Penny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | Link to this | Hansard source

I move:

That the Declaration of percentage of Commonwealth supported places to be provided by Table A providers for a course of study in medicine, made under paragraph 36-35(1)(b) of the Higher Education Support Act 2003, be disallowed.

I am moving this motion on behalf of the opposition to disallow the Minister for Education, Science and Training’s declaration increasing the cap to 25 per cent for the number of full fee paying domestic undergraduate medical students able to be enrolled in Australia’s public universities. This is a fundamental point of difference between the government and the Labor opposition. This government wants to allow yet more $200,000 degrees, whereas Labor believes in fair and equitable entry into our universities based on merit, not on money.

We believe in entry to universities based on merit, not on the size of your bank balance. The government’s only solution to the doctors shortage is to allow more students to jump the queue and buy their way into a medical course, even if those students with money have lower marks. Labor believes increasing HECS funded medical places is the only way to ensure more doctors are willing to work in rural and regional areas.

The policy change that this regulation encompasses is the result of an agreement announced by the Prime Minister following the Council of Australian Governments meeting in February. There is no doubt that this was hastily cobbled together and not thought through. We learnt during a recent Senate estimates hearing that the Department of Education, Science and Training—and presumably the education minister—did not know about the change until the public announcement was actually made. And it shows. Fumbling this announcement, the Prime Minister repeatedly demonstrated his complete ignorance and lack of understanding about how Australia’s university system works. During the COAG press conference, the Prime Minister said:

... there would be an increase from 10 to 25 percent in the number of fully-funded places ... in university medical schools that will bring, for medical students, the figure of fully-funded places up to the same level as exists for other faculties.

But he got it completely wrong. These are not fully funded places. They are full fee paying places—a big difference to students, a completely different type of funding mechanism. Instead of being supported by the Commonwealth, these places are full fee and are fully paid for by the students. The change does not, as the PM thought, bring the number of these students up to the same level as other courses. Other faculties and courses have a 35 per cent cap and this declaration brings the cap up to 25 per cent for medicine. In a valiant defence of the Prime Minister’s fumblings with some basic understanding of the structure of higher education, during Senate estimates a DEST official told us:

We are all aware that not everything is absolutely accurately stated during the course of press conferences, because they go on for a long time and many things are said. I think that what the Prime Minister was intimating was quite clear ...

Perhaps all that was clear is that you cannot believe everything that the Prime Minister says! But students in this country already know that. In 1999, the Prime Minister said that there would be no $100,000 degrees in Australia. This year there are over 60 degrees in this country which cost more than $100,000. The policy change that this government is bringing forward and that we are debating here today will increase the number of $200,000 degrees in Australia. In fact, none of the degrees to which this proposal applies will cost less than $100,000. This is all about creating more opportunities for the select few who can afford—or perhaps, rather, whose parents can afford—to spend more on a medical degree than many Australians can afford to spend on their first home.

This government’s approach is simple: any growth in university places should come from full-fee places. Under this government, it is students who will meet the full cost of expanding medical education in Australia. Full-fee medical degrees cost an outrageous $216,000 at the University of New South Wales, $148,000 at the University of Queensland and $205,000 at the University of Melbourne. Figures are similar elsewhere in the country. To those students, the Prime Minister’s promise that there would not be $100,000 degrees in this country must ring extremely hollow! Of all the full-fee medical degrees available in Australia’s public universities, none of them cost less than $100,000. These are not sums within the contemplation of ordinary Australian students. But, in the Howard government’s Australia, apparently $200,000 is a reasonable amount to pay to become a doctor.

The President of the Australian Medical Students Association, Ms Teresa Cosgriff, put it simply and eloquently when she spoke a truth that it seems only those opposing the declaration before us understand. She said:

Full-fee places are simply not an option for most students and it defies logic to argue otherwise.

The skyrocketing cost of obtaining a degree under this government is impacting on participation in higher education. There can be no question about this at all. Late last year, Central Queensland University handed back 490 HECS places to the Commonwealth because of insufficient student demand. So, just one year after the Howard government’s 25 per cent HECS hike, student demand has softened sufficiently in some courses such that at least one university has been unable to fill its quota of places. Along with CQU, James Cook University and Edith Cowan University are also reportedly facing the prospect of handing HECS places back to Canberra.

Central Queensland University’s decision to hand back these places is unfortunate for that institution, but it actually presented the Commonwealth government with a unique opportunity to do something about the doctors shortage in Queensland. If the Howard government were serious about providing more opportunities for students to study medicine and to become doctors and work in regional areas experiencing shortage, the Howard government would have converted these returned places into HECS funded medical places. But instead of doing that—instead of turning the 490 HECS places CQU handed back into medical places in Queensland—the Howard government is content to simply increase full fee paying places in medicine by 285 right across the country.

Commenting on the Howard government’s decision that we are debating today, Dr Mukesh Haikerwal, who is the National President of the Australian Medical Association, said that the government’s plan to increase medical student numbers would be more effective if the places were HECS funded and not full fee paying. In other words, even the AMA—and they can hardly be accused of being a Labor lobby group—are saying: ‘This is not effective policy; this is not the way forward. What the government should be doing is funding HECS places.’ That is actually what the opposition has been saying. Ms Cosgriff from the Medical Students Association also comments that the decision to increase full-fee places rather than HECS places is ‘a simplistic measure that addresses neither the question of equity nor the workplace shortages we are experiencing’.

Whilst the previous minister missed his chance late last year, the new education minister could convert any further places James Cook or Edith Cowan universities are reportedly considering handing back to the Commonwealth into HECS funded medical places. Let us see if the new minister, Ms Bishop, has a little more foresight than her predecessor and is prepared to use the opportunity to expand HECS funded places for medical students so we can properly address the doctors shortage which exists.

Labor knows, from doing things like talking to people at universities, that there is spare capacity in medical schools, at James Cook University and Griffith University, where new HECS funded medical places could be located. If this was to be done with the HECS places being given back to Canberra in other disciplines because of softening demand, it could be done without costing the government one extra cent. More HECS places in medicine are the only solution to our severe doctor shortage. Federal Labor will continue to focus on increasing the availability of HECS funded places producing graduate doctors. Our policy at the last election was to have 1,000 additional commencing medical places. This policy far exceeds the increase in full fee paying places that this government is putting forward as its solution.

It is ridiculous to expect that someone with a $200,000 debt is going to work on an average general practitioner’s salary in the country. Doctors with fee debts bigger than mortgages will clearly, for market reasons, be drawn to higher pay specialisation. The Howard government’s plan will exacerbate the existing biased distribution of graduate doctors staying in metropolitan areas because full-fee places in medicine are not rural bonded. Full-fee students cannot be required to work in a rural or regional area. Those senators in the National Party who profess to represent rural and regional Australia might think about the impact of this government’s approach and the fact that full fee paying places are hardly going to yield the sorts of doctors who are likely to move into rural and regional areas as general practitioners, simply by virtue of the fact that they will have been saddled with an enormous debt because of this government’s policies.

Peter Beattie, like other state premiers, is working hard to solve the shortage of doctors, particularly in regional and rural areas. His task is made so much harder by this government’s refusal to provide sufficient HECS funded medical places. In light of the Howard government’s stubborn refusal to do what should be done, the state and territory governments clearly signed up to this second-best outcome. We in federal Labor acknowledge the difficult position our state and territory colleagues have been put in by this government, but we cannot support the expansion of $200,000 degrees in this country. This approach will do nothing to solve the doctors crisis and may only make it worse.

Senator Vanstone was the education minister who, in 1996, introduced full fee paying domestic undergraduate courses to Australian universities. She presided over the introduction of a policy that puts the size of your bank balance ahead of your hard-earned school marks when deciding who can go to university. But even Senator Vanstone, if you look back at what she said then, would not go as far as the current minister is going here with this latest change. When announcing the introduction of these places in 1996, Senator Vanstone said in a press release:

The only course where the extra opportunities will not be available will be Medicine where, for health policy reasons, the Government wishes to limit the number of medical graduates.

It would be instructive to hear from the government what has changed over the last 10 years—which health policy reasons have changed so that we can now allow one quarter of the domestic medical students at our public universities to be full fee paying.

Or perhaps Senator Vanstone could tell us the fate of the highly respected foreign doctor working in Brisbane who, according to the Courier Mail of 19 March this year, may be kicked out of country because of a technical dispute over medical expenses for the doctor’s child, expenses which the family is willing to fully pay. There is a desperate doctor shortage in Queensland, which has been the justification for this increase in $200,000 degrees, yet the federal government is contemplating kicking out a highly regarded and qualified doctor. This does not make any sense.

This increase in the cap on full fee paying students is yet one more example of how this government is Americanising our university system. Over 10 long years we have seen higher fees, less opportunity and diminishing public investment at a time when we would have thought Australia’s prosperity into the future as well as the needs of our ageing community require a greater investment in our public education system. The Howard government has cut $5 billion from our universities since 1996. It is little wonder that the OECD reports that Australia was the only developed country to have reduced public investment in tertiary education during this time. The average increase in the OECD was a 38 per cent increase. So, whilst Australia is going backwards, the rest of world is surging ahead.

Student debt in Australia has blown out by $10 billion under this government, with current and former students now owing the Commonwealth $13 billion. This government’s education agenda is clouded by misguided ideology and a lack of understanding. Education is an investment in our future. It is not a cost to be avoided. Labor has opposed having full fee paying domestic undergraduates at our public universities since they were introduced by this government. It was our policy to abolish these fee paying places at the 1998, 2001 and 2004 elections. We are consistent in our position that education is an investment. We are consistent in our position that access and entry to university should be predicated on your ability and on your hard-earned school marks, not on the size of your or your parents’ bank balance. We again move today to prevent to further spread of $200,000 degrees.

Russell Trood (Queensland, Liberal Party) Share this | Link to this | Hansard source

I rise to oppose this motion of disallowance. In doing so, I cannot help but think that Senator Wong might feel somewhat embarrassed about having to come into this chamber today and move this motion in relation to what is essentially a policy train wreck for the Labor Party. Various elements of the party are at odds with each other as to precisely what should be done in relation to this issue. Senator Wong gave an account of some of the decision making, but I will take the opportunity to inform the Senate a little more fully as to the circumstances surrounding this issue.

Penny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | Link to this | Hansard source

Senator Wong interjecting—

Russell Trood (Queensland, Liberal Party) Share this | Link to this | Hansard source

I think it would be quite instructive, Senator Wong, if you would listen. Senator Wong made the point—accurately—that this decision is a result of a COAG meeting last month. What she neglected to inform the Senate was that it was essentially a COAG decision which resulted from a specific request made of COAG by the Premier of Queensland, Mr Beattie. Mr Beattie came along to the COAG meeting desperate to find some political cover for the maladministration of health in Queensland and desperate to get some sort of joy from the COAG meeting so that he might take something back to Queenslanders to try to explain the shortage of doctors which exists in Queensland and move himself some way down the track where he might be able to say, ‘I have got the health problems in Queensland under some sort of control.’

Mr Beattie asked the COAG meeting whether there might be some support for an increase in the number of doctors educated in Queensland. The COAG meeting was, as Senator Wong said, obliging—it offered that support. Indeed, Premier Beattie came out of the COAG meeting enthusiastic about the results of the COAG meeting. He said in a press conference later: ‘I’m happy. I’m very happy. These COAGs just get better and you get happier too.’ He was in full enthusiastic puppy mode. Enthusiastic about the decision, he said: ‘I fully support this and I express my appreciation to my colleagues for supporting this proposition from Queensland because we do have a doctor shortage,’—as we indeed do.

So here we have the Premier of Queensland enthusiastic about the results of the COAG meeting but what happens next? The shadow minister for education in the other place, the member for Jagajaga, goes into the public domain and, with her usual and well-known obsessive ideological opposition to full fee paying places in relation to education, comes out and says, ‘We oppose this decision from COAG’—putting herself at odds with a decision which the Premier of Queensland was specifically interested in securing from the COAG meeting. One wonders how this came about. It turns out that this seems to have been a decision taken independently of any decision making within the Labor caucus.

Penny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | Link to this | Hansard source

For three elections we have run the same line.

Russell Trood (Queensland, Liberal Party) Share this | Link to this | Hansard source

Taken independently, Senator Wong, of any decisions made within the Labor caucus—Ms Macklin standing there on her own making this decision. Not surprisingly, she found some opposition among her colleagues in the caucus about the decision. So what happened next? The interesting thing was that various senior members of the caucus came out in opposition to the decision taken by the shadow minister for education. The member for Lalor, the shadow minister for health was quoted as saying:

The only body that can determine this is federal caucus ... Currently there is not a federal Labor Party position on this matter.

As far as I know, there is still no federal Labor Party position on the matter.

This might have been an occasion where we might have expected the Leader of the Labor Party to invest himself on the matter and become involved in trying to sort out the confusion which exists between the Premier and the Labor Party caucus here in Canberra. What did he do? He certainly did invest himself in the whole matter, to the point where, rather than take what might have been a logical course of action, to assemble the caucus and try to sort out the matter and sort out the differences between Canberra and Queensland, he decided to support his shadow minister for education. In some respects, that might have been regarded as a useful and loyal thing to do, but it of course put him at odds with the Premier of Queensland, who specifically requested this kind of decision. Hence we find ourselves in this rather bizarre situation where a decision specifically sought by the Premier of Queensland is opposed today by Senator Wong—coming into the chamber and asking for a disallowance of this particular declaration. That is the reality of the decision making in relation to this situation.

The reality is that the Premier of Queensland is desperate to find some new doctors. And one can sympathise with him, because there is a need for new doctors in Queensland—indeed there are shortages across the country. This COAG decision is designed to provide the opportunity for more people to be trained in the medical schools across the country so that we can increase the number of doctors who are available to treat people—in this case, the citizens of Queensland in particular.

As Senator Wong said, the decision is to increase the cap on fee paying places from 10 per cent to 25 per cent. The expectation is that, if this opportunity is taken up, there would be an increase of around 400 new places in medicine in public universities by 2007. The decision to increase the cap may not necessarily be taken by all universities. Universities will not be forced to make that decision. They will make choices about whether they increase the cap. Some universities across the country at the moment choose not to have full fee paying students. Universities such as the ANU, the University of Western Australia, Flinders and, I understand, James Cook University do not have full fee paying students, and they may decide to continue with that policy and not to implement this decision. But if the university system were to accept this opportunity, there would be in the vicinity of 400 new places, new doctors, for the country.

Senator Wong said in her remarks that there was only one way the Howard government would ever be prepared to increase the opportunities for medical training in Australia, and that would be through full fee paying places. She seems to have neglected the fact that, during the press conference after the COAG meeting, the Prime Minister made it clear that, if there is a need for additional Commonwealth places in medicine, that would be considered at the next COAG meeting later this year. So there will be an opportunity, Senator Wong, to specifically address this question later in the year when COAG meets again—and there is a likelihood that there may be further places made available later in the year.

The important thing to note is that this decision does not represent a decline in or the removal of some of the places already existing in medicine. This means that an additional number of people will be able to train in medicine. In a couple of years from now, there will be something in the vicinity of 2,195 new Commonwealth supported places, as Senator Wong wanted, in medicine in Australian universities. That is a very considerable number. It represents precisely the policy that Senator Wong is happily advocating.

There are other aspects of this matter which I think should encourage Senator Wong. For example, there is an increase in the FEE-HELP loan limit available to students, which rises to $80,000 as a result of decisions taken by the government. So those students who choose to take this course from the full fee paying places will have an opportunity to get access to a loan scheme which will make that easier for them.

The point has been made, again by Senator Wong and by others in this debate, that people should only be allowed into medical schools—and, indeed, people should only be allowed into universities as a whole—by maintaining standards. Merit is important; I agree with that proposition. I agree and I particularly agree with it in relation to medicine. I am not the person who would look with enthusiasm upon being operated on by yet another Dr Patel in Queensland, whose particular medical talents perhaps are better suited to a knackery or an abattoir than an operating theatre.

There is no sign, there is no indication, there is nothing which suggests that this decision is going to result in a decline in the standard of people entering medical schools. There is nothing, Senator Wong.

Penny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | Link to this | Hansard source

There are lower TE scores for full-fee payers.

Russell Trood (Queensland, Liberal Party) Share this | Link to this | Hansard source

Nothing says that. In fact, you also know as well as I do that medical admission policies are strict. You also know, Senator Wong, that there is a range of tests which students are subject to for access to medical schools—the Undergraduate Medicine and Health Sciences Admission Test, the Graduate Australian Medical Schools Admission Test, and often universities ask students to go through interviews and the like. This is a rigorous process and nothing I have seen—and Senator Wong has not provided us with any evidence this afternoon—indicates that these standards are likely to fall as a result of this decision. So some of these claims are just nonsense. They have no foundation other than a reflection of the ideological expectations that exist on behalf of the Labor Party in this matter.

Penny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | Link to this | Hansard source

And yours is ‘buy your way into university’.

Russell Trood (Queensland, Liberal Party) Share this | Link to this | Hansard source

Senator Wong, it is not a question of buying your way in—it is giving an opportunity to students to get access to universities who would not otherwise have it, and I would have thought you would have been enthusiastic about that. I thought you would have been particularly enthusiastic given the fact that your comrades in Queensland are desperate to increase the number of people involved in medical education—which is precisely what this decision does and will do over the next couple of years.

Let me go a little further, because the problem in medical education in this country is not just about students getting into universities. There is a wider problem and it is a problem which needs addressing and, sadly, it is a problem which cannot easily be resolved. Sadly, it is one which is an affliction of the Queensland health system and all the troubles that now beset it. It is all right to increase the number of medical places in universities, and that is desirable, but students in medical schools of course need in-house training. They need training in hospitals—they need the opportunity, as it were, to get their hands dirty. If they are not given that opportunity within medical schools, and also to be involved in teaching and in learning expertise within universities then they are no good to the community.

That is the task for the Beattie government—it has to provide those opportunities not just in medical schools. We do not just have to have the opportunities in medical schools, we have to have the opportunities in hospitals and, until such time as those opportunities are available—not just for doctors but also for the allied health professionals: the nurses, the physiotherapists, the radiographers et cetera—then we are not likely to have a fully functioning medical system. That is a need which the Beattie government needs to address. It is a problem which will exist as long as there are hospitals across the state which are at excess capacity and where there are insufficient opportunities for medical students to gain training. So, the case in relation to this disallowance collapses at every level and I assert the fact that the government opposes this motion of disallowance.

Natasha Stott Despoja (SA, Australian Democrats) Share this | Link to this | Hansard source

I rise to speak to this disallowance, proposed by the Australian Labor Party, on behalf of the Democrats and as their higher education spokesperson. We will be supporting the disallowance of the government’s declaration to increase the percentage of full fee paying medical places in each course. We have said previously and still believe that this is a short-sighted—so somewhat unsustainable and superficial—remedy to the medical workforce shortage, and we believe it will not do a lot to increase Australia’s access to general practitioners.

Following on from Senator Trood’s comments, he is right to suggest that there is a much broader problem here, and I would suggest that there is also an issue of chronic underfunding and under-resourcing in both the health and education sectors in this country—a consequence of successive governments and indeed currently as a consequence of cost shifting involving both state and federal governments. So there is no doubt that it is a broader problem, but this is not the solution that the government seems to think it is.

We believe this proposal, which aims to decrease the required percentage of Commonwealth supported places from 90 per cent to 75 per cent of places, which therefore allows more medical places for full fee paying students, is not a particularly equitable solution either. It is an inadequate approach to a chronic long-term problem that we have all been aware of for years. In fact, it is doubtful that it will make any difference to the shortage, particularly in the regional and rural areas that everyone keeps referring to. Medical students who pay up to, and possibly more than, $200,000 for a degree may not necessarily feel a public duty to serve their community as a GP. In fact, I would probably suggest that they would be focused on servicing their FEE-HELP loan rather than necessarily be performing GP tasks in regional and rural areas. Just as Senator Wong was saying, there is absolutely no way that you can ensure and insist that that will be the effect.

These students are likely to pursue more lucrative specialist careers in urban areas than offer their services as a GP in a country area. I do not wish to generalise, because I have no doubt that many of those students would simply want to do their best for their communities wherever they may be, but the harsh reality of their circumstances will be that they have an incredible debt as a consequence of this study. There is no impetus for full fee paying students to take jobs in rural areas. Increasing full-fee degrees, as opposed to HECS places, actually eliminates the opportunity to make medical degrees rural bonded, which would ensure that some students work in regional areas. Regardless of your view on the rural bonded places in medicine, obviously, once you take away that Commonwealth component, you lose any opportunity to ensure that that work is performed in regional and rural places, which therefore makes part of the argument by this government for this particular measure somewhat spurious.

Generally, full fee paying places do have a lower cut-off score than HECS places. Full-fee medical places are likely to have lower cut-off scores. I have no doubt about it. Shouldn’t we be increasing the opportunities through Commonwealth funded places for those clever doctors who achieve maximum scores as students to study and aspire to be health care professionals? It is simply another move by the government to further entrench a user pays system. Once again, it is another example of the government abrogating its responsibility to adequately fund Australia’s universities. If I sound ho-hum about this, it is not because I am not angry about the policy suggestion; I am just used to the policy. This is just another step by the government to entrench a system where it is about bank balances and not brains. I do not think anyone is particularly surprised by this move. The government’s logic is a bit twisted in some respects. You cannot argue that you are going to get the best health care professionals and doctors and then argue that you are not necessarily going to have lower cut-off scores when the evidence has been to the contrary. You cannot suggest that students are going to end up serving their time in regional, rural or remote areas when you know there are going to be financial and other imperatives that maybe steer those students or doctors to more lucrative practices in order to pay off their debt.

In the past 10 years, Commonwealth contributions to university running costs have decreased by 61 per cent to 41 per cent. It is a radical change in the funding arrangements when it comes to public funding in this country. That whole cost-shifting exercise was started by Labor but has been undertaken by this government in particular. We know that student contributions have increased from 14 per cent to a whopping 42 per cent. Students are paying a hefty whack of their degree. In order to do it, we are seeing massive changes in their lifestyle and their sacrifice. I believe it is also having an impact on the way universities operate. The government has been quite happy to offload a significant amount of its responsibility for funding to individual students, but it is not just full fee paying students bearing the brunt of the government’s miserliness. Those students who are paying their HECS fees have noticed a sharp hike in their contributions. In fact, at the start of this year, only three of the 37 institutions—that is, public universities in this country—had not raised student contribution levels. Everyone is doing it. As a result of the changes to the Higher Education Support Act, or the introduction of the HESA, a few years ago, everyone is hiking up their fees and charges. In fact, 29 of those universities had increased those HECS fees by the maximum 25 per cent. Combine these factors with the inadequate student income support and the loans scheme that encourage mortgage-size debts for students, and you have an education system that is pricing itself out of the range of most Australians, particularly those disadvantaged Australians.

I noticed that Senator Wong talked about the Americanisation of the system. It is interesting because, when you compare our fees with public institutions in the US, you see that we come off worse. I am not disputing the fact that there are private universities in the United States, but we are starting to leave the public institutions for dead. We have among the highest fees and charges in the industrialised world. It is an absolute shame. Instead of reinvesting or putting more money and resources into the sector, whatever that may be for—higher education or, more broadly, vocational education and training, lifelong learning, schools or anywhere—this government is ducking that responsibility. I find it extraordinary that it gets away with it.

Following the 25 per cent increase in HECS, demand for university places fell by 16,000. Increasing the number of full fee paying places may not have the intended effect of increasing doctor numbers. In fact, it may work the opposite way. There is more evidence of the emergence of a user pays system in the higher education sector. I am not sure if this has been discussed in any detail in this place yet but, recently, the education minister revealed that lawyers had reinterpreted a section of the Higher Education Support Act 2003, concluding that universities were not compelled to fill all Commonwealth subsidised places in a course before enrolling full fee paying students in popular courses such as medicine and law. They do not have to stick by that so-called proviso in the Higher Education Support Act anymore. The rules for enrolment of domestic fee-paying undergraduates were a critical safeguard in the act that prevented the higher education sector from charging full fees for more than 35 per cent of places for domestic undergraduates in each undergraduate course of study.

Let us all remember that wonderful debate back in December of that year when the four Independents gave the government the numbers to pass one of the most shameful and regressive pieces of education legislation in this country’s history. Well done, you four Independents. What did you get for it? Not much. You got the review of indexation requirements for universities, but no guarantee that indexation would actually be implemented.

I hope those four Independents are very proud of those efforts to put debt on the kids of Australia. This is what they got. There was a critical safeguard in there in terms of guaranteeing the number of places that had to be filled before you could enrol those upfront, full fee paying places. And what have they got? A reinterpretation of the law. So that critical safeguard has gone too. The one rule that ensured some more equitable access to university study for domestic undergraduates—and that has gone too. For such an important change in the rules, the manner in which it was done seemed to involve absolutely no consultation with other groups. It was presented as a fait accompli, not to be challenged.

We have seen the situation where universities have been forced to pay back funding for Commonwealth supported places, having been unable to fill them. Why not allow universities to inject this funding into creating sufficient Commonwealth supported places to meet demand for all disciplines instead of creating more full fee paying places? This is where governments make a very clear and conscious decision. Do you want more places for people who can pay or do you want to expand the sector in the way that recognises the merit and the opportunity for all and ensures that publicly funded and accessible education is available? That is the fork in the road. The government has made a very clear decision: ‘Elite education for the rich is okay. It is okay under coalition country policies. We do not want to be a clever country. We want to ensure that there are distinctions—and if you’ve got money and you can pay you are okay.’ We have been heading in this direction for at least a decade, and the government now makes no bones about it. So if you are short on medical places, short on doctors, the answer is: let’s put in full fee paying places. That is not a solution.

The relaxing of the HESA 2003 regulations apparently should have a positive impact on regional universities: they should be able to attract full fee paying students in high demand courses when places run out quickly. But this fails to recognise that those rural and regional students with money may prefer to head to some of the city universities. Those without money will not necessarily enrol in full fee paying courses—they will not be able to do it. But you might suggest, and I am sure the government would, that there is FEE-HELP to fund the increasing number of Australian students who will be paying for full fee paying courses at public universities and, of course, at a number of private institutions.

That is an aspect of current higher education policy in this country that we should not forget. It is a new definition of cost shifting, where we take money from the public sector, from taxpayers, and we give it to private institutions. We have seen it happen in schools. The Democrats fought those proposals the first time around. They had support the second time around—not so good; lost that debate. One debate where we have had minimal support has been on that cost shifting of public university dollars, taxpayers’ dollars to universities, into the private institutions. They have been going into the private institutions at the behest of the Prime Minister and, indeed, with strong support from the Leader of the Opposition, Kim Beazley. So private institutions are now accessing those funding dollars, and of course FEE-HELP now applies to a number of private institutions. So it is not enough that the government is luring students into paying for the full cost of their degrees. Under FEE-HELP, let us not forget that undergraduate students must pay a 20 per cent loan fee on their FEE-HELP debts. With more than 23,000 students already paying the full cost of their courses under the FEE-HELP scheme, students are obviously being saddled with more and more debt. It has already blown out, but it is going to blow out even more if this loan cap is raised.

I want to address the issue that Senator Trood has brought up about the loan cap, and that is increasing the cap on the FEE-HELP loans from $50,000 to $80,000. That is one of the Prime Minister’s pledges following the last COAG meeting. It is an increase in the amount that students will incur in debt and have to pay back—and don’t forget that 20 per cent loan fee. Reports suggest that this increase has already taken place. However, from my understanding of the law and from studying this policy for goodness knows how long, it appears that this change, unlike the increases in full-fee places, must be legislated for. So I ask the government today, and hopefully they will come clean on this: when on earth do you plan to introduce the legislation to increase the loan cap? I know we have dealt with a lot of delegated legislation and we have even dealt with issues that have required legislation, things like the ARC board, or NBET, back in 1996-97, but we have done that through administrative means and not bothered with legislation. In fact, I seem to recall the Notice Paper showing that we were supposed to deal with the student assistance amendment bill on the closing down of that student loan, which of course was closed administratively more than a year ago anyway. So I know we do not always do things through legislation under this government. But when will the legislation be introduced to deal with the increase of the cap on the FEE-HELP loans?

What is the Labor Party position on this? I noticed Senator Wong interjected when Senator Trood was talking about this as a great solution. That interjection was spot-on: more debt for students. But I do not know what the official position of the Labor Party is. Are you opposing the increase in the cap? That is going to be the next line in the sand in this debate: are we going to see an increase in that cap from $50,000 to $80,000? The decision on this is significant. First of all, how the decision is made is important. It has to be made in a transparent way. It has to be done in a way that allows sufficient debate to take place.

Inadequate levels of student income support are also having a huge impact on our students, leaving them high and dry. We already know that student income support is a key in access and equity. It is a key to ensuring that, in particular, students or aspiring students from traditionally disadvantaged backgrounds can enter into and participate in higher education. You would be aware of course, Madam Deputy President Crossin, of the recent student income support inquiry. Actually, it was not so recent: we reported just over a year ago—there was a slight hiatus because of the election. It was Democrat initiated and it was the first Senate inquiry to look solely at the issue of student income support.

Look at the anomalies that that inquiry threw up. The inquiry found that Austudy recipients are not eligible for rent assistance. That still exists—isn’t that extraordinary! Part-time scholarships are not exempt from tax. There is no logical policy reason for any of these. Even the government has not been able to put forward reasons for these anomalies, yet they hurt and hit our students. The inquiry recommended that the rent assistance anomaly be dealt with, but so far nothing has been done. Why not deal with some of these issues that are crying out desperately for some fixing instead of tampering unnecessarily with the HESA Act?

A recent inquiry found that half of the part-time students surveyed would rather be full-time students if their finances permitted. One-third believed that a lack of government support was stopping them from studying full-time. The study also showed that part-time students were more likely to come from lower socioeconomic backgrounds and have attended public schools. Student income support matters—it makes a difference. But loan schemes and increased full-fee courses do little to improve that access. I would prefer it in a way if the government did not pretend this was about addressing shortages and just said: ‘Yes, it’s okay—we’re happy with an elite education system for the rich. If you have money, you can pay and we’ll see what happens to the rest of you.’ The reality is that these measures are a financial and psychological disincentive to participating in education at a higher level. That is shameful.

According to the COAG website, the Commonwealth, states and territories agreed that these new measures are not to displace current places or future increases in Commonwealth funded student places. Apparently, an increase in Commonwealth funded medical places will be considered at the next COAG meeting, which is in June. Why wasn’t it considered in February? Why not consider that instead of increasing the number of full fee paying places? The state health ministers are waiting for the June COAG meeting to hear whether or not the number of additional HECS places addresses workforce shortages. While some have welcomed this increase in full fee paying places, they have made it clear that they are expecting a significant increase in HECS funded places to address doctor shortages, particularly in hospitals and regional areas. Queensland wants 325 HECS places and my own state, South Australia, wants at least a modest 46. I urge the government at the next COAG meeting to come up with a better outcome—one that is a real solution and does not disadvantage those students who are traditionally disadvantaged; one that does not place more barriers and financial obstacles in the way of people who want to pursue education at all levels, specifically those people who want to become doctors. (Time expired)

Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Aged Care, Disabilities and Carers) Share this | Link to this | Hansard source

I am also pleased to support the disallowance of this move by the government to introduce $200,000 medical places in Australian universities. In doing so, can I say that the position we are taking today is consistent with Labor policy that we have held over many years. Senator Trood’s attempt to explain what he thinks has been the history and evolution of this was mischievous. I suppose that is a nice way of putting it, but misleading would probably be more accurate. To tell half a story might be a little bit entertaining for those people who were listening to him, but it goes a long way from the truth. Labor has been opposed to full fee paying students. This is consistent with our policy and there has been no deviation.

The COAG communique from last month recognises the chronic doctor shortage we have in Australia. You could say that it has taken this government a very long time to realise that their actions over the last 10 years have led us to the position we are in today. Ten years of inaction and not responding to what we have known to be a growing doctor shortage by not increasing HECS places for medical students at universities has put us in this position. The blame for that must be sheeted home to the government of the day. We know that it takes 10 years to produce a doctor. The fact is that this government have been in power for 10 years. It is now totally the responsibility of this government in the way they cut medical places over that period of time and also did not allow for growth and keeping up with the known demand that we were going to have. The reason we are in this circumstance is directly attributable to this government and nobody else.

The response to the acknowledged doctor shortage that we face in this nation from the government of allowing universities to increase the number of full fee paying places—that is, people will have to pay up to $200,000 to get themselves a medical degree—is wrong. It is wrong for two basic reasons. It is wrong in principle and it is wrong in effect. The reason that it is wrong in principle is that entry into these places will not be based on the merit or scholastic achievement of the school leaver; it will be based on the depth not of their pocket but probably of their parents’ pocket. That is the entry requirement that we will have for this cohort of doctors coming into our universities.

Senator Vanstone in 1996 was absolutely correct when she said on introducing full fee paying places in Australian universities that the one area that was exempt was medical places at universities. She used then the evidence that said that it was not consistent with good health policy. I would like to know what has happened between 1996 and now. The principle was right then and the principle remains right now. In response to Senator Trood’s comment that these people are going to be equally talented, it stands to reason that a successful applicant who is entering in the knowledge that they are going to have to pay $200,000 for this degree will be less qualified than a person who could have achieved a place but did not have the $200,000. There is just simple logic there. You cannot deny it.

You can say that they will be marginally less qualified to take that place, and maybe that is the case. But is this not a question of equity? How fair is it that someone who is pretty bright but whose parents have a lot of money should become a doctor in this country and not a person who is also pretty bright but comes from the wrong side of the railway track? There is an equity question that this policy does not address, and it is an equity question that I will continue to defend in terms of full fee paying places.

Coming from regional Australia, I know that my university, James Cook University, which is based in North Queensland and increased its HECS places this year, will have to hand back a number of places because it has not been able to fill them. Why, you ask, has it not been able to fill those places? It is because, for people in regional areas who are less used to going to university, cost is a real disincentive. The year that HECS goes up, we know that those students do not apply. There is a direct correlation between increasing the cost of a degree and people from rural areas not applying. That is a truth. That is happening now at the Central Queensland University, it is happening at James Cook and it is happening in regional universities right across Australia. I raise the issue to underline the fact that people who have less money in their pockets will not go to universities. They will not take places in universities if they are going to have the high costs following their graduation.

I said I was opposed to this policy for two reasons. I said it was wrong in principle, but it is also wrong in effect. I am actually interested in solving the doctor problem in Australia. I come from regional Queensland. We are the people who, everyone understands, are finding it hard to attract doctors into our region. I am opposed to this because it will do nothing to solve that problem. I am interested in outcomes in this place, and this policy will not, in my view, put another doctor in Barcaldine, Boulia or Charters Towers. That is what I am interested in doing. Unfortunately, this policy will do nothing to solve that problem. What it will do for those 285-odd students who do graduate in four or five years time is put them into Wickham Terrace. For those people who do not come from Queensland, that is our specialist street. That is the street that the specialists work on. If you graduate with a debt of $200,000, you are interested in paying off that debt. The best way to pay that off is to specialise quickly, get onto Wickham Terrace and charge a lot of money so you can fix up your debt. It is not going to Boulia and working in the state public health system, because you simply do not earn the same amount of money.

We know this not only because it is commonsense but also because, during the inquiry into Medicare that we conducted some years ago, the Australian Medical Students Association told us that they were opposed to the bonded student policy that was being discussed. They said that students who were bonded to go to regional and rural areas would buy out their bond and stay in the cities in order to get through university and then pay back that bond, rather than spend the number of years that they were meant to be bonded to go into the bush. We know that is happening already now. That is what is going to happen. People are not going to end up in rural and regional Australia as a result of this measure.

You do not have to just rely on me and my commonsense approach to this policy. The Australian Medical Students Association criticised the government for its ‘attitude of denial’ regarding the latest attempt to justify its massive hike in full fee medical student places. Teresa Cosgriff, the president of the association, said:

To state that the current funding system provides equitable access for students is ridiculous.

She said:

Full-fee places are simply not an option for most students and it defies logic to argue otherwise.

She went on to say:

While the Government has acknowledged the need for additional doctors to be trained, it has invested nothing into additional HECS places for medical students.

The Australian Medical Association’s Dr Mukesh Haikerwal said on the day that this policy was announced:

... the Government’s plans to increase medical student numbers would be more effective if the places were HECS-funded, not full-fee paying.

He said:

... Government funding of the places would better reflect the Government’s commitment to easing medical workforce shortages, and would give the brightest students, not just the wealthiest students, the opportunity to pursue a medical career.

In his press release he goes on to say that the sort of people who will be applying are the people from wealthier families, rather than people who should get there on merit but simply do not have the dollars in their pockets. He goes on to reiterate my point that these doctors will not end up in rural or regional areas but on Wickham Terrace in Brisbane and in the inner cities of Sydney and Melbourne.

As I said, I am actually interested in solutions. We do have a shortage, but the answer that would truly solve this problem is the increase of the number of HECS places at universities. That is the fair way of doing it. That is the way that will get the best and brightest students into those places—those who have the most motivation to follow their careers rather than pay off their debt.

Can I also say that, if we are actually keen to solve the problem of doctor work force shortages in rural and regional Australia, we should do what is proven to work. Universities in South Australia and James Cook University have proven that if you recruit students from regional and rural areas, if you train them at universities that have a focus on rural health—like Charles Sturt University in South Australia and, certainly, James Cook University in North Queensland—if you train them with a focus on regional health and if you then offer them placements in interesting regional and rural places—for example, lots of students are doing fantastic placements in Mount Isa and on Thursday Island, and I know the Northern Territory has provided great opportunities for these sorts of placements—then the likelihood is that they will apply for jobs and will stay in regional and rural areas.

So, if you recruit from regional areas, if you train students in universities that have a regional health focus and if you give people placements in regional areas, the proven likelihood is that they will end up working in regional areas. The last part of that story is that, if people get married in those regional areas, they end up staying there for life. They are the facts. This policy will do nothing to deliver that outcome. As I said, I am a Queensland senator based in a regional area. I have a commitment to solving this doctor shortage problem. This policy does nothing to solve that problem; $200,000 degrees do nothing to solve the doctor shortage in rural and regional Australia. I am pleased to have been consistent with Labor policy over many years and to support the disallowance of this measure.

Question put:

That the motion (That the motion () be agreed to.