Maria Vamvakinou (Calwell, Australian Labor Party) Share this | Hansard source

My grievance tonight is on the issue of access to GPs in my electorate, the material workforce shortages we're experiencing, and the large decline in bulk-billing access. This issue is especially important to me because there is no historical ambiguity when it comes to public health policy in this country—that is, Labor built Medicare and will always protect it.

As we've all seen in communities right across Australia, after nine long years of cuts to Medicare by the former coalition government, it's never been harder or more expensive to see doctors than it is now. The former government froze the Medicare rebate for six years, ripping billions of dollars out of primary care and causing gap fees to skyrocket. We're seeing the impact of material workforce shortages in my electorate, where doctors are walking away from general practice in droves.

The Tullamarine-Broadmeadows catchment, which takes in other suburbs across my electorate, is experiencing a severe GP shortage. A true count of GPs in the area by one of the largest players in the catchment shows a 0.71 GP full-time equivalent per 1,000 residents—that's less than one GP per 1,000 residents. I'm aware that there are measures that speak to a 1.1 benchmark, but the reality on the ground in my electorate is that we're experiencing something very, very different.

There's also another concerning consequence of the almost decade-long neglect from those opposite, and that is the large decline in bulk-billing access within our community. The workforce shortage combined with funding models has caused a supply-demand imbalance in the area. It's my understanding that, in the last three months, seven clinics representing around 30 per cent of all GPs in the Tullamarine-Broadmeadows catchment switched from bulk billing to mixed or private billing. It is also my understanding that all major bulk-billing clinics in Craigieburn, which is in the 33rd percentile on the index of relative socioeconomic disadvantage, have now switched to mixed billing. As this trend continues, it is likely to soon impact suburbs such as Broadmeadows, one of the most disadvantaged areas in Australia. For context, Broadmeadows is in the 2nd percentile of the index of relative socioeconomic disadvantage. Most recently, a nine-person GP clinic switched from bulk billing to private billing in Broadmeadows.

I'm deeply concerned that the remaining bulk-billing clinics, as well as bulk-billing GPs in mixed-billing practices, will increasingly switch to charging fees. My electorate can't afford this, and the health of our community generally—and also locally in my area—cannot afford this, which is why I'm calling for an urgent review of the distribution priority access status for the Tullamarine-Broadmeadows catchment and request it be granted full DPA status. While I recognise that DPA is only a short-term measure and it will take a long time to secure GPs, I believe the area urgently requires this change. The Australian Labor Party is the party of Medicare. The previous Morrison government abandoned GPs and primary care and decided that dealing with the crisis they helped create was all too hard. Speaking to the crisis in general practice in Australia, the Australian Medical Association stated during the term of the previous government: 'This is the product of deliberate government policy over many years that has taken general practice for granted.' And in reference to the Morrison government's failed budgets, the AMA said that the budgets those opposite put forward to the Australian people were all rhetoric and no funding, with more of the same.

I would say that the attitude of those opposite to general practice and to the health and lives of the Australian people can be summed up by a word that comes up time and time again when it comes to their record of achievement in this area, and that word is 'neglect'. Neglect has caused so much damage to the wellbeing of Australians across nearly a decade and to many in my electorate. So I'm pleased that such a difficult issue in my electorate is, at least, being addressed by this government, and I want to thank the Prime Minister and the Minister for Health and Aged Care, the Hon. Mark Butler, for hitting the ground running and tackling the day-to-day concerns of Australians especially in health. The minister for health is speaking of real investment into Medicare to start to deal with the real crisis in general practice which he has described as probably the most terrifying of a range of real pressures in the health system. This is a marker of a government that explains the reality as it is and of a minister who is aware of the real state of crisis that general practice is in at this very moment. Contrast this with what I can only describe as the near decade of generalised neglect from those opposite.

We've committed to investing in general practice and to strengthening Medicare with almost $1 billion of investment. Our Strengthening Medicare Taskforce has already started to identify the best ways to boost affordability, improve access and deliver better support for patients with ongoing and chronic illness, and this work is backed by the $750 million Strengthening Medicare fund. Our 50 Medicare urgent care clinics will take pressure off our overwhelmed hospital emergency departments and make it easier for people to see a doctor when they need to see one. After they have worked tirelessly throughout the pandemic, we'll give our doctors the resources to invest in their GP practices with our $220 million Strengthening Medicare GP Grants Program. Of added importance to the people of my electorate is that, through Labor's cheaper medicine policy, we've made the biggest reduction to PBS medicine prices since the scheme was established.

I acknowledge that there's no easy fix here. These are problems that were created and compounded over a decade, and have been over a decade in the making. A constituent of mine, a resident of Craigieburn in my electorate, notes:

Most bulk billing clinics around Craigieburn & surroundings are not entertaining new patients and even applications like HotDoc don't allow appointments to be booked to see GPs, which is really bad and taking away the rights of a patient to consult a doctor.

Most bulk billing clinics have changed to mixed billing in the last few months & now demanding more money from patients. It's just not acceptable and is a serious issue which requires our attention.

Another local resident highlights that, with the increased cost-of-living crisis, we cannot have patient access to medical care become another cost-of-living issue. It is these voices of grievance that I want to raise in this parliament, because their contribution to the debate is one that is most grounded in reality.

While acknowledging the abandonment of the primary healthcare space by the former coalition government, I do believe that clinics also have a responsibility to their patients. First and foremost, they must factor in the realities of the people and the communities in which they operate. The easy option of switching to mixed or private billing cannot be the immediate fallback position. We must all carry responsibility, in the interests of patient care, and this responsibility must also be carried by our primary healthcare providers, because every person in my electorate deserves access to universal, prompt and world-class medical care. It's almost an established fact that general practitioners aren't being drawn to work in what are described as 'peri-urban' areas. This reality is a social justice issue for the people of my electorate. It's a reflection of a shared reality from lived experience.

What makes this even more damning is the number of overseas trained doctors who live in my electorate who, if not for the difficulties associated with having their skills recognised, would otherwise help fill our shortages. Australia's medical bodies need to take a closer look at this. It's an issue which must be addressed because it's an issue that means we are missing out on the possibility of addressing our workforce shortage.

The disparity in health outcomes between wealthier areas and areas of socioeconomic disadvantage is a reality, but we must be determined to address the fact that just because something is a current reality doesn't mean it is a given or must be allowed to continue. Disparities and determinants of health must be addressed, and addressed in a way that draws a line between the near decade of neglect from those opposite and a Labor government that invests in the health of everyday Australians.

The universality of Medicare is one of the Australian Labor Party's greatest contributions to Australia. Our fundamental believe is that it's your Medicare card, not your credit card, that should determine your access to health care in Australia. Just as every new Labor government in Australia has had to do, I am confident that cleaning up the mess left by the former coalition government in this area will be among of this government's greatest works and one of its greatest ongoing contributions to the people of my electorate and this country.

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