Perin Davey (NSW, National Party, Shadow Minister for Water) Share this | Link to this | Hansard source

I'm very pleased to speak on this bill tonight, because this bill, the Higher Education Support Amendment (2022 Measures No. 1) Bill 2022, gives legislative effect to a policy that was key for the Nationals before the last election. I particularly refer to the part of the bill that gives effect to the Higher Education Loan Program, HELP, measure for rural doctors and nurse practitioners, which was announced by the coalition in the 2021-22 MYEFO.

This measure provides a partial or full HELP debt reduction for rural doctors and nurse practitioners who reside and practise in regional, rural or remote Australia. It was a key pillar of the Nationals in the last government to try to take constructive and practical measures to address our regional health work shortages for the long term. We all understand that it's not a silver bullet and it will not flood the regions with doctors and nurses tomorrow, but certainly over the long term it will attract to the regions more health graduates who will, hopefully, stay—as I have. Once you move to a regions, you know how wonderful it is to live in the regions and you stay in the regions.

This measure was previously included in the Education Legislation Amendment (2022 Measures No. 1) Bill 2022, but unfortunately the bill lapsed at the dissolution of the 46th Parliament. The Nationals supported the introduction of this to encourage the relocation and retention of eligible doctors and nurse practitioners by reducing their outstanding HELP or HECS debts. It allowed for the waiver of indexation on outstanding HELP debts for eligible doctors and nurse practitioners while they reside and complete eligible work in our rural, remote or very remote areas. These debts for doctors can be up to the value of $100,000. It's no wonder, with debts like that hanging over their heads, that our graduates were seeking quantity over quality in how many patients they could see and how much reimbursement they could get.

This measure is backdated under this bill to the time of the previous government's announcement in the 2021-22 MYEFO. I do thank the government for doing that. I truly welcome that because it provides the certainty that some graduates that were considering this measure needed.

This program is expected to encourage up to 850 eligible doctors or nurses to relocate to a rural, regional or remote area each year. Those of us who live in rural Australia know only too well the difficulties we have in finding and keeping good doctors. These difficulties are exacerbated by the fact that at the moment, as we read today, skilled migrants in nursing, pharmacy and health care are waiting more than two years for visas. As was highlighted by my colleague Senator Anne Ruston today in question time, this is despite those people being in occupations designated for priority processing by the federal government. Yet, for some reason, the subclass 887 skilled regional visa does not fall into a priority area. This means migrants in the same occupations who apply to fill different types of skills shortages, including those who want to work in the cities, are getting fast-tracked, with applications processed in as little as 25 days, but we've got doctors and nurses waiting two years or more. This stark difference has been fuelled by a ministerial direction issued by immigration minister Andrew Giles in November to prioritise some teacher and healthcare worker applications over and above other occupations, including applicants in regional areas.

We in the regions know that there are never enough doctors or nurses. Sometimes this is because of an overload of work or we lose them. Other times, it's because of changes to government policy, such as another key initiative that was implemented to attract overseas trained doctors and bonded graduates to rural areas: the Distribution Priority Area classification system. Yes, admittedly, in government, we extended the DPA classification system to include regional centres such as Dubbo, Shepparton and the like. But, when they got into government, the new government expanded the classification to identify peri-urban areas. How is that helping our regional health workforce shortage? The current DPA classification system and changes brought in by this government have seen the shift of overseas trained doctors from areas like Maitland to Newcastle, where, as I said before, they can get quantity of patient numbers but at the expense of the quality of our health workforce in regional areas.

This government, as part of its 2022 election commitment to ease city health pressures, included fringe suburbs across Australia like Fairfield, Hornsby, Penrith, Warringah, Rouse Hill, Richmond and Windsor—and that's just in New South Wales. So they are now eligible under the DPA classification system. When overseas trained doctors are looking for a cohort, of course they are going to look at where there is quantity.

This one change has seen serious shortages starting to develop in country towns. It's a short-sighted policy no doubt made to appease some Labor seats, but it's having devastating impacts in the regions. We see, on a daily basis, overcrowding in city hospitals and enormous pressure on emergency departments. Penrith gets DPA doctors, yet our regional areas, which get crowding in emergency departments—because it's the only place you can go to see a doctor because our GP clinics are crying out. We have cases where local governments are footing up to $700,000, as in one example in South Australia, to try and attract a GP to their region, because they can't entice anyone and they're now competing against the peri-urban areas of Adelaide to attract an overseas trained doctor.

I know, because I live in the regions, the lifestyle and the wellbeing benefits of living outside the big cities. I know the benefits my children have had being able to live in a smaller community where they're free to walk to work, go swimming in the rivers and ride their bikes without fear. But those wonderful rural settings needs services, and they will only attract services if they have the infrastructure and health services to support them. I've written an op-ed that was published in the Land earlier this year about the need to attract a health workforce to the regions. It is a vicious cycle: if you don't have a doctor, you can't attract the other professionals you want into regional areas, but you will not attract a doctor to a regional area unless you've got those other important services and professional people living in the region.

Why this government would bring in policies or make policy changes that effectively undermine the ability of regions to attract doctors is inconceivable. That's why today's bill is so important. It's important that we all get behind it and we all pass it. Waiving these debts to attract graduates into our regions will attract them for the long term. It will get them into our regions to live there, to hopefully start families there, to help support and nurture the next generation of medical professionals in our regions.

I acknowledge and thank the government for bringing forward this bill today. The Nationals absolutely support it, because it was our policy, and I congratulate the government for picking up good policy when they see it. I commend the bill to the chamber.

Anthony Chisholm (Queensland, Australian Labor Party, Assistant Minister for Education) Share this | Link to this | Hansard source

I thank senators for their contributions to this debate. The bill will support students through fairer grandfathering provisions and the Job-Ready Graduate scheme and will support our rural, remote and very remote communities by encouraging our doctors and nurse practitioners to provide services in those areas. The bill will also put in place a scheme for eligible doctors and nurse practitioners to have their HELP debts reduced or wiped if they live and work in rural, remote and very remote areas of Australia. This is a policy which we have continued from the former government. We want to make sure in rural and remote communities they have access to health services, and it makes sense to continue this important measure. We expect to support around 850 medical practitioners a year in those areas. Again, I thank senators for their contribution, and I commend this bill to the chamber.

Jess Walsh (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

The question before the chamber is that the second reading amendment moved by Senator Faruqi be agreed to.

Question negatived.

Mehreen Faruqi (NSW, Australian Greens) Share this | Link to this | Hansard source

by leave—Madam Acting Deputy President, because we can't have a division at this time, maybe you could note the position of the Greens, supporting this amendment.