House debates

Wednesday, 17 June 2020

Bills

Health Insurance Amendment (Continuing the Office of the National Rural Health Commissioner) Bill 2020; Second Reading

6:05 pm

Photo of Anne WebsterAnne Webster (Mallee, National Party) Share this | Hansard source

Absolutely. We have reached a crisis point. In September 2019, I convened a health forum with senior representatives of a number of local health organisations from across the Mallee. It came as no surprise that the most immediate concern from all involved was the lack of workforce. That is why it's so important to me that we implement the changes and the strategies to address the inequity that exists in the healthcare system. It's simply not okay that a person's location determines their access to health services and therefore their quality of life. But at the moment it does. That is why I am pleased to see the continuation of the Office of the National Rural Health Commissioner that will support the government to address the challenges of regional healthcare delivery.

Since its establishment in 2017, the office has delivered valuable outcomes for regional and remote Australia The office brokered the landmark Collingrove Agreement to develop a framework for the rural general subspecialty and delivered advice to the government leading to the $62.2 million investment in the National Rural Generalist Pathway. The office has since progressed the pathway by working with GP colleges to apply for subspecialty recognition for rural generalism within the field of general practice. More recently, the office has been investigating options to improve access to allied health professionals in rural communities and has worked closely with local doctors and health professionals in communities to prepare and respond to the COVID-19 pandemic, particularly through the rollout of the GP led respiratory clinics.

The rapid establishment of these respiratory clinics has been welcomed in Mallee, with three clinics opening: in Mildura, Horsham and Swan Hill. In Mildura, a clinic led by Sunraysia Community Health Services was the first in Victoria to be funded as part of the government's plan to establish 100 respiratory clinics across Australia. By taking pressure off the hospital and local GPs, this clinic has delivered enormous benefits to the community. In just over one month, the clinic triaged 528 telephone consultations which led to 345 GP appointments and 326 tests for coronavirus.

Lister House Medical Clinic in Horsham was chosen to operate the respiratory clinic due to its exceptional standing in the community. Lister House has been operating in Horsham since 1946 and is one of the original GP Super Clinics in Victoria. Its status as the biggest clinic in the Wimmera-Grampians area positioned it to be the best candidate to operate a respiratory clinic next door to its current building. Swan Hill District Health Service is operating the Swan Hill clinic, and I was pleased to meet with the CEO, Peter Abraham, and visit the clinic recently. It has been widely welcomed in the community.

The requirement for social distancing has created many challenges for accessing healthcare services, and the government responded with a significant shift to telehealth. I also acknowledge that GPs in Mallee have applauded the $669 million expansion of Medicare-subsidised health services. What needs to be understood is that a 10-year reform of telehealth occurred in 10 days. From March to May, over 11 million telehealth services were delivered by 70,000 providers to almost six million patients. By significantly reducing the level of physical interaction between patients and health practitioners, we have been able to slow the spread of the virus to our most valuable frontline workers and to vulnerable members in our communities.

With the surge in telehealth, we have seen a proportionate reduction in transport costs, accommodation costs and time out of work and away from family. Sentiment among family members is absolutely positive. It is also vital that telehealth subsidies remain in place after COVID-19. Telehealth has the potential to transform regional healthcare delivery, to be part of the answer, and I am working to keep it a national priority going forward.

The new, and now permanent, Office of the National Rural Health Commissioner will take a broader perspective on rural health reform, with deputy commissioners enabling the office to have expertise across a range of vital rural health disciplines, such as nursing, allied health and Indigenous health. The office will support the government's work to deliver major reforms, including providing a rural focus for primary healthcare reform, the National Medical Workforce Strategy and considering the review of the Rural Health Multidisciplinary Training Program. The office will also continue to play a key role to progress the National Rural Generalist Pathway.

Continuing the Office of the National Rural Health Commissioner demonstrates the government's dedication to supporting better outcomes for healthcare service delivery in regional Australia. The government needs to work on getting the settings right so it can address the maldistribution of our nation's healthcare workforce. A number of government initiatives are delivering positive results, and this work needs to be continued and expanded. Take, for example, the Workforce Incentive Program, which provides targeted financial incentives to encourage medical practitioners to deliver eligible primary care services to rural and remote Australia. In Mallee, we are fortunate to have many overseas trained doctors filling positions. I am pleased that the Visas for GPs Program commenced in March last year. The program directs overseas trained doctors to areas in need of primary health services—in particular, rural and remote communities. Under this program, the percentage of overseas trained doctors directed to fill primary healthcare positions in rural, regional and remote communities has increased from 35 per cent in 2018-19 to 52 per cent as of 30 April 2020.

The Murray-Darling Medical Schools Network evolved from the hard work of the National Party and was announced in the 2018 budget. It aims to provide end-to-end training for rural students in rural locations across New South Wales and Victoria. The Murray-Darling Medical Schools Network is one part of the $95 million investment set up to work towards the train in the regions, stay in the regions program. The guiding logic behind this program is train local, stay local. We know that people from a regional city or town who can learn in a regional place have the best possible chance of graduating and staying in the regions to work. The network consists of university campuses in Wagga, Dubbo, Orange, Bendigo, Shepparton and Mildura.

I know that La Trobe University is doing fantastic work with their rural medical pathway program in partnership with the University of Melbourne. This is the first course to commence as part of the Murray-Darling Medical Schools Network. Under this course, 15 students from regional and rural areas will begin their studies at either La Trobe's Bendigo or Albury-Wodonga campuses and undertake a three-year Bachelor of Biomedical Science before going on to study a four-year Doctor of Medicine at the University of Melbourne's Shepparton campus. There are seven Mallee students undertaking this program in 2020. They are: Alfred, Isabella, Abdo, Abigail, Kunind, Maddie and Oscar. These bright young students already understand the unique challenges of healthcare delivery in regional Australia. Many of them have firsthand experience. It's clear that these students are passionate about making a difference to regional and remote communities.

Alfred, who was born in India, says he wants to travel Australia, working in remote communities and ultimately return to his hometown in Mildura to work locally. Kunind, from Mildura, wants to pursue a career in craniofacial surgery and hopes to bring this area of medicine to areas in rural Victoria. I wish him all success, as it will mean patients won't have to travel to a major city to receive treatment or wait for a specialist to visit. Maddie, from Milawa, wants to address doctor shortages by working with close-knit communities in rural and remote Australia. She ultimately aims to become a rural generalist or to work with the Royal Flying Doctor Service.

Abdo aspires to becoming a general practitioner to give back to his local community of Mildura by addressing the chronic doctor shortage in the area. Abdo is committed and passionate about addressing the inaccessibility of the doctors in Mildura. Oscar is from Cohuna and he wants to develop a dependable reputation and close sense of connectedness to a small rural community. He also wants to be a rural generalist and become experienced in as many specialisations as possible in an attempt to increase the breadth and efficiency of medical care delivered in regional areas.

I truly believe in the efficacy of local, regional training as a solution to the workforce challenges we face. My husband completed his internship and registrar year at the Mildura Base Hospital in the late 1970s. The hospital was a thriving teaching hospital at that time. It took just two years to complete and gave us, as a young couple, the opportunity to experience a regional town and become connected to a wonderful community. And here we are, 43 years later, having raised our family, who have remained local and are now raising their families in Mallee.

I also know that Monash University has developed a postgraduate course under the Murray-Darling Medical Schools Network. Starting in 2021, 30 students will begin the rural end-to-end program studying at Monash in Churchill. Students will then complete clinical training in rural and regional hospitals and community based practices, including Mildura. I look forward to welcoming these future students to the region. It is wonderful to know that La Trobe University, Melbourne University and Monash University students from Mallee are taking up these opportunities and I wish each one of them the very best in their career aspirations. I hope they're the first of many to achieve success through regional training programs.

These are the types of programs that will deliver real differences to the provision of healthcare services in regional areas like Mallee. I welcome the continuation of the Office of the National Rural Health Commissioner and will continue to address the shortcomings in regional and rural health care.

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