Sussan Ley (Farrer, Liberal Party, Shadow Minister for Justice and Customs) Share this | Link to this | Hansard source

I move:

That the House:

(1)

supports long term viability of regional and rural medical practices, hospitals and services;

(2)

notes with concern the failure of state governments to provide adequate health services for Australians living in regional, rural and remote areas, particularly in relation to cross border health;

(3)

acknowledges the Royal Flying Doctor Service and the significant contribution it makes by providing aeromedical emergency and primary health care services to people who live, work and travel in regional and remote Australia;

(4)

calls on the Australian Government to eliminate inequality in healthcare access and services experienced by those living in rural and remote areas by:

(a)

increasing the recruitment and retention of rural medical practitioners and health care professionals;

(b)

assisting Australians who live in regional, rural and remote areas with the cost of travel to specialist medical appointments in capital cities and regional centres; and

(c)

providing adequate funding to maintain and expand small rural hospitals and health services and their maternity and other procedural services.

I am pleased to move this motion on rural health and, I hope, give the issue of the health and medical services of rural Australians some prominence in this parliament. Australia is one of the most urbanised nations in the world, and this Labor government is one of the most urbanised governments we have ever had. It is actually difficult to find one government MP who has lived a life and run a business in rural Australia. This is of concern because, with our declining rural population, we need champions for the bush, and in this place I see too few.

I represent over 95,000 people in rural and regional Australia, and in these areas we have health services of a considerably lesser standard to those in the capital cities. All patients, no matter where they are, should be afforded the same care and support, but this is not happening. The New South Wales state government, in particular, has failed my constituents time and time again. Overworked doctors and nurses should not have to help cover the bills for medical supplies in the hospitals in which they work, and local service clubs should not have to fundraise all year round just to buy basic hospital equipment.

It is fairly well known that the New South Wales government is in a state of recession and that its health services are battling to pay their bills. Ordinary recurrent operating expenses are not being met. This, were it to happen in Sydney or Melbourne, would be highlighted as an utter disgrace. Good health outcomes are very much about early intervention, and I really think this is the key because time and again too much time passes between symptoms being noticed, a proper diagnosis being made and medical attention actually arriving. I cannot stand it as a local member when I hear the stories of people who say, ‘It was just too far,’ or, ‘We could not afford it,’ or, ‘We did not know,’ or, ‘The specialist was not visiting.’ That is really not good enough. The Rural Doctors Association says that rural communities’ access to early medical intervention is:

… currently compromised by metrocentric policies, shortfalls in appropriately trained personnel and inadequate funding systems and systems that jeopardize sustainable local emergency services.

As the federal member for an electorate that bounds three states, I am always surprised at the restrictions that prohibit doctors from practising in two states at once. It is incredible to me that the New South Wales, Victorian and South Australian state governments cannot—or will not—make it easier for doctors to practice in two states in order to provide suitable health outcomes for the residents of their states. In Farrer, there has been much talk of cross-border health agreements for years. I have yet to see one successful completed agreement. There has been much grandstanding and many promises. In fact, there is supposed to be an arrangement in Albury-Wodonga by July 2009. I will watch closely to see how this develops.

At the more western end of my electorate, there is trouble getting GPs and health workers because communities just cannot offer the salaries those professionals would attract in either a more remote area of Australia or a big city practice. In instances that have been quoted to me recently where a doctor is found who is willing to work for the wages that are able to be paid, on becoming tied down in interstate bureaucracy and differing licensing requirements the doctor, in many instances, just gives up and looks for work elsewhere. The ability to attract doctors to regional Albury was of such concern that a local group of health professionals formed their own working party, and employed someone with their own funds, in order to recruit a new generation of GPs, specialists, psychiatrists et cetera. They were concerned that the ageing of the current doctors meant that our community would soon be without doctors. It has been a successful program and I commend them on the initiative, but it should not have had to come to that.

In the town of Finley, the area health service was not able to negotiate an agreement to retain the services of a doctor in the town. The local nursing home took on the task. Since I was elected as member for Farrer in 2001, the Tocumwal community has lobbied for an ambulance station for eight years. Everyone knows they need an ambulance station but still there is not one. Last year in the New South Wales state parliament, my colleague John Williams, the member for Murray-Darling, raised the issue of renal dialysis, outlining that a government study had said that there would be a massive explosion in demand for renal dialysis services, a major driver being the increase in Aboriginals having a high rate of kidney failure which required renal dialysis. But in Deniliquin, in my electorate, at least five people were travelling to Shepparton for renal dialysis services—a round trip of 500 kilometres. The Rotary club raised community funds to purchase a renal dialysis chair for the local hospital, but the Minister for Health refused to negotiate or commit. These are examples of how the rural people that I represent struggle on a daily basis for the same services as their city relatives. Admittedly, it is a positive story of their resourcefulness and resilience, but it should not have had to come to this. (Time expired)

Peter Slipper (Fisher, Liberal Party) Share this | Link to this | Hansard source

Is the motion seconded?

Barry Haase (Kalgoorlie, Liberal Party, Shadow Parliamentary Secretary for Roads and Transport) Share this | Link to this | Hansard source

I second the motion.

Dick Adams (Lyons, Australian Labor Party) Share this | Link to this | Hansard source

I would like to thank the member for Farrer for giving me yet another opportunity to speak on regional and rural medical services. It is also another opportunity for me to point out the lack of purpose in relation to this area of health care from the previous federal government. I remember during the last election the case of two small hospitals in the electorate of Lyons—at Rosebery and at Ouse—where politics was played for the purpose of playing politics because of cutbacks from the federal government to the state. Those communities were used politically, with no opportunities to improve their service delivery.

I got a bit excited when I read the motion. Initially, it sounded very good—‘that the House supports long-term viability of regional and rural medical practices, hospitals and services’. That was very good and to the point, and I certainly agree with that. And, of course, the Royal Flying Doctor Service does an excellent job and we should recognise it whenever we can. However, I certainly cannot agree with the rest of the motion. It is a shame that, over the last 11 years, those on that side of the House were not more concerned about rural health. I know that the member for Farrer was not a member for that length of time, but there was a lot that could have been done that was not done. It is a shame that they relied on 17-year-old data—population figures from the 1991 census—when they developed the incentives for doctors and other rural workforces. It was pretty old data. That was the sort of support for long-term viability for rural health that those on that side of the House showed in those decisions.

Part 2 of the motion gives me quite a deal of concern. It suggests the member for Farrer’s lack of real understanding of health and service delivery in rural and regional Australia. I want to outline a few of the failings of the previous Liberal government. In the 2004 election the Liberal government promised $15 million to establish the Rural Medical Infrastructure Fund. Despite this, it was revealed in the estimates of 2007 that only $3.5 million of that program had been allocated. In the 2007 election, the Rudd Labor team promised to rectify this.

In the budget last year we honoured that commitment when we announced $46 million over four years for rural and remote communities, strategic planning for small rural private hospitals and our new National Rural and Remote Health Infrastructure Program, which is operating tremendously. On 28 January 2009, just a few weeks ago, Minister Roxon announced the first 53 of those projects—a total of $12 million. In less than 12 months after the budget we have already allocated more than three times as much as the Liberals managed to allocate for the whole term of the last government. I think those figures speak for themselves. This is in addition to the substantial funding commitment of GP superclinics, many of which will be built in regional areas. We have established an office of rural health, in case the opposition and the member Farrer missed that significant development. They may have missed that.

In part 2 of that motion the member for Farrer also suggests that the state governments are responsible for failing to provide adequate health services for Australians in rural, regional and remote areas. The shadow minister, who has just arrived, raised that in the chamber today during question time. This seems to be the little game that that side wants to play—blame the states for health care. The opposition has forgotten that in 2000 more than $1 billion was removed from the Commonwealth-state funding for our hospitals, which resulted in the Commonwealth share of funding falling from 50 per cent to 45 per cent. So there is a fair bit of history that goes with this as well, and there is a fair bit of history that the member of Farrer should mention when she gets into these discussions. This is not a one-way street. This government has done more in its first year than what the previous government did in a three-year term. (Time expired)

Kay Hull (Riverina, National Party) Share this | Link to this | Hansard source

I would like to congratulate the member for Farrer for bringing forward this very crucial and vital private member’s business and for the way she has put it together, with thought and commitment to her electorate and to rural and regional areas. I would like to support the member for Farrer in raising some of the issues that are certainly impacting upon rural and regional areas. My most significant concern at the moment is the lack of obstetricians being attracted to the Riverina region, and obviously to regions right across Australia but most particularly in New South Wales. We had a practising obstetrician in the public sector. He was overrun and overwrought and eventually, after telling the state government time after time that he could not continue like that, he eventually had to resign. In place of that local obstetrician we now have a 19,000-kilometre fly-in fly-out arrangement at the Wagga Wagga Base Hospital. We bring in an obstetrician from London. I will quote from the Wagga Wagga Daily Advertiser, which stated that ‘the costly travel exercise has been going on for 12 months’. The position on offer is for a Director of Obstetrics, but it has not been accepted by the obstetrician who has been flying in and flying out from London for 12 months now to the Wagga Wagga Base Hospital.

The practice of flying locums in to cover the shortage of doctors in Wagga Wagga has been at significant cost to the people—about $320,000 per doctor a year. But the problem that I would like to raise is that a doctor has been flying in and flying out from London to provide the service at Wagga Wagga Base Hospital and this position has not been advertised on the New South Wales Health website in order to give other candidates the opportunity to apply. That is of great concern. I think that that has been rectified since the doctor has determined that he is not going to take up residence, but this is where money is required—in recruitment and retention. We have a fabulous recruitment and retention committee in Wagga Wagga. I think it is unique. A group of specialists with private money have set up their own recruitment and retention workgroup. They have an executive officer who goes off to conferences and health gatherings of doctors all over the country recruiting specialists to come to the Riverina.

We have significant problems. Dialysis particularly in Wagga Wagga Base Hospital is certainly a challenge. Many people drive for many hours to receive dialysis three, four or five days a week, but family members have to wait outside in the car park for the five hours of dialysis time because there is nowhere in the Wagga Wagga Base Hospital for them to wait for their family member or the person they travelled with.

There has to be a different view on how we are going to attract particular specialty crafts. I refer back to obstetrics. There must be cooperation between midwifery and obstetrics. There needs to be a new model of care for obstetrics. Money should be allocated by government, including the state government, to encourage new models of how we are going to deliver services to rural and regional Australians. I am very pleased to have the A healthier future for all Australians—interim report December 2008, wherein there has been some consideration given as to how we start to resolve these issues. I would certainly encourage the government to have further talks with New South Wales— (Time expired)

Bernie Ripoll (Oxley, Australian Labor Party) Share this | Link to this | Hansard source

This is a very important motion, but I am afraid that justice has not been done to it in this chamber tonight. As much as I respect the member for Farrer, I do take issue with the criticism from the opposition that the Labor Party has not lived the life of the bush, does not represent rural communities and only represents the urban areas. I do not agree with that, but even if it were true—and it is not—this government’s record will prove that we have done more in the area of rural and regional health in 12 months than the former government did in 12 years. The reality is that those from the opposition who represent those areas have been very good at driving political agendas but very bad at driving dollars and funding for health into regional and rural communities over a very long period of time. If I can recall the Howard years for any one great thing it is the practice of cutting funding to health, whether it was in urban, rural or regional areas.

What we need now is change. We need a government that is prepared to work in partnership with the states, not just blame them and take money away from critical and vital areas. Unfortunately, this motion does very little to put any of that on the record. The motion talks about supporting the long-tern viability of regional and rural medical practices and hospitals—and we ought to do that—but very little evidence has been provided of any action in that area over the past decade. The motion also notes the concern at the failure of state governments to provide adequate health services. But, if that is the view of those opposite, why did the Howard government stand idly by while this took place?

The motion talks about the Royal Flying Doctor Service, but opposition members failed to actually mention it in their speeches. That shows what little regard they place upon the great services provided by that organisation. The motion also calls on the Australian government to eliminate inequality in healthcare services, and so the Australian government should work to eliminate inequalities—inequalities that have stood in place for many years and decades. But it will actually take a government that is prepared to put funding on the table and work with the states and local and regional communities to make that happen. You cannot just talk about it. The difference is that this government, the Rudd government, has been prepared to commit $64.4 billion to the states and territories and it has further committed $1.1 billion for doctor training in those communities to make sure that what is contained in this motion can actually be delivered. Otherwise, they are just hollow words; they are just words in a motion that are politicised and designed to draw attention and blame somebody else for what, in the end, is a collective problem and an issue for all of us in this place.

This should not be a debate about who is responsible, because we are all responsible. The opposition, and perhaps the shadow minister for health, would do themselves a great service today if they took a very close look at the words contained in this motion and actually decided to act in partnership with the government, the states and rural and regional communities. Perhaps if those members elected to those areas and who, allegedly, care about these issues could see what positive plans can be brought forward then they could assist this government in actually delivering that funding and they could support us in this place when we try to make a difference. Health to me is a little bit like infrastructure—if you do not continually maintain it and invest in it every year, eventually it falls apart and gets to a state of disrepair that makes it exceptionally difficult to fix. That is the situation we face today. We will fix infrastructure and we will fix health as well.

Peter Slipper (Fisher, Liberal Party) Share this | Link to this | Hansard source

Order! The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting. The honourable member will have leave to continue speaking when the debate is resumed.