Michael McCormack (Riverina, National Party) Share this | Hansard source

We should thank our nurses each and every day—not only our nurses but our pharmacists and our doctors. Anyone who puts on scrubs and goes into a theatre ward and anyone who serves our hospital system or our medical system needs the applause and the gratitude of this place and of Australians right across the nation.

I'm one who listens very carefully in question time. This government is now nearly four years old. For four years, the Labor government has been blaming the Morrison-McCormack government in particular and previous coalition governments per se for the financial stresses it claims it's under. They exaggerate the figure. Yes, we did have a debt, that debt born out of a global pandemic the likes of which we had not seen since just after World War I—which, of course, ended in 1918. We did what we could. We spent the money that was needed to keep people in jobs and, more importantly, to keep Australians alive—not just Australians but our Pacific neighbours and friends as well.

Through those Morrison years, there were more than 94 million telehealth consultations through Medicare, with 16 million patients, and that was a significant achievement. Speaking as one who comes from rural and regional Australia, we don't ever want to see telehealth replace hands-on medical professional care. It was necessary during the COVID years and it's necessary at any time, but, particularly in remote Australia and in Indigenous communities, we don't want to see telehealth replace a person who can give a consult. During the Morrison years, from 2019, 857 new medicines were listed on the Pharmaceutical Benefits Scheme—another significant achievement. There were 1,400 additional nurse placements for the regions, and that is something that we should also be very proud of as a former coalition government.

The Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 is about empowering nurses. The bill worries me as one who comes from the regions and as one who wants to see nurses being the best they can be, just like pharmacists were, and we empowered those during the COVID crisis, when it seemed that the AMA, the Australian Medical Association, wanted only doctors to issue vaccinations when we knew that in some rural communities the only health professional in town was a chemist. That chemist needed to be able to issue vaccines as well. It just made good sense. And the member for Barton, in her contribution, talked about the fact that in some regional communities a nurse is the only health professional in town, and she's right. Sadly, she's very accurate.

But, as the member for Mallee quite correctly pointed out in her earlier speech, the first order of business of this federal Labor government in the medical field was to change the distribution priority areas. That saw doctors operating in some regional communities take their shingle from the wall and move to Newcastle or Wollongong or the Gold Coast or anywhere but regional and remote Australia, and this was wrong. They were making money. They were providing a level of health care second to none, but they saw the opportunity to move to the coast and did so, and good luck to them. But as the national rural health reporter Steven Schubert of the ABC wrote in an article from 15 December 2022 headlined 'Rural doctors say they are losing staff to big cities due to policy change':

Annette Pham thought she had recruited two doctors to work in her GP clinics, but a policy change in Canberra resulted in both of them pulling out almost overnight.

Ms Pham and her husband own four GP clinics on the New South Wales south coast, all within a few hours' drive from Sydney and on some of Australia's best beaches—

no question there. The article continues:

"We had two that pulled out officially after signing contracts," she said.

"Then we've had probably a further three that looked at our practice, they looked at other practices and they inevitably decided in the end that they would stay in the city."

That is a problem. The article also says:

Rural Doctors' Association of Australia (RDAA) chief executive Peta Rutherford said the organisation was getting reports the policy—

this is the distribution priority areas policy moving the boundaries such that it takes in those areas I mentioned before, Newcastle and Wollongong and the Gold Coast et cetera—

was going to have an impact on rural communities before it had even been implemented.

Well, if that was the fear before, it certainly ended up being a reality afterwards. And it is true that doctors took their practices and took themselves and moved to other areas of Australia, more populated areas of Australia, areas of Australia where there are more doctors. Unfortunately—and I don't blame them; I blame the government—what this policy meant was that regional areas and some particularly remote areas then got left high and dry as far as doctors were concerned.

I also will recall the health minister talking about bulk-billing rates, which we know, because it was quoted so many times in the House of Representatives last year, dropped by 11 per cent under Labor to 77 per cent from the previous 88 per cent under the coalition. He was talking about rural people, and he said that if they can't get a doctor's appointment, they could pick up the phone and try another doctor. That might all be well and good in Adelaide, but it doesn't cut the mustard out in country towns because you're lucky to get a doctor bulk billing or otherwise. You're certainly lucky if you can get a bulk-billing doctor.

I know Labor will pat themselves on the back and say: 'Bulk-billing rates are something that is a priority. The GP aftercare clinics, the urgent care clinics—we're rolling them out across the country.' Yes, they are but in Labor electorates and in electorates that they want to win. We heard the member for Lyne talking about Taree, and I do hope Taree gets one of those care clinics because it's needed and not just in Taree but in many other regional communities as well. They are needed and they are good. I will acknowledge that they do fill the gaps of the state public health system and the overall medical system where people often do need, particularly after hours, to take babies and children when there is no other doctor available, and that is saving lives. I acknowledge that.

But what we are talking about here is nurses being given more scope to provide medicines to do what sometimes ordinarily would be the job of the local general practitioner. I do wonder what the AMA thinks of this. I know that a lot of the legislation that Labor is bringing to this place and has done since May 2022 is often rushed. There's often not the stakeholder engagement that you would expect in important nation-changing legislation, and that is something that truly troubles me.

I know that the member for Mallee, who happens to be married to a doctor, said that the Nationals—indeed, the Liberals too—want to rectify the poorer health status of regional Australians. I know that would be a goal as well of Labor members. Surely that's something that would be across the board. It's a status driven in large part by poor access to health services in the bush. Sadly, we people in country Australia don't live as long as those who live in metropolitan Australia who have closer, better and more diverse access to health services than those who live a long way from the city lights. We as a party, and I will say as parties of coalition, are committed to supporting regional communities and driving policies and programs to improve the health status of regional Australians. Again, I say that I know that would be a goal of Labor too. It would be silly to say it's not, but health has to come above politics. It truly does. I know when I entered this place in 2010, I was told by more than one person that if you get the health of your community right, it provides that happiness factor, that satisfaction factor, and everything else will seem to take care of itself. Indeed, that is the truth.

This bill seeks to grant eligibility for Pharmaceutical Benefits Scheme rebates on medications prescribed by a new category of prescribers, and they're called authorised nurse prescribers. As I understand, there will be training for those authorised nurse prescribers. Whether the training for six months is sufficient—I'm certainly not in any way, shape or form denigrating those nurses and the work that those nurses perform, whether they are young, freshly out of the system and straight into the hospitals, the practices or the clinics or whether they have been there for decades. I certainly do not in any way put criticism on what they do because the care of their patients is first and foremost.

The government's proposed authorised nurse prescribers will be registered nurses with additional training who work in a collaborative arrangement with an autonomous prescriber professional who can already prescribe independently, expanding the scope of practice for a registered nurse. Labor is proposing this new model of prescribing in Australia. Nurses who meet these criteria are not expected to be qualified to prescribe until the middle of 2026, but that's only less than six months away. That's not far away in the scheme of things. So I do wonder and I do question, as with much of what Labor introduces, whether it's policy on the run, whether it masks a more serious situation—and that is the lack of doctors practising in Australia. I would like to think that Labor would not be using this as a trojan horse to not then provide the necessary funding, ongoing support, for such things as the medical schools.

I will say that the Murray-Darling Medical School Network is going tremendously well. I know that in Wagga Wagga, in Bendigo, in Mildura, in Shepparton, in Dubbo and in Orange it is actually answering and fulfilling a need that was there. I'm so glad that I was able to, with former health minister Greg Hunt, fund that vital network of services which are provided in just about every town and city. The former minister for education is now taking the credit, and he played a part too, so I do thank the member for Wannon. It was a coalition initiative. Indeed, every one of those facilities, in every one of those centres I mentioned, is producing 20 to 30 new doctors—well, they will be when the doctors graduate; of course we know that takes some years. It certainly started under the coalition government. I know that Mike Freelander, the member for Macarthur, came and opened the one at Wagga Wagga late last year and gave some generous words. He knows that we need to be more bipartisan when it comes to health, because health is everything.

There are some conditions and there are some parts of this legislation which do worry me. I know the member for Mallee has set out her concerns, and I know that each and every regional member would also, understandably, share some of those issues that this legislation has in it.

See this speech in context