Emma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | Link to this | Hansard source

It's often said that we have a universal healthcare system in Australia, but we don't. The further you live outside a big city, the worse your access to health care is likely to be. In some rural towns, there is no GP anymore. If you're diagnosed with diabetes, heart disease or another chronic condition, your quality of life is likely to be worse, and your life expectancy shorter, if you live in the outer suburbs, the regions or the bush.

I raise this because, in the electorate I represent on the Central Coast of New South Wales, we have an emerging GP crisis. The Central Coast is a popular place for young families and older people to live, but it's also a place where GPs books are closed and patients are waiting weeks for routine appointments. In the words of Dr Sachin Choudhary, who manages two practices on the Central Coast including the Lake Haven medical centre, 'We are in crisis and we need help.' Yet the Central Coast is not classified by this government as a distribution priority area for GPs, which means that recruiting and retaining GPs in our region is tough. I recently met with Belinda Field, CEO of Yerin Aboriginal Health Services in Wyong. Belinda is increasingly concerned about the challenges their health service is facing in recruiting and retaining GPs and the impact this is having on their patients. Yerin has 4,000 active patients and a four-week wait for routine appointments, and, in a region with one of the fastest-growing Aboriginal populations in Australia, they can't take on new patients. They're struggling to get by with eight part-time GPs. Belinda told me, 'The current classifications are a farce.' We actually do have a shortage of GPs on the Central Coast, and Belinda believes the rules must change to support GPs to work in our Aboriginal medical services.

I've also heard from Theresa Mason. Theresa manages the Central Coast Community Women's Health Centre. It was founded in 1976 and, for over four decades, has been providing support to local women through counselling, advocacy and legal advice at its centres in Wyoming, Wyong and Woy Woy. Until recently, the Central Coast Community Women's Health Centre also had three part-time GPs at their Wyoming clinic providing specialist women's health care. In Theresa's words: 'Our women's health GP clinic is a safe place for vulnerable women. Our services are provided by women for women, and 70 per cent of our services are bulk-billed. They are affordable.' But the centre, which receives referrals from across the Central Coast from women in crisis who are often really vulnerable, has had to advise patients that, from the end of this month, from the end of March, they will not have any doctors at the clinic, and they can't offer any future appointments until they can recruit replacement doctors. According to Theresa, they've been advertising for over 12 months and only managed to secure one GP who left a short time later. Theresa says others have been interested but only if the Central Coast was a distribution priority area. They are currently working with the primary health network to apply for the Area of Need Program as, without female GPs, they can't provide their specialist services, leaving, in Theresa's words, 'vulnerable women falling through the cracks'. This is a clinic which had 4,351 visits in 2019-20 of which nearly 30 per cent were for emotional and mental health, and the clinic now can't see patients. It's not good enough and it's not safe.

This shortage of GPs also impacts affordability. Across Australia, out-of-pocket costs for GP appointments have increased by 37 per cent since this government came to office. This is being felt by many people in my community, especially those who can least afford it. Dr Sachin Choudhary, who I mentioned earlier, urgently needs to recruit two GPs at each of the clinics that he manages. He wrote to me: 'Much to the disappointment of our GPs, who used to pride themselves in offering services at no cost to patients given the area's low socioeconomic demographic, we are gradually introducing co-payments to patients who can barely afford to pay.' I have written to the health minister this week to raise these urgent concerns. In the words of Theresa Mason, 'There is a critical shortage of GPs on the Central Coast.' As Belinda Field, the CEO of the Yerin Aboriginal Health Services, said, 'The current classifications are a farce.' And, as Dr Choudhary says, 'We are in crisis and we need help.'

Our community deserves better. As an MP and as a pharmacist, I'm calling on the government to act now to review these classifications and to urgently improve access to primary care in communities like mine. If people don't have access to GPs, they end up in crisis in ED. The cost to them and to our health system is too much. It must change. The government has to act now.

Jason Falinski (Mackellar, Liberal Party) Share this | Link to this | Hansard source

The global pandemic has forced us to re-examine our national health system at a time when it has been placed under unprecedented stress. The regulation which restricts operators in the health space has created a strong disincentive for genuine innovation to occur. Despite the incredible inhibitions imposed by regulation, the Sargood centre, in Collaroy, is a world-class facility, helping those with spinal cord injuries. Their holistic approach means they also engage with families and carers of those with spinal injuries by equipping them to improve their lives. The Sargood centre is an outstanding example of what happens when specialists are allowed to innovate and start their own businesses to provide medical support.

If we are to productively engage with the long-term health challenges of our nation, we need regulation which empowers Australian healthcare providers. The success of the NDIS has essentially been one of partnering with individuals who know what they need better than any bureaucrat in Canberra could ever know. This is particularly the case with injuries which are complex and life-changing, like many of those related to spinal injuries. We need to be encouraging operators like the Sargood centre, who provide highly tailored rehabilitation depending on the individual and their unique circumstances, harnessing the innovative drive of the private sector, coupled with government support for individual choice. This is the trifecta of modern health care. This is how we will create affordable quality care into the future. There have only been a few moments in the history of our nation when there has been reason to pause and examine the state of our health system. The pandemic is one of these. There is an opportunity for us to partner with organisations like the Sargood centre in providing dynamic health solutions to some of our community's most vulnerable. The reality is we are already long overdue for healthcare reform, from how we administer Medicare and our Pharmaceutical Benefits Scheme to private health insurance. We risk our medical centre stagnating at the time when we need it most, and the strain put on our healthcare system is only growing. The human cost of this is simply devastating.

Our frontline workers in the medical profession are the backbone of our community—from doctors and nurses to occupational and other therapists. We need to be providing these selfless workers in our community with conditions which do not see a typical working day place undue stress on them or their families. The Sargood centre provides a model in which the private sector can provide excellent quality of service whilst providing highly competitive conditions for employees. Whilst those working in health care do so to help others, it is our job and responsibility as a community to look after them. Overworked, stressed and impoverished healthcare workers should not be the norm in our hospitals or surgeries. Mental health issues are growing, a silent pandemic that continues to affect the lives of many on the Northern Beaches. Providing flexible working conditions is long overdue when it comes to our industrial relations regime. This is something that competition between healthcare providers can drive as they seek to attract and retain talent.

It is always encouraging when I see businesses in my electorate, like the Sargood centre, lead the way when it comes to providing Australians with world-leading health solutions. These are the kinds of businesses that we need to be incentivising to grow and develop. Starting a business is hard. Starting a business seeking to be an industry leader is rarely accomplished. For those few businesses that can make it, the last thing they want or need from their government is red tape which stops them employing more people and growing or innovating further. Sadly this is what the Fair Work Commission does on a regular basis. Health regulations, as they stand, are quite literally keeping Australians sick and impoverished. It's time to end the regulation racketeering that benefits a small elite at the top of a hierarchy at the expense of working Australians.

What I love most about our community on the Northern Beaches is that, despite all these challenges, organisations such as the Sargood centre continue to operate and flourish. They are drastically improving the lives of others. For their presence, innovative spirit and commitment, the Prime Minister came to honour their achievement. What they do cannot be accurately thanked in these words, but the example they set should not be ignored, and for that I thank them.

Question agreed to.

House adjourned at 17:24