Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

I rise to continue my remarks on the House of Representatives report Lost in the labyrinth.

Bur first I would like to acknowledge one of my constituents, Luke Elson, from Como High School, who has been here since Saturday night visiting Canberra. Welcome to Canberra, Luke. I hope you get a lot out of the week in your time here.

To return to the report, Lost in the labyrinth is the report on the inquiry into registration processes and support for overseas trained doctors. I again acknowledge the chair of the committee, the member for Hindmarsh, and his remarks, and also the Chief Opposition Whip, the member for Leichhardt, who was particularly keen to see this inquiry go ahead.

As I stated in my tabling remarks, the crux of this issue is the shortage of doctors and medical staff across Australia. It was particularly interesting that, on the day of the tabling, there was an article on the front page of the West Australian entitled 'Call for GPs to help amid new baby boom'. The article referred to great shortages of obstetricians and gynaecologists in Western Australia in the face of a surge of births last year, and shows the challenges that we face from medical staff shortages across Australia. 32,494 babies were born last year in the West, and it looks like that number will continue to grow, with latest projections suggesting the state's population will reach 3.06 million by 2026, which is 400,000 more than was estimated in 2006.

There is no doubt that we need more medical staff in Western Australia, and overseas trained doctors can only be part of the solution. That is why in Swan I am also supporting Curtin University's campaign for a new medical school at the Bentley campus which would help address this issue. I can also see that there would be many benefits for local health care from having such a new facility in Swan—in particular, for the Bentley antenatal clinic, where I am currently running a community campaign to save maternity services there. I note that over 3,000 people have signed the petition for the Curtin medical school, demonstrating community support for the proposal. However, I must say that it did take me by surprise to see a counterpetition, signed by 250 people who do not want the medical school at Curtin.

However, even if the government approved the medical school in my electorate tomorrow, it would still be 2019 before the first graduates emerged. So overseas trained doctors will continue to play a role. The purpose of the particular inquiry that we have just had is to improve what, at the moment, is a regulatory process that is not doing its job for Australian communities. It is not, as the Australian put it in a report, designed to fast-track overseas trained doctors into Australia. It is about improving a flawed process.

I want now to go into more detail in my speech today, including on the recommendations that were made. The report makes 45 recommendations for improving the registration and support processes for overseas trained doctors, which I think you will agree is a significant amount. I would not say there was one recommendation that was a standout or more important than the others. They are all important and have been welcomed by many in the industry.

I was sent a press release from Rural Health Workforce Australia titled 'Report on overseas doctors deserves praise,' which was a very positive response and reflection on the committee and the secretariat's work. In their press release, they said:

If these recommendations are adopted, they will have a significant impact on addressing medical workforce shortages in rural Australia. As part of that vision, we agree with the committee that more needs to be done to encourage Australian-trained professionals to work in rural communities and remain committed to that goal.

Just by the way, as background before I speak more about the recommendations, I would like to echo some of the words of the chair on Australia's system of medical practitioner accreditation, which provide a bit more background for members listening. Australia's system of medical practitioner accreditation and registration was overhauled in 2010 following the formation of the AHPRA, with AHPRA designed to oversee 10 national health boards. The Medical Board of Australia is responsible for a new national scheme of medical accreditation and registration, and its formation was designed to streamline former state and territory processes. It is this transition to a national scheme that has been confusing and difficult for IMGs and others and forms the background to this inquiry. For many stakeholders, this was the first time they had been consulted. I think this inquiry has been a great listening exercise and hopefully we have achieved a result which everyone feels they have contributed to.

The committee visited most states in Australia; in fact, I think we actually visited all states. A highlight of our trips was Cairns, and I also recognise Warren Entsch, the Chief Opposition Whip, who helped initiate this inquiry. There was a trip to Townsville and trips to most of the committee members' electorates around Australia as well. The nature of the committee hearings had a common thread. A lot of it was repetitive and a lot of it was about conflict, but at the same time it was the message that got to us and it was the message that was put by all parties and stakeholders who had an interest in the output of the committee's inquiry and recommendations. I was particularly impressed with the member for Shortland, who at stages during the inquiry defended the role of the inquiry and the modus of the committee, which were challenged sometimes by people giving evidence. I do say that the member for Shortland was quite passionate in her defence of the committee and the work that we were doing, so hats off to the member for Shortland for that.

During the hearings we heard of international medical graduates having difficulties gaining access to their primary sources of verification. In terms of recommendations, the committee identified a need for the Australian Medical Council to increase the availability of the Australian Medical Council Structured Clinical Examination. We did receive some feedback from candidates attempting the structured clinical examination. Their view was that it is currently limited and leaves candidates unaware of shortcomings in their knowledge and unable to take steps to rectify these shortcomings. Publishing detailed information outlining the processes for determining the allocation of places for the structured clinical examination and providing constructive written feedback for candidates who have undertaken the examination will reduce demand by identifying the difficulties that repeat candidates have encountered. The report also recommends that an independent evaluation of the workplace-based assessment model be a priority. Issues relating primarily to specialist medical college assessment processes were raised during consultations as well as the need to improve recognition of previous medical training and experience that international medical graduates have gained in their home country.

The Health and Ageing Committee agreed that the Department of Health and Ageing and the Australian Medical Council should publish agreed definitions of levels of comparability on their websites, for the benefit of international medical graduates applying for specialist registration, and develop and publish objective guidelines clarifying how overseas qualifications, skills and experience are used to determine the level of comparability.

The report also recommends that specialist medical colleges adopt the practice of using workplace-based assessment during the period of peer review to assess the clinical competence of specialist international medical graduates in cases where applicants can demonstrate that they have accumulated substantial prior specialist experience overseas. This recommendation is part of the committee's desire to improve specialist college assessment processes for overseas-trained specialists seeking special registration in Australia. Furthermore, a recommendation for all specialist medical colleges to consult with the Australian Medical Council, to ensure each college undertakes a consistent three-stage appeals process for assessments, will make international medical graduates aware of their right of appeal regarding their application for specialisation. To further strengthen this process, the development of an independent appeals mechanism to review decisions relating to the assessment of clinical competence to be constituted following an unsuccessful appeal is also recommended.

The committee recommends that—prior to undertaking practice in an area of need, position or regional, rural or remote position with indirect or limited access to clinical supervision—international medical graduates be placed in a teaching hospital, base hospital or similar setting. I note this is a practice Curtin University also promoted as a benefit for its proposed medical degree for domestic students.

Maria Vamvakinou (Calwell, Australian Labor Party) Share this | Link to this | Hansard source

Order! It being 12.30 pm the debate is adjourned and the member for Swan will have leave to continue his remarks.