Janelle Saffin (Page, Australian Labor Party) Share this | Hansard source

I strongly support the Health Workforce Australia Bill 2009 and in fact welcome it because it will address some major gaps in health workforce planning and service delivery. I commend the Minister for Health and Ageing, Nicola Roxon, for her good work in getting this bill to the stage where it is before the House and for the work she has done through COAG in securing those agreements, which will be vital for the operation of the HWA when it is set up.

Through this bill, the Rudd government will establish a national health workforce authority. It is an example of the cooperation that is required between the Commonwealth and the states to address some of the outstanding, long-running issues around health—around demarcation, who does what where, who is funding what and some general service delivery issues. It will be called Health Workforce Australia, HWA—another acronym, I know. I am afraid every area is replete with them. HWA is part of the $1.6 billion health workforce reform package agreed to by COAG in November 2008. HWA will, among other things, manage the majority of initiatives under this particular COAG package. The character of HWA will be that of a statutory authority under the Commonwealth Authorities and Companies Act 1997, commonly referred to as the CAC Act.

I now turn to why this new body, HWA, is needed. I will then move on to its specific role and comment on its salience to, and impact on, rural and regional Australia. I will then make some general comments. Before I do that, I would like to associate myself with some of the comments made by the member for Lyne in his contribution, particularly about the Garling inquiry. I appeared before that inquiry and gave a written submission on what the member for Lyne was talking about—the resource distribution formula. Under this formula, the North Coast, of which my seat of Page is a part, will be underfunded by a certain percentage—that is, according to the information on the New South Wales Department of Health website. This has an impact on service delivery for the North Coast Area Health Service. The figure is somewhere between $20 million and $40 million—because there is no absolute agreement on the percentage by which we are underfunded. Over the years, there has been a ratcheting-up of the North Coast in that area, but it is not enough. It would be good to see NSW Health make some announcements on corrective action in that particular area.

Health workforce planning has suffered generally from a lack of targeted planning, a lack of coordination and a lack of a unitary body that can operate across sectors and jurisdictions. Over the years, I have seen some well-meaning projects aimed at securing more doctors and nurses for rural areas. Some of them have been successful and some of them have not—most often, they are in the latter category. There have been some state and territory schemes, but there is no overarching national approach—particularly over the last decade, when the need for doctors, nurses and other health professionals was escalating. There was an axing of GP training places and a big reduction in the amount of money that the Commonwealth put into the Australian healthcare agreements. The contribution from the Commonwealth went down from 50 per cent to about 43 per cent. This reduction in funding certainly had an impact on the public health system, particularly the public hospitals, to which a lot of the dollars from the Australian healthcare agreements go.

We have all seen in our own local areas and nationwide a doubling in the number of presentations at hospital accident and emergency departments. All local members would be familiar with that. The numbers have almost doubled in most places. There are a number of reasons for that. It is about the lack of funding that is available, but it is also about changes in the work practices of GPs and medical health professionals in our communities. There was a time when some doctors were always on call and you were able to access them out of hours, but that has changed in a lot of areas as well. There is so much in health that needs to be redressed, addressed, corrected and fixed up. There are matters that have been left unattended by a range of governments, particularly the previous government, whose policy laziness astounds me. Since we came to government , that is one of the things I have been discovering more and more of.

The creation of this new single body, HWA, will address some of the gaps that I have outlined above. It will address them in a formal sense and I hope that it will address them in an informal sense as well. That discussion needs to happen on a daily basis so that some of these issues can be addressed in our communities. HWA will operate across both the health and education sectors, sharing jurisdictional responsibilities. It is essential to have effective coordination and integration of workforce planning and policy, running in tandem with the complementary reforms to education and training. This will cover integrated clinical training arrangements and, critically, support workforce policy and planning for the future.

In addressing why HWA is needed, I have covered some of its role but I take this opportunity to elucidate on this point. HWA will comprehensively plan, coordinate and fund pre-professional entry clinical training across all health disciplines. This training will, among other things, provide key support for coordination and supervision at regional and local health service levels. There will be new arrangements that attach clinical training funding to students in a range of settings—and they can be private or community—with payments to service providers. To support the training to universities and other accredited training providers, they can enter into arrangements with HWA so their own students are able to secure appropriate clinical training places. This has been one of those areas, one of those gaps.

For the first time, we will have a national body charged with taking a national approach to health workforce policy and that will be able to provide advice to ministers on health workforce issues. We will also have improved national health workforce information and a national workforce statistical resource developed that will have some cogency and some credibility to it. Back in early 2008, when I was pursuing the matter of Lismore’s status as an area of need vis-a-vis doctors, I found that the figures that the previous government used for health workforce planning—particularly in rural areas—were based on 1991 census figures. That says it all, really. The figures were so out of date that they had no relationship to reality.

Finally, and most importantly to me and the people of Page, will be the impact of the establishment of HWA on rural and regional Australia. One, HWA will assist and improve access to services in rural areas by delivering more doctors and nurses. We know that is what we need, but we need a range of other specialties and allied health professionals as well. I hope that HWA will be able to work on these areas. Two, it will provide those doctors and nurses with better support while they train. Three, HWA will facilitate more opportunities for expanding clinical training arrangements in rural locations, and that is a good thing. Four, HWA will provide greater opportunities for skills development in the rural based workforce. I will give an example of a local issue I am dealing with, in Urbenville. The honourable member for New England and I share Urbenville.

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