Rick Wilson (O'Connor, Liberal Party) | Hansard source

As the federal representative of 47 rural, regional and remote shire councils, I rise today to highlight an inequity that should concern all levels of government and all Australians. In the O'Connor shires of Lake Grace, Narembeen, Gnowangerup, Jerramungup, Ravensthorpe and Kojonup, local councils are being forced to fund access to primary health care because the existing system simply does not work in thin markets. Together, these six shires contribute more than $1.4 million each year in cash as well as housing, vehicles, surgeries and other support just to attract and retain a doctor. In some cases, that cost represents up to 16 per cent of their annual rate revenue. That money should be funding roads, community facilities, economic development and local infrastructure. Instead, it is being used to maintain primary health services that are a Commonwealth responsibility.

Last week the Local Government Rural Health Funding Alliance hosted a workshop here in Canberra, with more than 30 councils from across Australia coming together with the Australian Local Government Association, the National Rural Health Alliance and the Rural Doctors Association of Australia. Their findings were unanimous: local government has become the funder of last resort for primary health care in rural, regional and remote communities.

What stood out was how widespread the problem has become across Australia. WALGA reported that local governments are now contributing around $9.5 million each year to support GP services, with 91 per cent of that funding coming from councils with populations of under 5,000 people. These are the very councils least able to absorb those costs. The alliance's workshop revealed many more councils paying out hundreds of thousands of dollars per year covering housing, vehicles, medical premises, staff, locum doctor cover and even utilities.

In New South Wales, the Bogan Shire currently spends about $600,000 a year, almost 20 per cent of its rate income, operating its medical centre. The reality is that many rural Australians are paying out three times—once through their Medicare levy, then again through out-of-pocket consultation fees and finally through their council rates. Meanwhile, in metropolitan Australia, primary health care is funded, as it should be, by the Commonwealth. But, in the bush, this Labor government expects some of the smallest and most financially constrained councils to carry a responsibility that lies with them. Meanwhile, these same communities see a Medicare underspend of around 50 per cent per person of what is spent on a city dweller.

These rural communities are not asking for special treatment; they are asking for equitable access to health care. This government must recognise the challenges of thin markets and deliver targeted funding solutions for MM6 and MM7 communities like mine in O'Connor and beyond, because no council should have to choose between funding a doctor and building the infrastructure that its community needs to thrive.

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