are trained. That is of vital importance to the Australian people, because not having the health professionals on the ground has an enormous impact on the Australian people.

I could talk for hours on this report. It is one of the best reports that I have seen in this parliament. It is a report that offers solutions, it is a report that identifies problems and it is a report that can show us the way forward, and the government should get behind the recommendations. It is a unanimous report, which was hard to get to because of the different perspectives that we all have on health. But the bottom line is that it is a document that governments of all persuasions can work with and that can deliver better health outcomes to the Australian people.

I thank Ian Bigg, and I thank the secretariat yet again. They did a fantastic job and, without their assistance and the participation of the chair, Alex Somlyay, we would not have the report that we have before us today. (Time expired)

Alan Cadman (Mitchell, Liberal Party) Share this | Link to this | Hansard source

I was not as heavily involved with this committee inquiry as I could have been due to having a number of committees meeting at the same time, but I am delighted with the report. I think it is extremely well written and comes with practical management solutions to what is a most difficult problem in Australia—probably the most difficult management problem for Australian governments, both federal and state, and even local.

One of the things that struck me about the report was how well Australia comes out compared with the rest of the world on most of the things relating to health. In ‘Health expenditure per person, Australia and other selected OECD countries’, for instance, Australia in 1993 spent slightly over $2,000 per person. The OECD average was $2,400. In 2003 Australia spent $3,855, and the OECD average was $4,000. We spend slightly less than Canada, more than France, a lot more than Japan, more than New Zealand, more than the UK and less than the US. I think that is not a bad place for us to be, but it means that we need to be very careful.

When we examine the funding flows for hospital and medical services, it looks like that famous Barry Jones concoction which looks like spaghetti junction. It was supposed to be a process of projecting what the future for Australia was going to be like. The health funding process is looking exactly like that. There are arrows and lines going in all directions, and that is part of the management difficulties identified by the committee which need cleaning up.

In examining the funding costs and the capacity to shift blame and costs, the committee went into a whole lot of detail about how this is occurring and can occur. Some people say it is a matter of good management to make somebody else pay; others say it is a matter of complexity. Both answers are right; however, where it can be avoided it will save costs. The estimated costs of cleaning up the management system are somewhere between $1 billion and $4 billion. So there is much to be gained if we just clean up the system and make it more efficient and are prepared to work together so that we get adequate and good results for the benefit of those seeking to use the health system.

On selected health indicators, taking Australia’s ranking among OECD countries on life expectancy, morbidity, mortality, health, labour force and risk factors, Australia works out very well compared with the rest of the world. I am very conscious that Australia is often criticised for having a poor health system. I think our health system is about as good as anybody else’s, if not better. It is better than most, and we should be proud of it. It does not mean to say that every citizen is satisfied with it. I know in Western Sydney there are a lot of people unhappy with the current health system and the way in which it operates, and a lot more can be done to make sure that it works more effectively and that some of the management practices are changed.

When one comes to look at the variation between the states and public hospitals, however, it is very interesting to note the way in which management has occurred. For instance, in Victoria, administrative staff number about 9,000 and diagnostic and other health professionals number about 11,000. In New South Wales, it is round the other way: there are more administrative staff than there are health professionals, and that does not surprise any of us who live in New South Wales. They are so busy managing they do not look after the people who are crook. That is a great shame because the system suffers from being overbureaucratic and it suffers from being unable to deliver the expectation of the people of that state.

One aspect of the report that I found particularly interesting was about investment in prevention and early detection, an emphasis that is now being given by state and federal governments in, for instance, kidney health. The report says:

Chronic kidney disease is a common, under-recognized, progressive, preventable and treatable condition. Over the last 25 years, while the Australian population has grown less than 40 per cent, the numbers of Australians being treated with dialysis or a kidney transplant has grown by more than 400 per cent.

That indicates that we are into the system far too late. Kidney failure and other problems have increased greatly, but we are not into the system in a way that will stop these preventable traumatic occurrences.

Osteoporosis is another one. It is a preventable skeletal disorder. In 2001, two million people had osteoporosis. Attributable direct costs are about $1.9 billion per annum. The disease affects women in particular but it also affects men. Bone density testing, medication and diet and can make a big difference. Chronic obstructive pulmonary disease is another disease where early intervention and better lifestyles can make a real difference to the health and cost outcomes. Multiple sclerosis is a random, chronic and disabling disease, the cost of which is approximately $1.3 billion per year. All of these things can be dealt with more effectively.

I refer the House to the recommendations in the early part of the report. I agree with previous speakers about some of the significant recommendations relating to the coordination of the existing jurisdiction based recruitment of overseas trainees. I think most Aussies would prefer to have locally trained staff, and the Commonwealth should take a role in the identification of appropriate staff and their coming to Australia.

Another committee of which I was a member found that a tradition has grown in the area of adoption such that the states have taken charge of adoption but are not doing it particularly well. This is another area where a committee has identified a need for effective Commonwealth leadership.

Another recommendation is about providing an adequate number of health professional graduates to meet the projected demands. The committee recommended that the government have a strategy to produce enough medical professionals by 2021 to meet Australia’s needs. That seems a long way off—it seems a long lead time—but, when one examines the number of doctors, specialists and nurses needed to fulfil our projected needs, 2021 is a reasonable target. It is absolutely essential that the necessary funding to expand the training system is forthcoming. It is no good stealing other people’s graduates and hoping that they will fit into Australian conditions and go to the bush or to remote areas. It just will not happen.

When my wife and I lived in outback New South Wales, we were most thankful to have the services of Dr Paul Retter, a refugee from Czechoslovakia. He was a wonderful doctor. He moved to the city and now lives in my electorate. He is now in his nineties. Paul Retter and his wife, Irene, were a godsend to the people in those remote areas. They were frequently asked out to dinner, and they were highly regarded. Whether it was for mothers with little kids, elderly people with chronic disease, or accidents which occur on farms and in rural areas frequently, their services were absolutely critical to the survival of that community.

There are not too many Paul Retters in the world. Doctors who are used to living in urban areas in other countries come to Australia and expect to fit straight into an urban environment. That should not be their expectation. They should be trained to serve the whole of Australia. Nothing is better than the home-grown doctor or medical professional, and that is the focus that we need to give.

I commend this report. It is a very interesting and sensible report, as you would expect. The committee was extremely well led by Alex Somlyay, who is a man of great experience and has great skill in producing terrific reports. This will make a difference to Australia and I look forward to the government’s response to it.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to speak on the report on health funding of the House of Representatives Standing Committee on Health and Ageing. I would just like to note that the committee has been very well served by its chair, the honourable member for Fairfax, and the deputy chair, the member for Shortland. The member for Shortland will shortly be stepping down due to other commitments. As it happens, I will be assuming the position of deputy chair. I look forward to continuing the good work of the honourable members for Shortland and Fairfax.

The House of Representatives Standing Committee on Health and Ageing convened its inquiry into health funding to investigate and report on how the Commonwealth government can take a leading role in improving the efficient and effective delivery of high quality health care in Australia. It is worth emphasising that the purpose of this body, consisting of federal members of parliament reporting to the federal government, is focused on what the federal government can do. The report is partially named The blame game.

It is not the purpose of this inquiry or its report to give the government reason or opportunity to say, ‘Don’t look at us—don’t tell us what needs to be done; tell it to the states,’ or, ‘We’re the good guys and the states are the bad guys,’ or, ‘The states are the good guys and the federal government are the bad guys.’ The report, which was signed off by MPs across the party divide, contains a message to the federal government which consists of actions that, in the committee membership’s view and that of the many witnesses and contributors to the report from around the country, the federal government itself needs to pursue and implement.

The report includes 32 recommendations, covering a national health agenda, the health workforce, private health and improving accountability. I am sure the content of this report will be referred to by MPs, journalists and commentators for some time to come, and that we in this place have ample opportunity to raise points on its content over the months before this government—in fact, all of us—will be held to account at the 2007 federal election.

I have only a few minutes to speak to this report today, so I will limit myself to just one or two points. The first category of recommendations focuses on the primary area of concern within the health system—the roles and responsibilities of governments and our need to elucidate and rationalise the funding, structural and service delivery arrangements to maximise health returns with a minimum of waste. It should be done, it is recommended, without turf wars or hissing matches or a preoccupation with historical arrangements and practices. The idea of a substantial reorganisation of the national health system is large—in fact, very large—but so are the costs of ignoring this path forward.

The total health expenditure in 2004-05 is estimated to have been in excess of $87 billion. The funding mix by source is relatively stable from year to year, at 46 per cent federal, 23 per cent state and local, and 31 per cent private funding. Over the 10 years to 2004-05, health expenditure rose by an average of 8.3 per cent per year, or 5.3 per cent per year after inflation. Everyone expects this to continue and to contribute towards ever-increasing budget allocations of governments and households around the nation.

Most projections envisage a doubling of government funding as a proportion of GDP over the next 40 years. I am glad that the 26,000 people over the age of 65 in my electorate of Hindmarsh are notionally benefiting from increasing health expenditure and the continuation of life which it has provided for. By the time we in this place reach our 70s and 80s, we are going to have to make some pretty challenging economies for Australia as a whole to be able to deliver world’s best practice to all who need it around the nation. We have heard, from time to time, people from all walks of life talk in favour of shaking up the mix of health funding sources and service delivery responsibilities.

The Minister for Health and Ageing has spoken in favour of the federal government taking over hospitals. The South Australian premier has offered him the keys. In fact, even the federal shadow minister for health has been speaking on similar lines for some time. This is all very encouraging, but it will take real political courage when rearranging $80 billion plus of funding and spending per year—a figure which is rising.

It could affect other financial landscapes and features that offer, I suppose, a nervousness with the consequential political risk. It would be a welcome change if all players, from the Productivity Commission through all levels of government and the very public whom the system is here to serve, could maintain a focus on the desired outcomes, which I have to say has not been the case over the last 10 years. Since the abolition of the Commonwealth dental scheme 10 years ago, the government has consistently stated that dental care is not a federal issue. From what we have been hearing, if there is gum disease or dental disease in the non-working population and teeth are falling out left, right and centre, the federal government are not going to lift a finger. It is much better in their view to play the silly little game that they think absolves them from the consequent suffering in the community. We hear constantly that it is the fault and the responsibility of the states.

What do you say to Mrs Mazzone, a constituent in my electorate of Hindmarsh, who contacted my office last month? She is a pensioner and of very limited means. Mrs Mazzone has been on the public dental waiting list for over 2½ years. She finally received a letter recently telling her that she could go to a private dental clinic and that it would be paid for by the public scheme. When she turned up to the dentist, after having to wait 2½ years, she was told that she had chronic gum disease, that he was not a gum specialist and that she would have to go and see a gum specialist. She went back to the dental clinic, only to be informed that she now has to wait at least two years to see a gum specialist. That is another two years of waiting, during which there will be further deterioration in her teeth and her gums. So how is Mrs Mazzone’s health going to be affected—not just her gums and teeth but her ability to maintain overall health? For someone to have to have rotting gums or bleeding teeth month after month I feel is totally inhumane, and no government should pass the blame on to someone else. We have all been elected here to try to do something to help people.

I am sure that, if the government are listening to this debate on this report, they will be automatically and instinctively thinking, ‘This is great: we can get a free kick against the South Australian government for not putting enough funds into dental care,’ or whatever they want to say. But, if they are thinking that, they will have proved my point that they have simply wiped their hands of health outcomes. That is evident. In seeing a woman’s pain and her suffering, as I did last month, it is just callous and ruthless to have people wiping their hands of it and saying, ‘It’s not our responsibility.’ I think we all have a moral duty to make sure that we make life better for people. If you have bad teeth and health problems with your teeth, why is it any different from when you have a broken arm and you go to a doctor to fix your broken arm? There is no difference. Pain is pain; they are both health issues.

Looking at the table of recurrent health expenditure by health area and the sources of funds in the report, you will see that dental services is an area of expenditure that is far and away like no other additional area of expenditure picked up by the individual out there in the community. Over $4 billion is being spent per year, with perhaps only $250 million coming from other sources. Again bringing the attention of the House back to health outcomes and where people on very limited means are clearly unable to cover the expense of maintaining their own health, as demonstrated by people enduring ongoing decay of teeth and gums for year after year, I think the government does have a responsibility to step in and take action. It does so in other areas of health; it should with dental health as well. I am glad that the committee agrees with me on this point, as is evident in recommendation No. 3 of the report, which states:

The Australian Government should supplement state and territory funding for public dental services so that reasonable access standards for appropriate services are maintained, particularly for disadvantaged groups. This should be linked to the achievement of specific service outcomes.

It is idiotic not to; it is cruel and idiotic if we do not. It is immoral not to prevent suffering and it is financially idiotic to allow a person’s health to deteriorate for want of minimal care and treatment to a stage that requires much more substantial and expensive intervention.

I congratulate the members of the House of Representatives Standing Committee on Health and Ageing for recognising this and having the ability to make the recommendation that is clearly contrary to the own minister’s and Prime Minister’s irresponsible position on dental care. This brings me to another chapter of the report—promoting wellness. The hospital system is the most expensive element of the health system and obviously keeping people out of hospital through preventive health measures is the way we have to go. (Time expired)

Michael Johnson (Ryan, Liberal Party) Share this | Link to this | Hansard source

I am pleased to speak on the Commonwealth parliament’s report on the inquiry into health funding, entitled The blame game, tabled in the Australian parliament today by my colleague from Queensland the honourable Alex Somlyay, member for Fairfax, who is chair of the committee. At the outset let me thank him and the deputy chair, the member for Shortland, for their leadership and stewardship of this committee in the last 18 months.

I took a deep interest in this committee coming from Queensland, where health was very much a political issue in the last election. It is certainly an issue in the Ryan electorate, where the Wesley Hospital is located. Apart from wearing my hat as the member for Ryan, wearing my hat as a citizen of this country I took a deep interest in the direction of this committee. I am very pleased that the findings of the inquiry were submitted today and have wide support from members of both the government and the opposition.

Of course, we know that health has a very unique place in this country—it is an issue that really affects every Australian very directly. Like education, it is one of those issues that seem to exist at every election and it is certainly an issue that concerns every citizen of this country. Health is a complex matter. It is an expensive matter. It is a bureaucratic matter. It is a sensitive matter. It is overlapping and it is also cumbersome. But, at the same time, our health system is very professional. It is world class. It has amongst its practitioners very dedicated and compassionate people—people who have dedicated their lives to the health profession and the allied health profession and to serving their fellow human beings.

My brother is a doctor—he is a neurosurgeon. My sister is completing her medical degree. So I am aware, as an Australian citizen, of some of the issues that they bring to my attention. It is important that the views and experiences of people who are at the coalface of the medical system—who are actually at the pointy, sharp end of the health system—are taken into account by governments in our country. The Australian health system, as I touched on, is a world-class health system. It is generally very highly regarded. It does have amongst the best practitioners in the world. They can certainly hold their heads high for their dedication, passion and supreme levels of skill.

In speaking on this report, I want to refer to a couple of matters that might be of interest in particular to my constituents in the Ryan electorate. Before I go on to that, I want to say that the committee received 159 submissions, and 59 exhibits were accepted as evidence to the inquiry. The committee was resolved to conduct an inquiry into health funding back in March 2005. We received submissions from all states and territories and from groups and individuals residing in all parts of our country. Five state and territory governments made submissions—the ACT, Victoria, the Northern Territory, Western Australia and South Australia. The committee welcomed the contributions from these governments, but I also must say that, as a Queensland based federal member, I was disappointed that the state government of Queensland—as well as New South Wales, but my particular area of interest is Queensland—regrettably, declined to provide a submission to the inquiry or to appear at any of the public hearings. There was considerable media coverage on the health area and the health portfolio in Queensland given some of the terrible incidents and stories that have been revealed in the media in the last couple of years in relation to what happened at Bundaberg Hospital.

I am pleased that the member for Hinkler happens to be the chamber with me, because, as I understand it, he sat on the board of Bundaberg Hospital for some 15 years and, sadly for Bundaberg hospital, his time on that board was terminated when the Goss Labor government came to power in Queensland in 1989. There has never been any suggestion that, during the coalition years of government in Queensland, the hospital suffered from or went through any terrible periods of time with maladministration. Of course, the board should be accountable and take responsibility for the stewardship of the hospital. Certainly there has never been any suggestion of any outrageous cover-up.

The structure of this report is loosely aligned around the terms of reference. The committee has developed a number of key themes from the evidence that was received from those who, in person or in writing, gave submissions. As I said, the health system is very complex and any changes to funding arrangements need to take a holistic approach because of the nature of the health system and the mutually dependent and complementary nature of different parts of the health system in delivering health services for the consumers of Australia—no less so than our education system, where there is great overlap, buck-passing, blame shifting and cost shifting, and that also seems to be the case in health.

I want to focus in particular on the private sector as a key stakeholder in the health system. It is a very important stakeholder in our health system, in our health architecture, and it must continue to be so. It must interact more with the public sector because both have a very crucial role to play in providing quality care. It needs to be better integrated to take advantage of the things that it does well, with the skills and the experience that its employees bring to health delivery and health management. But, at the same time, no system or sector is perfect and it can always tie in better with the public sector.

Funding for health needs to be reorientated to support a system that focuses on wellness rather than illness, on prevention rather than cure. Members of parliament from both the government and the opposition on this committee have alluded to that. I certainly very strongly support models that promote wellness rather than illness. We need to try to address the enormous cost of health in this country by trying to educate our fellow Australians to live a more healthy lifestyle and be very conscientious of their habits, in terms of how they exercise, whether they exercise and also their diet. That is very important.

I am certainly happy to put my hand up as someone who is probably not as prudent in an exercise regime as I should be, compared to the days before my election to the federal parliament. It is something that is very important. Whenever I get the opportunity to visit younger Australians at schools in the Ryan electorate, I certainly take the opportunity to encourage them to take care of their health, live and eat healthily and wear their school hats in the hot Queensland sunshine, because we do not want our kids to be exposed to the sun any more than they need to be.

The community’s knowledge and understanding about the Australian health system need to be improved to clarify the expectations about the probable trend towards rising private health insurance premiums, the out-of-pocket costs and the waiting times for treatment. In conclusion, I was delighted to be a part of this committee and to contribute where I was able. I touched on some of the points that colleagues have made about responsibility to aspects of the health system. Opposition members gave the example of dental health care and financial responsibility for that. At the end of the day, we live in a federation between a Commonwealth government and state governments, and that entails a division of responsibility and accountability. Hopefully, this report will address that and try to take that problem out of our healthcare system.

Justine Elliot (Richmond, Australian Labor Party) Share this | Link to this | Hansard source

I rise also to speak on the report on the inquiry into health funding. At the outset I would like to acknowledge the work of the committee and the work of the chair, the member for Fairfax; the deputy chair, the member for Shortland; and all of the members of the committee and the secretariat as well. I would like to support the previous comments made by the deputy chair of the committee and also the member for Hindmarsh.

This report is entitled The blame game. The first recommendation of the report deals specifically with this issue and focuses on this area of concern, an area of concern that so many people constantly raise, which of course is the roles and responsibilities of the levels of government and the need to specify the structures and service delivery arrangements. This is a vitally important issue and needs to be urgently addressed. For every health issue that arises, we often hear the Howard government standard response of: ‘That’s up to the states.’ That certainly is not good enough when talking about the health of all Australians. What we need is a national strategy to fix this problem. We need to have national leadership in overcoming this issue of the blame game and defining those roles and responsibilities so we can adequately address all of the health concerns of all Australians.

This is certainly an issue that many people constantly raise in my electorate with me—that what they see and hear is constantly this blame game, not actually fixing the problems; particularly in my electorate, with so many elderly people whose health needs are quite extreme. They raise this constantly, wanting to see some national leadership in resolving this issue.

I am also very pleased that the committee has raised the importance of dental care, another major issue in my electorate. I note that this is under recommendation 3, which states:

The Australian Government should supplement state and territory funding for public dental services so that reasonable access standards for appropriate services are maintained, particularly for disadvantaged groups. This should be linked to the achievement of specific service outcomes.

Dentistry is such an essential element of our nation’s health service, and I believe that all Australians should have access to affordable and timely dental care. It is a major issue to the people in my electorate of Richmond, as indeed it is to all Australians. Since the federal government scrapped the $100 million a year Commonwealth dental health scheme, so many people have had to wait years to get their teeth fixed. I am constantly approached by elderly people who cannot get their teeth fixed. They are often in extreme pain and they often cannot eat, so they are of course incredibly distressed about that situation. Some of these local seniors have been telling me that they are waiting sometimes for up to two years to have essential dental work performed. This situation is just not good enough, and it is shameful that our elderly are in such a dire predicament. Not being able to access timely and affordable dental care leads to a whole range of other medical problems such as malnutrition and many other medical conditions. This then places a greater burden on our health system because of the fact that these people cannot access affordable dental care.

The report notes at paragraph 3.112 on page 72: ‘The provision of dental care in a timely manner can significantly affect a person’s quality of life and future health costs.’ It is absolutely imperative that they are able to access decent, affordable dental care. The committee rightly notes concerns in relation to the affordability of dental care, the excessive waiting list and the shortfall in trained dental health workers. It is also important that this committee has unanimously agreed that the Commonwealth needs to provide more funding to dental care. As I said, this is a major issue in my electorate, so much so that over 4,000 people have previously signed a petition for the Commonwealth to restore federal funding for dental care.

I believe this recommendation in relation to dental care is a very important and significant part of this report. Indeed, it is a recognition of the failings of this current government in relation to dental care. The recommendation is a start, but it is only a start. What we need and what I will continue to fight for is a fully funded federal dental health scheme. This is what our nation needs and what Australia deserves.

I note further the very important recommendations in respect of producing adequate numbers of health profession graduates to meet the projected demand as contained in recommendation 5, which relates to training doctors. That recommendation suggests:

The Australian Government implement a strategy for Australia to:

• be self sufficient by 2021 in producing adequate numbers of health profession graduates to meet projected demand;
• provide the necessary funding to expand the training system to accommodate the required number of students; and
• consider using the AusAID budget to expand medical training to further assist developing countries.

This is a need that has to be urgently addressed because we have such a shortage of doctors and health professionals right across this country. In particular, looking at the future health needs of an ageing population, this is an issue that must be resolved now because the health demands are just going to increase significantly. As I said, in my electorate there are many elderly people; in fact, 20 per cent of the population is aged over 65 years—and it is that percentage that is predicted for Australia’s overall population by 2040. So at the moment we are seeing, on the ground, the demands of an ageing population and we certainly have to get that right for the future health needs of our nation, as so many people will be entering that age bracket in the years to come. This is particularly pertinent to rural and regional areas, and I will discuss that shortly. But, as I said, the shortage of doctors and health professionals needs to be urgently addressed right throughout the country.

I further note recommendation 11 in respect of developing standards for the delivery of health services in regional, rural and remote areas. It seems that for too long regional areas have been treated like second-class citizens when it comes to health care, and that is certainly what locals constantly tell me. We need a national system that will ensure that people in regional areas have access to affordable health care as well as adequate resources. We also need a federal policy to recruit and retain doctors in our rural and regional areas. Every day I hear of dire situations in so many smaller towns that have difficulties in recruiting those health professionals. There need to be so many more incentives in place to make sure that we can get trained health professionals to our regional areas. We need to provide more incentives to make sure that we have adequate services in those areas. And this is not just in remote areas; the electorate of Richmond is not that isolated. Even in areas such as Tweed Heads they have difficulty recruiting doctors and health. The recruitment of trained staff across all the health professions is a major concern and it certainly needs to be a major focus.

In closing, it has been a privilege to be a part of the health and ageing committee and I would like to thank all my parliamentary colleagues for the work they have done in the course of the committee inquiry, listening to the concerns of Australians in respect of healthcare issues. I hope the recommendations in this report receive the support of the government and that we see positive changes to the provision of health services, particularly in the funding of dental services—as I said, that is a major need—as well as an increase in the recruitment and retention of healthcare professionals, especially in regional and rural areas where the need is so dire.

Debate (on motion by Mr Neville) adjourned.