Nola Marino (Forrest, Liberal Party) Share this | Link to this | Hansard source

I am very pleased to second this motion by the member for Murray. Rural clinical schools are often, as the member for Murray knows well, quite critical in providing the graduates so desperately needed in regional, rural and remote communities to deliver the services that are generally accepted as being standard in an urban or metropolitan environment. But in many parts of regional Australia the services that those communities need are not locally available. Specialist services are generally provided in areas of high population, but it is essential to get specialists as well out into major regional centres, including Bunbury in the south-west of WA. Even basic services are often in short supply in regional areas. Many country towns still struggle to retain services as basic as simply having a general practitioner on call. That is why the rural clinical school training program is so vital.

As the member said, it was designed in the late 1990s and introduced by the Howard government in the early 2000s to address the shortage of medical practitioners within rural, regional and remote Australia. In fact, I would argue that it is perhaps the only evidence based intervention developed to date that has had a measurable impact on the urban and rural maldistribution of doctors in Australia. The rural clinical school initiative is working and, as the member for Murray rightly pointed out, there is further work to do. It is a very practical response that works on the ground, and it does need continued support to do so.

We know that the aim of the program is to ensure effective medical student training, to be maintained in rural Australia. We hope that this continues to ensure the development and retention of that local medical workforce. The 25 per cent rate also ensures that we get young people—people of all ages—in the program. We want to recruit more students from rural regions to go back and stay in those areas to practise.

The rural clinical school is important, too, for students from urban backgrounds who have not had an experience in a regional area. They can find out just how rewarding it is to be any form of medical practitioner. But a GP in a small regional community is critical. I said to one group of people at the rural clinical school, 'In a regional community, the local GP is akin to God to families.' Where you go for the most critical thing for your family is medical treatment. Local communities, small communities, which do not have any medical support have absolute respect for their doctor. You have to feel it to actually understand it—and I understand it very well, as does the member for Murray. This positive experience is important, which is what the rural clinical school provides.

In 2008, the rural clinical school in my part of WA won a national university teaching award for innovative curriculum and the Premier's Award for strengthening the state. That is how good it is. The program includes two cities in my electorate: Bunbury and Busselton. The Edith Cowan campus, which is in the same block, includes the South West Health Campus and the St John of God private hospital. It offers three fully-furnished homes. Accommodation is so important for the students who come out to rural and regional areas. They are just a walk away from the university and the hospitals. The Busselton office is located in Gale Street, which is only a five-minute walk from the Busselton Hospital and is fully furnished as well. A really important part of what this program delivers is the capacity for these students to enjoy their time and to form an affinity, a connection, to the community as well as an understanding of how important they are.

I commend the member for Murray for her motion. This is a practical approach. I understand the specific issues that she has raised in the second part of the motion regarding intern and specialty training places. This is a program that we who represent rural, regional and remote Australia understand as being critical to our local communities. There is very little that is more important than the health of families and individuals in our communities. It is the presence of local GPs, doctors and specialists across the board which helps our communities to function and keeps the members of our community safe and healthy. I commend the member for this motion. (Time expired)

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

I wish to make a few comments in relation to this motion on rural clinical schools. When I saw the motion, I thought it was a great opportunity to highlight some of the opportunities that we have in Bendigo in relation to this issue. Access to health services in rural areas—as you know, Mr Deputy Speaker—is always a challenge. Whether it be health services or medical shortages, they are amongst some of the top issues facing our rural and regional communities.

We need to acknowledge the historic difficulties for Australians in rural and regional areas in accessing adequate health care, compared to our city counterparts. An example of this is clearly demonstrated when we look at our GP levels: 200 doctors per head of population of 100,000 in regional Australia compared to 370 doctors in major cities. In other words, there is almost half the number of GPs in regional areas for a larger geographical area.

I only have to take a quick drive out of Bendigo to hit a small township where these issues are occurring in my electorate. So the question, of course, is: how do we fix this? I note the comments on the data from public universities that show higher rates of RCS graduates working or intending to work in rural areas. This is encouraging, but I believe that we can do better than 'intending to work' by looking at the medical places that we have and at new initiatives.

I take on board the comments that we do not need more medical students, but perhaps it is where we have our medical students in training that we need to address. Many in this chamber would know that La Trobe Bendigo is part of the Murray-Darling Medical School, which is an innovative new model of medical education in rural Australia. It is a joint initiative between La Trobe University and Charles Sturt University, and basically takes in the area in its name: the Murray-Darling. It is a new medical school and offers medical training in a regional campus from year 1 to year 5, which currently does not exist in Victoria. Under the model, it is basically 'grow your own', as we have just discussed here today. It is about taking regional students and training them in a regional setting in the hope and with the aim that these students will have careers in their regional towns and communities.

La Trobe Bendigo is already having this success. Under Labor, $40 million was spent on building the Rural School of Health. As another speaker referred to, we cannot talk about medicine and clinical placement for GPs alone; we need to consider the whole health profession. La Trobe is already training nurses, psychologists, dentists—in fact, every area of allied health—but the one area it does not have is medicine. Therefore, it is the missing jewel in the crown.

How successful have they been? La Trobe Bendigo students are seeing more than 80 per cent of their health graduates go on to work in rural employment. So the model works. In the model to recruit in the regions and train in the regions, in every aspect of their training they stay in the regions, so it is already working. This is by having the School of Rural Health. We have the facilities ready to train these extra doctors.

This is an astounding statistic, because we know, when we compare it to domestic students graduating from medical programs, that fewer than 10 per cent are actually ending up in our regional communities. Some stay and some go. The ones that come to Monash and Bendigo describe their trip to Bendigo as being like a rural exchange. The word 'exchange' suggests that they are not there for long haul, and, whilst some may stay, many return to the city for their final year or for further clinical placement.

I agree with the comments in the media and the community that medical graduates cannot fix the rural workforce shortages if there are no jobs to go to. I agree with the statement that we need to expand our rural training capacity so that new doctors are not forced to return to the cities for their internships or specialty training. This is where Bendigo offers a unique opportunity with its new hospital that is being built. This hospital does provide the opportunity for a larger workforce. It is doubling the number of beds that it has and therefore the number of patients that it will receive and therefore the workforce. (Time expired)

Russell Broadbent (McMillan, Liberal Party) Share this | Link to this | Hansard source

The first thing I would like to do is congratulate the member for Murray in her continuing efforts to fight the good fight on behalf of regional Australia, particularly in regard to her own constituents, in that she has always put their health, wellbeing and future at the forefront of all her activity. I commend her for that and thank her for bringing this very important motion to the floor of the chamber.

Also I thank the member for Forrest, who never gives up in her pursuit of policies that benefit rural, regional and remote Australia. There are a number of us in this House, and I was pleased to hear the new member for Bendigo speak on behalf of rural and regional people. We cannot ever lose sight of the fact that the whole of Australia does not live on the eastern seaboard of this nation; in fact, they live in rural and remote places.

The best part about what the member for Murray has presented for us today is that—and I hope the people in the gallery hear this and those listening to this hear it—we are looking right now at and talking about something that has been a success. It has been supported by both sides of the House. It has been supported by two governments and now three governments in a row. It has worked. It has taken rural students—and if I get a chance I will quote three here—from a rural background, from rural activity and from rural, remote and regional areas and educated those people through our medical schools, and they have gone back into regional areas.

Every health minister in the past three governments has supported this proposal. In fact, it goes right back to Michael Wooldridge. Every health minister has supported this proposal, and it has been a success. What a pleasure it is to stand in the House of Representatives in this great nation, in this great south land, which has so much that is rural and remote about it. Our image of ourselves is about the rural and remote. The story we tell to the world is about the rural and remote. It is about the adventure that Australia is.

This particular program, in its essence, has delivered services to people in rural and remote areas through their GPs. It has been successful. We had people marrying—or partnering, as we might like to say these days—somebody in the city and never returning to the country after being educated in the city. We know they are lost to us completely. They are not lost to the nation, but they are lost to our country areas. This education program that the member for Murray has highlighted, in its success, has taken people out of the city. In one story here—which I probably will not get to now because the time has gone—the young lady actually went from the city to a regional medical school, then she thought, 'I'd really like to do my internship in a regional hospital.' That doctor has every chance of the fulfilling the dreams, the aspirations and the energy behind what the member for Murray is highlighting today, even if it is one person and it is one doctor. There will be plenty of doctors for city people.

I know this city of Canberra has plenty of doctors. They do not particularly want to come and service us out in our regional areas, because out in regional areas we are not as well as the rest of the community. We still play up pretty badly and have a terrible reputation for health, but it is improving. I just heard a debate in the Federation Chamber on lung cancer, which was most enlightening—and most embarrassing for some of us too. Having said that, it is important that the subject of this motion before the House is recognised as a very, very important initiative that has been successful.

We are not arguing with anybody. The member for Murray is simply saying: 'Here is a process that has worked. Here is an opportunity for future generations of young people coming out of our secondary schools, right across regional Australia, to enter into these rural health schools.' It is very important to us, it is important to this nation and it is very important to rural and regional people that they get the same opportunities for health care as people do in outer Melbourne or in the city centres. I commend the member for Murray and especially the member for Forrest for their continuing efforts on behalf of people right across rural and regional Australia.

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

I too commend the member for Murray for bringing this motion here before the House. As the former Parliamentary Secretary for Health and Ageing in a previous life and then a minister for regional affairs, I think I have a fairly unique perspective on this very important issue before the chamber. I want to pay tribute to the work of previous health ministers, particularly Michael Wooldridge and Tony Abbott, through to Nicola Roxon and Tanya Plibersek, who all have supported the continuation of the clinical rural medical schools, some 17 schools managed by 16 universities, providing critical opportunities not only for rural kids but also for the many patients in those regional areas who are desperately trying to access those services.

I particularly want to recognise two of those schools, at Deakin University and the University of Melbourne—and I know the member for Murray has a very long association with Melbourne university's rural clinic. They both run rural clinical schools in my own electorate of Ballarat, and I have met many of those fantastic students and I know the many opportunities that are being provided to them. I also particularly want to mention the clinicians who are training these young people. GPs' and specialists' lives are incredibly busy, and the fact that they are making a commitment through the rural clinical schools to continue training really is a tribute to them and to their communities.

I am very proud of the work that Labor did in expanding accommodation as part of the Rural Clinical Schools program and across a range of other programs within the Health portfolio. That has brought many more opportunities to students in our regions, and I certainly want to commend the member for Murray for bringing this motion before the chamber.

One of the things that I was delighted to see was the opening of one of the accommodation facilities in the small town of Daylesford, which has struggled to get a doctor. Again, I am very proud that Labor was able to initiate some 32-bed accommodation facilities being provided for rural clinical students. We know that rural kids want to stay in rural communities as much as they possibly can and are more likely to do so, and these rural clinical schools really have been a success story. Of course, we have a long way to go to continue to make sure that the inequality in health is done away with, but certainly the work of the rural clinical schools and the motion before the House are a good start.

Debate interrupted.