Graham Perrett (Moreton, Australian Labor Party) Share this | Hansard source

I too rise to speak on the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009. Like many people in the House, I have been waiting all year to speak on this piece of legislation. The purpose of the bill is to amend the Health Insurance Act 1973 to remove the restrictions which apply to New Zealand permanent resident and citizen medical practitioners who obtained their primary medical education at an accredited medical school in Australia or New Zealand and the specification in the act that the period of 10 years during which overseas trained doctors are restricted from accessing Medicare benefits must commence from the time the doctors become permanent resident Australians, even if they became medical practitioners prior to gaining that residency status. The bill also introduces a time period in which medical practitioners can appeal against a refusal to grant a section 19AB exemption or a decision to impose conditions in connection with an exemption which has been granted.

For New Zealand overseas trained doctors, this will be a welcome administrative clean-up, but, taken in the context of the Rudd government’s commitment to making changes in health generally, this will lay down one more plank in a nice solid platform for the Australian public. There are some scary facts out there, such as the reality that the very first baby boomers will be retiring next year—or will be eligible for the pension next year; I guess some will have retired beforehand. The people from the late World War II and post World War II baby boom in Australia—and around the world, but I am talking about Australians in particular—will be confronting our health system in great waves starting from next year. So it is important that we get our health system prepared and ready for the realities of an ageing Australia and, unfortunately, a slightly unhealthier Australia.

The member for Griffith, the now Prime Minister, Kevin Rudd, made a commitment in the lead-up to election night in 2007 to end the blame game when it came to health, to end the playing of politics in health and to instead deliver something which is in the nation’s interests and which saves and changes lives. We are not the sort of government to make political decisions like the decision to take control of one single hospital down in a marginal seat in Tasmania. We are not a government that believe in that sort of thing. We believe in preparing the nation for some challenges that are ahead.

To that end, we have had 80-odd health forums around Australia conducted by the Prime Minister; the Minister for Health and Ageing; the Minister for Ageing, Justine Elliot; and many other ministers. Below that, we have had another 80- or 90-odd other health forums conducted by backbenchers. I was fortunate enough to be with Minister Justine Elliott at the PA Hospital on the south side of Brisbane at one of these health forums, and the mood that was in the air and the way people responded to this government that goes out and talks to the professionals, the people at the coalface, about what their concerns are—their challenges, what they are doing well, what the opportunities are and what the threats are—were incredible. That was a great forum with Minister Justine Elliot. I had another at the Mater Hospital, also on the south side of Brisbane, with Prime Minister Kevin Rudd—it is his local hospital, but it services all of Queensland and particularly the south side of Brisbane—and Health Minister Nicola Roxon. I did my own health summit as well in my electorate office. I would particularly like to acknowledge the great work done by the Southside Division of General Practice, who provided me with great insights into some of the challenges on the south side but also some of the things that we are doing well and should continue to do and maybe pour some more money into.

It is one thing to talk to the people; it is another thing to actually do some real good. Obviously, money talks, and that is why the Rudd government poured money right from the word go into addressing some of the waiting lists that have grown over the last few years as the Howard government ripped over $1 billion—it is quite criminal really—out of the hospital system. They were happy to play politics with health, to say that it was a state issue and it was all the states’ fault. But, at the same time as they were pointing at the states with one finger, they were then reaching around and taking money out of their back pocket with the other hand. That is what they were doing, playing politics with the health system, and, unfortunately, that means playing politics with people’s lives. It does not take long to wander around a hospital to find people whose lives were changed significantly by the fact that their health system had been underfunded certainly in this century, in this decade, under the Howard government.

If we kept increasing the money going into health at the current rates, we would end up with a health budget and no other budget—no defence, no education, no support, no arts, no culture; it would all be health—so we obviously cannot continue to do that. As I said, we have got an ageing population and people are having fewer children. Disturbingly, people are also becoming quite unhealthy. I saw some data the other day saying that prepubescent girls are actually some of the fattest people in the world. Australia has got a gold medal in something like that, a gold medal that we should be ashamed of. It is scary to think that in 2009 we are creating a generation that will have a shorter life expectancy than ours. It is not something that we as a nation can be proud of. It makes us unworthy of the title of a civilisation if we are not able to produce a healthier lifestyle and children with a brighter future. We are getting something horribly wrong. Throw into that something like the Carbon Pollution Reduction Scheme, which is hovering around over in the red chamber, and we can see that we really need to get things right for the next couple of generations.

So what do you do? In terms of remedying that dreadful health diagnosis, you train more doctors and dentists. Both of those courses have been underfunded. But obviously that takes time. I would like to commend one of the universities in my electorate, the Griffith University, for what they have done in taking on medicine. But it takes time to turn a student into a doctor, a GP out there and able to save lives and change lives. It takes many, many years of study and then many years of training on the job.

So what else can you do? You can do something about prevention. A dollar spent on prevention is not the same as ‘a stitch in time saves nine’, but a dollar in time can save five or six dollars; that’s for sure. So we need to put more money into prevention. At the moment, if we look at our health budget, only about two per cent actually goes into prevention. When you look at the increase in chronic diseases, things like heart disease, diabetes, and chronic obstructive pulmonary disease—that is basically to do with the lungs and is connected to smoking or some workplace exposure or maybe even pollution—they are all on the rise. But, thankfully, we are able to combat those increases by a little bit of education and a bit of targeted activity.

I think we are guilty of having some poor workplace practices in this building. Perhaps we do not make the option of exercise something to be embraced by parliamentarians, as it should be. It is good to see that there are people who do set the right example. The reality is that we need to change our community’s approach to these chronic diseases. Too many people are dying too young because of preventable diseases.

I turn to the legislation before the chamber. We are particularly focusing on New Zealand overseas trained doctors. However, I would like to digress and mention the fact that overseas trained doctors from places other than New Zealand have made a significant change to Australian culture. Why? For a start, most of them are in rural and remote areas. If you look at the recent survey, you will see that 3,028 overseas trained doctors are working in general practice—1,068 of them being in capital cities and 1,437 in rural and remote areas due to district workforce shortages. That is a nice little figure that presents itself from the legislation. I know, coming from a country town myself, that doctors are seen as very significant people in communities. They are some of the better paid people, especially in rural communities, and what they say has sway on how the community treats people. It has been quite a cultural shift for the bush to have these 1,437 overseas trained doctors working in rural communities. It has meant a great stirring of Australian culture because so many of our bush traditions and rural traditions have now been melded and stirred and mixed in with these other traditions from all over the world.

A Zimbabwean doctor of Pakistani descent, say, can be working in rural Queensland and suddenly they have to find a mosque or some sort of way to pray and mix in with the local community. It has been a great insight into how open Australians are to change. Most Australians—97 per cent—come from overseas. So to have these rural communities suddenly having these influences from all around the world inside their community with these significant people—and they are doctors; as I said, they are very important people—augers well for the definition of what Australia is. Whatever that definition is, it is a much more lively and entertaining definition now because of the influence of these overseas trained doctors.

Obviously the legislation before us is about remedying a wrong and making sure that New Zealand overseas trained doctors are looked after as well as possible so that they can continue to do the great work in their communities. About three per cent of my electorate comprise people of New Zealand birth, which is about the norm for most electorates—except perhaps in Bondi or some places such as that where it might be higher. We have such a close connection with New Zealand. I am sure one day they will forgive us for the underarm bowling incident.

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