Lucy Wicks (Robertson, Liberal Party) Share this | Hansard source

I rise to also speak on the Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021, because it does provide some additional flexibility to help improve the operation of the statutory Bonded Medical Program and the Medical Rural Bonded Scholarship Scheme contracts. The amendments will ensure that the program continues to benefit participants and ensure that its key objectives are achieved.

The government currently funds a range of initiatives to help attract medical professionals to and retain them in rural areas across Australia, including this program, the Bonded Medical Program, which commenced on 1 January 2020. The program provides a Commonwealth supported place in a medical course at an Australian university in exchange for participants completing a return-of-service obligation by working as a medical practitioner in a regional, rural or remote community. This helps to deliver higher numbers of GPs and specialists to areas of workforce shortage, which is particularly important in areas like my electorate of Robertson and right across the Central Coast—and I note the member for Dobell referred to this earlier, in her contribution—where there has been a shortage of medical professionals, and particularly GPs, for some time.

This has been going on for much longer than the eight years the member for Dobell referred to. It has been going on for a very long time on the Central Coast. There have actually been a number of reasons for that, and the government over the last eight years has been taking a number of steps to specifically look at addressing the shortage of GPs on the Central Coast. We have had success in the areas that we have been tackling, including, thanks to the now minister, a task force to help address the shortage of GPs on the peninsula, for example. That task force helped to deliver a number of additional GPs to the area. But we know that there are challenges, not just simply in relation to DPA status. We have seen suburbs that have been given DPA—or district of workforce shortage, as it was called a couple of years ago—status, and then the shortage cleared up; it was no longer. There were sufficient GPs in that area. Then, if DPA status is given to another suburb, we actually find that that doesn't necessarily keep GPs in our local community.

I have a personal interest in health and wellness and making sure that our system is not only the best in Australia but the best in the world, and one of the things that I know is the importance of long-term primary care. Having long-term GPs here on the Central Coast is an important part of being able to solve this very challenging issue. It's one of the reasons why the government delivered the outstanding Central Coast Clinical School and Research Institute in the heart of Gosford, which opened earlier this year. It's a world-class medical research institute and university, which means young students will be able to train to be GPs and nurses. We want them to stay. We want them to love the Central Coast lifestyle so much that they actually stay, and over time I believe this will help address some of the shortages that we face in particularly challenging like the Central Coast.

As I was saying before, this bill will provide more flexibility to consider the personal circumstances of participants, such as allowing individuals to cease being a part of the program without penalty in the event of serious disability or death. This is one of the issues that key stakeholders and doctors have helped identify and seek to address. The amendments in the bill will also allow some legacy scheme participants to allow for more time to complete the return-of-service obligations. This will apply to certain long-term participants who would otherwise not be able to complete this program in the 18-year period allowed if they opted into the program. The changes also allow for breaches under the program to be more appropriately managed. It reduces the administrative penalty for each relevant breach from $10,000 to $1,000, assuring that it's appropriate and proportionate in the circumstances. The bill will also allow for appropriate administration of breaches of legacy Medical Rural Bonded Scholarship contracts by allowing the minister to waive penalties accrued by participants for breaches of arrangements prior to the start of the amendments. The changes will also enable the minister to determine if an individual who breaches their contract after the introduction of these amendments should have a Medicare ban applied.

We do know, as I referred to before and as the member of Dobell also outlined, there has been a real challenge in attracting and retaining GPs to the Central Coast for many years now. Since the coalition government came to office in 2013, we have been working on a number of important initiatives to help resolve this problem. I have been advised by the Hunter, New England and Central Coast Primary Health Network that the Central Coast currently has 339 general practitioners working in 92 practices. For a population of 337,000, this means there are only 100 GPs per 100,000 people on the Central Coast, which I understand is below state and national averages. This challenge will only become greater as several GPs in the Central Coast are retiring or are looking to retire in the next few years. Some general practices have advised they've got no other option than to close their doors because they can't find new GPs to fill these vacancies. As I said before, we do need a number of initiatives to help address this particular issue. We need short-term solutions to bring the required number of GPs to the Central Coast. We also need medium- and long-term solutions to make sure we're not always playing catch up—so when we solve the problem in one suburb or area it doesn't pop-up in another area. We actually want to address this in a holistic way.

While there are over 3,500 GPs graduating in Australia each year, very few end up deciding to live in a regional or rural area, and this is one of the problems we face in the Central Coast, and that is why the Bonded Medical Program is so important. It gives students the opportunity to live and work where they are needed most. In my own electorate, suburbs like Woy Woy, Ettalong and Umina Beach are classified as distribution priority areas, making them eligible for this initiative, along with Mangrove Mountain, Somersby, Kariong, Calga, Kulnura and also Wyoming. I know many GP practices in other suburbs across my electorate would welcome changes to the classifications of the Central Coast to enable more and future GPs to access this program because of the very real impact that it has.

The program also has a number of benefits for the higher education sector. I'm told the University of Newcastle normally hosts between 30 and 35 students with a bonded place, with some of these students entering their first year on the Central Coast. A spokesperson for the university told me: 'The changes in the bill are very positive in terms of increased flexibility for students and the long-term effectiveness of the scheme. We understand that they provide students with more flexibility and are more family friendly, which is very important for a university like Newcastle, where the majority of our students are mature age.'

The Morrison government is also investing in other projects to boost our medical workforce. Recently, as I referred to before, the Central Coast Clinical School and Research Institute building welcomed its first 170 medical students. This is something that was made possible following a joint investment, with the Australian government contributing $32.5 million and the New South Wales government and the University of Newcastle contributing $20 million each. In addition, the Australian government provided $12.5 million of transitional funding through the Department of Education and Training to help cover the costs of establishing the new medical and clinical schools. The school has recently welcomed over 700 students from the nursing program. This is just the start, with graduate entry nursing for international students, a master's in health economics, a master's in clinical exercise physiology and a master's in clinical psychology expected to be on offer from 2024. The University of Newcastle is also looking to offer a bachelor of public and community health, a new program that focuses on the integrated and community health needs of the Central Coast. The Central Coast Clinical School and Research Institute puts our region on the map as an area of medical excellence as well as forming part of our long-term strategy to attract and retain more doctors and professionals in our region.

The federal government is also undertaking an exceptional-circumstances review process for the Department of Health's distribution priority area classification system. I know this is very, very much welcomed on the Central Coast. It's going to provide an opportunity for changes to the Central Coast population and other factors to be assessed, and it allows GP clinics in non-DPA areas to apply for an exceptional-circumstances review, which is something that I know is very welcome at a number of local GP practices on the Central Coast. This review will help clinics recruit doctors to care for communities like the Central Coast.

In addition to this work, the Hunter New England and Central Coast Primary Health Network has been working to attract and retain GPs to our region with a number of bespoke incentives, support networks and programs. I'm delighted that from August this year the Central Coast has now become home to 33 new GP registrars commencing in our region. These new doctors have been distributed across the Central Coast region, and they will help to deliver better health services for local residents.

This bill allows for more appropriate and efficient administration of the Bonded Medical Program to meet and support the needs of the modern workforce, a workforce of medical professionals providing crucial health services in regional, rural and remote Australia. This couldn't be more important at a time like this. I commend the bill to the House.

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