Andrew Gee (Calare, Independent) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

Today I rise to introduce the Doctors for the Bush Bill 2024.

The rural doctor shortage is at crisis point.

It's a health disaster unfolding before our eyes, and its consequences are devastating.

All over central western New South Wales and around country Australia, doctors are leaving the bush and they're not being replaced.

In the electorate of Calare, the rural doctor shortage crisis is being felt in communities big and small.

Gulgong had four doctors but no longer has any at all.

This is putting pressure on the larger towns like Mudgee. It has two medical practices, and they are both no longer accepting any new patients.

Practices in communities like Canowindra and Molong have also lost doctors and are also closing their books to new patients or adopting a locals-only policy for appointments. In Wellington, it takes two months to see a GP.

The impacts this crisis is having on the health of country people are as concerning as they are shocking.

I spoke to one doctor in our area recently who met with a patient with advanced cancer and who had not been able to get in to see a doctor and had therefore missed out on vital treatment.

The rural doctor shortage crisis has been made much worse because country areas no longer have priority for overseas trained doctors.

Before July 2022, if an overseas trained doctor, or international medical graduate as they're known, wanted to practice in Australia and bill Medicare, they had to work in a country area for up to 10 years. These country areas were known, and are still known, as Distribution Priority Areas.

Bonded medical students also have to complete return-of-service obligations in a distribution priority area.

For many rural areas, this policy was a lifeline, providing competent GPs where there were none and ensuring that country people had access to basic medical services.

But in July 2022 all of that changed.

The government upended the Distribution Priority Area system, for the first time allowing outer metropolitan areas to be classified as Distribution Priority Areas.

All parts of Australia are classified according to what is called the Modified Monash Model. There are seven categories, ranging from MM1, which is a major city, to MM7, which is very remote.

Previously areas MM3 to MM7 were classified as Distribution Priority Areas. To give people context, larger regional centres like Bathurst and Orange are classified as MM3, Lithgow and Mudgee are MM4 and Molong, Gulgong and Canowindra are MM5.

The government has declared MM2 areas as Distribution Priority Areas now, thereby destroying—

Bob Katter (Kennedy, Katter's Australian Party) Share this | Link to this | Hansard source

It's exactly the same in Queensland.

Andrew Gee (Calare, Independent) Share this | Link to this | Hansard source

I take the member for Kennedy's important interjection. It's the same in Queensland. What has happened is it has destroyed the priority area for overseas trained doctors that country areas once had; they have lost their priority for these doctors.

This has meant that areas such as Fairfield, Hornsby, Warringah and the outer suburbs of Sydney and Melbourne now have the same priority as country areas for overseas trained doctors as country areas.

When you look at the map, the whole state of New South Wales is now basically one big Distribution Priority Area except for the inner suburbs of Sydney.

How could this possibly be? Sydney does not have a doctor shortage.

The Doctors for the Bush Bill 2024 remedies this blatant unfairness by restoring the priority that country areas should have by legislating that Modified Monash areas MM1 and MM2 can't be classified as Distribution Priority Areas.

It will mean that country areas once again have priority for international medical graduates.

This restores the Distribution Priority Area system to that which existed before the last federal election.

I would therefore expect that every single coalition MP will be lining up to support this bill.

This crisis isn't going away any time soon.

It's predicted Australia will be short 10,600 GPs by 2031.

At the same time, demand for GP services is expected to increase by 58 per cent over the next decade.

There is a fundamental unfairness and inequality in access to health services in this country.

In the central west of New South Wales, we call the Great Dividing Range the sandstone curtain. It divides city and country physically but in so many other ways as well.

There exists a stark divide in health outcomes between people who live in the cities and those who call the bush home. It's a divide as high as the Great Dividing Range itself.

In fact, the further away you live from a city, the sooner you are likely to die—and that's the cold hard truth.

Statistics from the Australian Institute of Health and Welfare reveal that, devastatingly, people who live in very remote areas die about 15 years earlier than their city cousins.

With close to one-third of the Australian population living in the regions, how can this possibly be? The answer is simple: country people have less access to doctors such as GPs, who are often the first point of contact when someone feels sick or has a health problem.

According to the Department of Health and Aged Care, in the six months following the changes to the Distribution Priority Areas in 2022, the number of GPs that moved away from country practice jumped by more than 55 per cent on previous years. These are the changes that the current government brought in.

Now the government will say that more overseas trained doctors are coming to Australia than ever before, and they're right. They are coming. But they're just not coming to country areas. We know this because our medical practices are at breaking point.

This just adds more pressure to already overstretched hospitals and their emergency departments.

Overseas trained doctors are choosing to practice in and around the major cities for many different reasons.

For starters they can earn more money. City people have higher incomes than country people it's as simple as that. Doctors can charge more. There is more support for GPs practising in the cities than there is in the country. Practices are larger in the cities. Workloads can be shared. Workloads can be easier and better managed. There's more peer support. Colleagues can be consulted about cases.

This is why I've requested that the health minister visit our region and see for himself this unfolding crisis. We don't want to berate or belittle him. We want to work with him to find solutions. And the Doctors for the Bush Bill is part of the cure.

My office is constantly receiving correspondence from constituents concerned about this issue. Kathleen Bruce writes about the GP and paediatrician shortage. She says:

My husband and I have always worked really hard, pay heaps of tax, is it not too much to ask for some health care for our children? It is Australia, it's a human right.

Jodie Lewis writes:

I love it here and don't want to move again but my partner will consider selling and moving if my daughter can't access a doctor when required.

Ian Marsh, the president of Gulgong RSL sub-branch, writes:

We are losing veterans from the community who after settling in our wonderful community post service have now found that they are not able to be supported through their post service lives by our Health system … I have grave fear for an adverse outcome as veterans are forced to battle alone due to the paucity of services.

The government needs to get serious about alleviating the rural doctor shortage.

Together in this House and the other place, we have the power to cure this crisis. Country people demand and deserve nothing less than equality in access to doctors and medical services. Lives are at stake, and immediate action from this parliament is required.

I urge all members of this House to support the Doctors for the Bush Bill 2024 and achieve better health outcomes for country people.

I commend the Doctors for the Bush Bill to the House and cede the rest of my time to the member for Kennedy.

Milton Dick (Speaker) Share this | Link to this | Hansard source

Is the motion seconded?

Bob Katter (Kennedy, Katter's Australian Party) Share this | Link to this | Hansard source

I take great pleasure in seconding the motion. It is a great honour to be able to second this resolution. I do not hope to do justice to it as much as did the previous speaker. It was one of the better addresses that I've heard in this parliament.

Having said that, I will say that for seven years of my life I carried around in my briefcase that I take everywhere with me the names of six overseas doctors because, as the member of parliament for Queensland's mid-west, I was determined that Julia Creek would always have a doctor. Before I went into parliament it never had a doctor. In theory it was supposed to have one, but the doctor never made it there. Then they brought in another doctor to go there. He'd agreed to go, but then he wouldn't. So I carried around the names of these overseas doctors that I could ring up who would come over to Australia and take up the position if it was offered to them.

What overcame that problem was one of the great ladies of Australian history, Lady Pearl Logan, who gave us equal educational opportunities in country areas. But she was also chairman of the body—my daughter, who was secretary of the body, got all the praise, and I think Professor Ian Ronski was the real driver—that got the first medical school built in Australia in 44 years. That dramatically overcame the problem, because 18 universities then walked through the door that we were able to open. The sandstone universities didn't want any competition. They wouldn't expand, so for about 20 years we just sat there with the same number of doctors coming out. But now there are 18 universities. I listened in horror to my colleague from Orange giving those figures. Why hasn't it solved the problem? When they get through now, in a study that I've seen, they feel that they should take it easy or get a government job, which will be more highly paid than any other. (Time expired)

Milton Dick (Speaker) Share this | Link to this | Hansard source

The time allocated 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.