Bob Katter (Kennedy, Independent) Share this | Hansard source

I pay tribute to the previous speaker, the member for Moreton. I think he does an excellent job in his portfolio and an excellent job as a member of parliament representing his area. He is one of the very few pleasant and intelligent people that we encounter in our daily dealings with government. I wish there were more like him. I avail myself of the opportunity to say a few words on the Health Insurance Amendment (Provider Number Review) Bill 2007, not because in itself it is of importance; it is purely obviating the necessity for a review every two years and saving a tiny bit of taxpayers’ money. The issue of provider numbers and the qualifying period is an appalling imposition upon rural Australia.

Previously we would get first-year doctors. All of western Queensland was manned by first-year doctors. They may not have been the best doctors in the world—heavens, it was just their first year in practice and they were thrown out on their own resources—but they were better than nothing. A lot of the doctors that go out there, and God bless them, have enormous difficulties with English. Their culture is so enormously different from ours that they have enormous difficulties in fitting in. But at the present moment we are making do with these doctors as opposed to the doctors we had previously.

The two-year qualifying period is appallingly bad. It took six years of fighting, arguing and battling from the time I formed the original committee to secure the Townsville medical school till the time it started—I think it was in its seventh year. We had our first graduates last year, so we are talking about a program that has most certainly put a big hole—about 12 years—in my life. The reason all that time and effort was put in was that we people in North Queensland, and there are a million of us up there, require 1,000 doctors. It may be that 1,500 or 2,000 doctors are needed, depending on what set of figures you want to use. In fact it is 3,000 doctors—that would meet the average for Australia.

Where are we going to get them from? Our young men and women go down to Brisbane and they are trained in Brisbane. They marry a Brisbane girl or a Brisbane man, and they do not return to North Queensland, which is 2,000 kilometres away. They have lived in Brisbane for six years. They are not suddenly going to up stakes, roll their swag and go back up to a small town from whence they came—and they do not. Hence the fact that the last time I reviewed the 21 doctors practising in the mid-west and Mount Isa only nine were Australian. All the rest had come from overseas. That is a lot of drawbacks for us.

Of course, if you introduce a two-year qualifying period we will get nobody at all. Some of the blokes who went there for one year stayed for five, six or seven years; some of them stayed all their lives in the northern and western towns—but I am talking specifically about North Queensland. If you say that they have to work in a big hospital for two years, that means we do not get them. Once they have qualified in a big hospital for two years, they are not going to gallop off to the bush. Previously they had to do that. If they wanted a job with Queensland Health, almost invariably they were sent there. But if we are required to provide a qualifying period, that just means we will not get those doctors. The first graduates came out of James Cook University. There were about 60 or 70 graduates last year, and it will effectively be another two years before we get them on the ground. When the students for this year graduate, it will be another two years before we can get any of those people on the ground.

If they are young and inexperienced, to some degree they are forced to take their own initiative when they are by themselves in these communities. If they are really worried, there should be a superintendent in Mount Isa or Townsville—it should really be Charters Towers, but we will say Townsville—who they can ring and ask: ‘I have a difficulty here. Could you please advise me?’ Surely the government can pay some specialists in Townsville to provide advice to the doctors in these outlying centres, or a superintendent from a hospital in Mount Isa, Charters Towers or Townsville, but the government has not done that.

I want to praise Minister Abbott very fulsomely because he has lifted the number of graduates—which was reduced to about 65, for reasons I do not want to go into. He has taken that number up to 160 graduates a year. We thank Minister Abbott very sincerely for what is a very great achievement. Michael Wooldridge was the ‘angel of the bush’, as I have described him in this House on many occasions. We got the first new medical school in 40-odd years—I think it has been 44 years since we built the last medical school. There are no extra graduates coming out. Now half of the graduates are women—and God bless them, but they tend to become mothers and not practise medicine on a full-time basis. I have said that they become 30 per cent or 50 per cent doctors. I was corrected the other day when I was told the number is lower than that. I do not know whether it is or not. But this new phenomenon of 50 per cent of the faculty being female has dramatically reduced the number of doctor hours that we have in Queensland.

Coupled with that is the fact that the population of Queensland has risen from under two million to four million in a 30-year period, and there has been virtually no increase in the number of graduates in Queensland. Most certainly that has left us in North Queensland—where the population had gone from about 200,000 or 300,000 to nearly one million—in very desperate straits. The old situation was that these people were employed by the state government and the state government insisted upon them going to country centres to receive their qualifications. Just the opposite occurs now. The state government said, ‘We’ve got you for two years because you’ve got to do two years to qualify, and we’re going to send you out to Cloncurry, Julia Creek or Cunnamulla.’ They had to go; otherwise they would not get any qualifications. Now just the opposite is true: if they go, they cannot become qualified. So we are not at all happy about the new situation that has arisen. We are very hostile towards it and I suppose, to some degree, I should be arguing that we review it again so that we can go back to the old system where a doctor went out to rural areas.

People would say: ‘They weren’t properly trained.’ They were better than nothing. That is the choice that we have really been left with. We have a hodgepodge system where someone arrives from overseas, they have very great difficulties with the language and they are in training. We have seen the terrible case in Bundaberg, but unfortunately that is not a Lone Ranger case in the state of Queensland, nor in other parts of Australia—but I refer particularly to North Queensland. So we have been left with a vastly substandard situation to what we had all the way up to the late eighties, and it has been exacerbated dramatically by the two-year qualifying period in a training hospital. The difference between a small town in North Queensland and a place like Townsville, Cairns, Mount Isa or Mackay is that most of the smaller centres do not have training hospitals. Most of them have single-doctor operations and there is no training, so they cannot get a provider number. That is the problem. We would present this firmly before the government, saying: ‘Do something about this.’

The Australian Medical Association trade union—and heaven knows they are the most powerful in Australia—stopped many doctors from coming into the country and stopped any new medical schools from opening. I might add that, thanks to the wonderful work by Michael Wooldridge and particularly Ian Ronski, Lady Logan and Mary Jane Streeton—they were most actively involved; there are many others whom I should thank—the first medical school was opened and in four years time an extra 160 doctors will come into the marketplace in North Queensland. We now have nearly 100 coming into the marketplace each year, but it will go up to 160. We most sincerely thank the government, Minister Wooldridge and Minister Abbott, who increased that number to 160.

But there is a huge problem out there that is not being addressed—that is, this two-year qualification period, which we are discussing today. It works in completely the opposite way that it should work. Instead of it ensuring that we get good and highly qualified doctors, it absolutely ensures that we never get good and highly qualified doctors, because they have to go to the big centres to get their qualifications. They cannot go to country centres to get their qualifications, so we lose them. This is a serious matter and it needs the attention of the government. People will die, as they have, as a result of government inaction on this matter. It requires standing up to the AMA, I think. That is not an easy task for any minister, but I am quite sure that the minister has the ability to manoeuvre through these waters. We need to get back to the situation where doctors in all those towns are linked in with a superintendent in a big hospital in, say, Innisfail, Mount Isa, Cairns, Townsville or Mackay—wherever the big hospital is—and are able to ring up if they have any difficulties. If they are working in a ward, they cannot go running up the ward every five seconds to ask another doctor for assistance. Really, in this time of great telecommunications, we can do this just as well in a small town where the doctor is linked to a big hospital as we can where the doctor is working in a ward in a hospital. There is no necessity for this imposition. We plead with the government to review the situation.

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