Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

The Health Workforce Australia Bill 2009 seeks to establish a new statutory authority, Health Workforce Australia, to oversee clinical training arrangements across the health sector and support workforce planning. The government needs the bill passed before July so that the new authority, agreed to by the Council of Australian Governments late last year, can commence operation by January next year—a point I want to return to a little later. There is no doubt that Australia faces ongoing challenges in providing an adequate workforce in the health and aged care sectors. A combination of factors has led to these difficult circumstances. We have an ageing population that requires greater access to medical services, and we have an ageing and changing medical workforce. There has been an increase in chronic disease, community expectations have increased and some health professionals are working fewer hours.

The Minister for Health and Ageing blames the woes of the health sector on the previous coalition government—of course that would be the spin of this government. The simple fact is that the former coalition government began dramatically ramping up the number of education places for health professionals almost a decade ago—indeed, from 2000. We provided for significant growth in the number of medical graduates, nurses, dentists, pharmacists and psychologists emerging from our universities. At the time, it was quite amazing that the state health authorities in particular were lagging behind in training staff for their responsibilities in terms of the provision of health services. Even more amazingly, it remained the case over the last decade or so that staff retention rates were abysmal in relation to the provision of services by state governments.

Even today, that remains a continuing bugbear at many of our public hospitals and indeed in many areas around the country where health care is provided. Many health workers are working under situations of great duress. They are concerned about their work colleagues and they are concerned about trying to improve health outcomes for their patients. Indeed, many of them are working in an environment which is completely unacceptable. That has added to some of the current woes that the government find themselves facing in relation to workforce shortages, and it is something they need to continue to work on. At the last election they promised to end the blame game—and there is no better area than health for this government to demonstrate that it can provide good outcomes. But that was only an election slogan, and nothing has changed over the last 18 months.

There was a massive expansion to address the needs of the health workforce under the coalition government. However, as this government will find out, it takes years to deliver the graduates of universities and colleges to the front-line of health care. The government has promised major increases across all fields of the health workforce, but after 18 months in office its recruitment drives have been found wanting. The government’s plan to return 1,000 nurses to the workforce last year fell far short, with just 310 additional recruits. Media reports also indicated that the government had difficulty filling additional tertiary training places for nurses.

The Rudd government’s budget, which will drive this nation into deficit and debt for decades to come, contained more than a score of small under-the-radar funding cutbacks in health that may hinder the development of the health workforce over the coming years. One such cut pulled $30 million from a program supporting postgraduate research into public health, which drew criticism from the Public Health Association. Its president described the decision as a worry because the program was important ‘in terms of supporting and developing the public health workforce’. This cut hardly fits with the Prime Minister’s pledge to fix public hospitals by mid this year; a deadline that runs out in just over a month. Indeed, the minister and the Prime Minister may try to paper over their promise by telling Australians that they have fixed our hospitals, but no Australian patient, no family, no older Australian believes this government when they say that they have fixed public hospitals, because it has become all too apparent that Labor state governments continue to mismanage our public hospitals and fudge the figures to pretend that everything is okay.

This bill is largely technical in nature, establishing the authority in law, setting out its make-up, functions and scope of operations, but a scope that allows wide interpretation of its role once the agency is operative. As part of the debate it is important to highlight a number of concerns and to pose a number of questions to the government that need to be answered, not just as part of the minister’s summing up in this debate, but also, importantly, in relation to a Senate inquiry, which we propose to put a number of questions to the government about what exactly they are trying to achieve with this bill and, importantly, how they propose to address the concerns of stakeholders and industry groups and, ultimately, how this is going to deliver better health outcomes to Australian patients.

One question, of course, is: will it result in additional layers of administration and bureaucracy that will soak up valuable resources? That has been the hallmark of the delivery of health services at a state level over the course of the last decade; it is at the core of what is certainly a dysfunctional health system in this country and it is at the core of the continuing problems that this government has refused to address.

Another question that needs to be asked and answered by this government is whether or not this authority will try to usurp some of the responsibility of the colleges and some of the other organisations that seek to provide professional development to the professions around this country. I would be very concerned if this authority, once established, heads down the path that Labor has taken us at a state level over the course of the last decade. I would be concerned that, if this government’s priority were to manage the health system in a way that the states have managed the health system over the course of the last 10 years, they would head down a track where, instead of employing doctors and nurses and other health professionals, they embark on a policy of filling the back rooms—putting extra dollars, which should be spent on patients, into spin operations conducted in media units out of ministerial offices and, worse still, out of government departments.

Bureaucrats and administrators have added layer upon layer of officialdom in the nation’s public hospitals and health services. The consequences have been plain to see: failing hospitals, overworked health carers and not enough money for necessities for patients. In some cases, in that Labor jewel of New South Wales, there is not even enough money to pay for food for patients. In some cases in New South Wales, particularly in rural settings, public hospitals do not have the capacity to pay for drugs to treat patients. This is an unacceptable situation and it makes a mockery of the recent statements by the minister that she has fixed public hospitals and that the states have done enough to address the concerns that patients around the country have in terms of the services provided at public hospitals. As a federal level of government, we need to make sure that we do not embark down this same path.

At the very time that this government is cutting back on a host of health programs through measures in this year’s budget, it is planning to spend another $125 million on bureaucracy in this authority—$125 million over the forward estimates, four years, is a significant amount. Many people would argue that that money could go towards helping families who are struggling to pay for their IVF treatment; those who have really received a slap in the face from this government. This money could go towards helping people, particularly older Australians, who require cataract surgery. These are debates that are unfolding and they have a long way to go because the government has been on a huge spending splurge.

At the same time that Kevin Rudd has been handing out billions of dollars in $900 cash payments, he has been taking with the other hand from Australian patients. He is cutting back cataract surgery and he is cutting back the assistance that the federal government will provide to families who are trying desperately to bring a child into this world. That is something we will be talking a lot more about, because tens of thousands of Australians really have great concern about this government’s decision to rip the money out of this budget for the very necessary cataract surgery that needs to take place for older Australians and, of course, for that support to families who are relying on IVF.

The government needs to refocus their attention. They need to refocus their attention onto the patient and away from the bureaucrat. If we are going to bring improvements about in the health system in this country, we need to put money into front-line services. We need to make sure that the health dollar is not being spent—like it is in Queensland, New South Wales or Victoria—on bureaucrats instead of on nurses and doctors. This government certainly has shown all the signs of going down the same health management path that those state Labor governments have, particularly in New South Wales. There is no better example than New South Wales—a better example you could not find around the country. New South Wales has a government which has squandered billions of dollars that should have been spent helping patients and helping doctors and nurses to help those patients, to get better health outcomes and to help older Australians who want some sort of dignity in their ageing years—Australians who, before this budget, would have been able to get government assistance to have cataract surgery. They are the people we should be helping, not supporting a government at a federal level now under Mr Rudd and Ms Roxon who are adopting the same management style as Nathan Rees and Reba Meagher in New South Wales. We do not want to see the federal health bureaucracy managed in the same way that state Labor has mismanaged health over the last 10 years.

I say to all Australians, particularly to those in New South Wales: look at the way that Labor has managed health in your state system and remember that this is exactly the same path that Mr Rudd and Ms Roxon are following. These people are not good for health in this country. Mr Rudd and Labor pretend to be the friend of patients in this country but they are not. Look at the outcomes in public hospitals around the country. Look at the outcomes for older Australians in aged care facilities right around the country. Our very own Australians are suffering at the moment because the government, at both the federal and state level, are spending more in the area of health and ageing on bureaucracy than they are on patient outcomes. That is something that we need to take the fight up to the government on because this government promised at the last election that, in the Prime Minister’s own words, they would fix public hospitals. So I stand in the parliament today and say to the Australian people: Mr Rudd has had 18 months to live up to his promise and he has failed to deliver anything in relation to his promise to fix public hospitals.

This Prime Minister has presided over a system in which many public hospitals, over the last 18 months, have deteriorated and yet he is looking the Australian people in the eye and saying that he has fixed public hospitals. If your mother, father or child is in a public hospital or in aged-care facility at the moment, is the treatment that they are receiving appropriate and adequate despite all of the wonderful care that all the doctors and nurses and other allied health professionals provide to patients in this country? The answer can be and must be: no. I say to Australian mums and dads around the country who want to get into hospital when their child is sick: Mr Rudd promised to you that he would ‘fix public hospitals’. They were the words he used during the last election campaign. Eighteen months later, nothing has changed; in fact, it has got worse. He is now telling you that things have improved in public hospitals over the last 18 months and, clearly, they have not. That is something that we need to remind the Australian people about. Mr Rudd promised that, if public hospitals were not fixed by mid-2009, he would seek to take them over. At every turn since then, this Prime Minister has sought to walk away from that promise. He does not intend to live up to his promise to take over public hospitals; he is now saying that public hospitals are fixed.

I would say to the Australian public: go to the Prime Minister’s website, where it once used to say, ‘I, Kevin Rudd, will fix public hospitals.’ He has now removed those words from his website. He now says that he is going to ‘substantially improve’ public hospitals. And his health minister, in the media recently, said that she would walk away even from that promise.

Let’s look at the facts in this debate. Let’s recognise that this government has made a number of promises in relation to improving the provision of public hospital and public health services around the country, and they have delivered on none of those.

The state governments at the moment are embroiled in controversy in relation to the numbers that they have been providing to the federal government to say that they have been knocking people off waiting lists. Well, literally they have been knocking people off—not because the surgery has been performed but because either many of these people are dying before they get elective surgery or indeed these figures cannot be relied on because they are being doctored by state health bureaucrats, at the behest of Labor ministers. This is not acceptable in the 21st century. We live in Australia. We should not be told by state health bureaucracies, at the direction of Labor ministers, that they can doctor waiting list outcomes. They should not be telling the federal government and the Prime Minister that they have improved their waiting lists in New South Wales or in Victoria when they have not. Indeed, we know that many of the waiting lists have got worse—they have deteriorated since Mr Rudd has been Prime Minister. Yet Mr Rudd stands up and says to the Australian people, hand on heart, that he has fixed public hospitals. He has not. That is why we need to continue this debate.

We will support measures that streamline the provision of health services to Australians. We will support measures that do away with this bureaucratic nonsense at a state level. We will help Australians get better health outcomes. We will support legislation that does away with bureaucracy and provides a streamlined path to better health outcomes and the provision of better patient outcomes at public hospitals around the country.

There are a lot of questions that need to be answered in relation to this bill. As I have said, we hope that at the Senate inquiry there will be the opportunity for people who have an interest in this area to come forward, to have their concerns aired. We as a coalition will listen to those concerns. We will genuinely listen to what people have to say through the consultation process of the Senate inquiry so that we can help make for a better health system in this country. We want to make sure that we can hear those concerns and urge this government to have them addressed. We do not want to see another bureaucracy created for the sake of creating another bureaucracy. That has continued at a state level for too long. We do not want to be part of this government’s media spin which says: ‘Put your hardhat or your white coat on, go into a hospital or onto a building site and say to the Australian public “Here I am; great footage. This is me, Prime Minister Rudd, doing as much as I can; I am working hard for the Australian people”‘—when in fact it is all just media spin. That is something that this government has quickly become known for. This is the government of media spin, and there is no greater example than in the area of health, where we have seen media spin at a state level over the last 10 years. So let us not fall as a country for the spin that is going on at the moment.

If this government has a serious agenda of providing support to our frontline health workers then it should bring it on—and we will support that. We urge this government to spend more on frontline services than in the media units which occupy the state bureaucracies around the country. We will make sure that we provide proper assistance, guidance and support to all of those frontline health workers, who deserve much more support than they have got over the course of the last 10 years because of a failure at the state government level. We will make sure that we recognise the hard work of doctors, of nurses, of physios, of psychologists, of pharmacists and of all health professional who are working in a range of services and who are passionate about delivering better health outcomes. As a coalition we will support those people because we believe in the services they are providing.

We want to support people who are delivering health services at the frontline, as opposed to Labor, who want to support the spinmeisters in the back rooms. We want to make sure that we can help those people who are working in our emergency departments around the country, under great stress, under enormous duress. These are people who work long hours in very demanding conditions. Quite often they are abused at all hours of the day and night, yet they remain so passionate about the health that they are trying to deliver to patients in a time of need. Yet they are frustrated on a daily basis by the bureaucracy and the bureaucratic process that has surrounded them—the bureaucratic process that has been imposed on them by Labor, not because they want to help those health workers and not because they want to help those patients but because they are trying to get the media spin line out to make people believe that they are doing something.

Labor at a federal and state level have become so obsessed about spin and media control that they have forgotten about patients. This is a government that has forgotten about patients. In their desire to put a hard hat on and get in front of the cameras, they forgot about the people who matter most. It has not taken this government long to adopt the same failed policies of state Labor, particularly the model that has operated in New South Wales over the course of the last 10 years, and that is going to mean even worse patient outcomes in the future.

So my plea today to the Australian public is not to look at what Kevin Rudd does. Kevin Rudd is a very tricky political operator—there is no question about that—but he is not delivering better outcomes for Australian patients. We as an alternative government want to make sure that we take the fight up to this government because we believe that they do not have the capacity to improve health services around the country.

One of the other concerns that this government has on its books at the moment is in relation to the National Registration and Accreditation Scheme. There is considerable concern in the medical community and in some of the patient advocacy groups around what the government has proposed in relation to national registration and accreditation. I made some comments at the annual dinner of the AMA in Parliament House a few weeks ago and I think I echo the concerns of many within the profession who believe that this government is embarking on an ideological war against those in the medical profession. This is a government that clearly wants to go down the path of the United Kingdom model, with state owned public hospitals and public provision of all health services into the future. It is certainly a case which has failed to have been made in the United Kingdom, and yet for ideological purposes this minister seems intent on taking the first steps in nationalising our health service, which would deliver worse outcomes for Australian patients.

We have seen in this recent budget their attacks on private health insurance and their attacks on a range of other health spending. Rural doctors under this budget will be worse off, and some of the detail in the budget papers has been teased out since Tuesday night a couple of weeks ago. The government had a glossy headline about providing services and support to rural health but in the end provided nothing.

The minister, in her second reading speech, said that under this bill:

For the first time, there will be one single body responsible for the delivery, funding, planning and oversight of all clinical training in this country.

If that is truly the minister’s desire, what is at the heart of this bill? If it is going to provide better outcomes, then people will be happy about that, but they will not be happy if it just adds another layer of bureaucracy which does not in the end improve health outcomes for Australian patients.

So we flag all of those concerns as part of the coalition’s contribution to this debate today. We do have real concerns about patient outcomes in this country. We do have real concerns that this Labor government at a federal level under Mr Rudd is embarking on the same failed policies and the same failed health management processes that have not proven to be good for patients at a state level. We will listen to the submissions that are made to the Senate inquiry and see what amendments can be made to this legislation to improve the delivery of the minister’s stated outcome. We raise all of those concerns and we look forward to contributing to this debate in due course.

Richard Marles (Corio, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in support of the Health Workforce Australia Bill 2009, which is a bill to establish Health Workforce Australia, a statutory authority that will be established under the Commonwealth Authorities and Companies Act 1997. I welcome the opportunity to participate in this debate, particularly to participate after listening to the interesting contribution made by the member for Dickson. What a difference 18 months makes. Listening to the member for Dickson making plaintive pleas about the level of funding for public hospitals, one only needs to remember that just over 18 months ago he was part of a government that had busily over the last 12 years ripped enormous funding out of the public health system.

The member for Dickson talks about the aspiration of the Rudd government to fix the health system in this country, and the reason it needs to be fixed is that it was broken by the Howard government. In his contribution he also seems to have an obsession about spin, and that betrays his own culpability as being a member of a government which wrote the playbook on publicly funded spin. One only needs to look at the $60-odd million that was spent on Work Choices paraphernalia to see testament to that fact.

Health Workforce Australia will manage a significant amount of funding around clinical training in this country. It will manage most of the initiatives which are contained in the $1.6 billion health workforce package agreed to by the Council of Australian Governments in November last year. During the 12 long years of the Howard government, the Howard government neglected the health workforce in this country. That is felt no more keenly than in regional Australia. It is felt no more keenly than in a place like Geelong, in my electorate, where there are many private practices that have closed their patient lists and where a simple event such as the retirement of a particular GP has left, on a number of occasions, many patients without a doctor and struggling to find their way onto a new GP’s list.

Right now it has been estimated that the doctor-patient ratio in Geelong is about one to 1,500. The GP Association of Geelong estimates that we in Geelong are about 40 GPs short of achieving what they believe would be the ideal ratio of one GP to every 1,200 people. That is a reflection of the state that the health workforce has found itself in after 12 years of the Howard government. This government, the Rudd government, intends to act differently in relation to health and this bill is very much an example of that. We are providing an unprecedented level of funding for health care in this country. The $1.6 billion provided by COAG in November of last year, consisting of $1.1 billion from the Commonwealth and $540 million from the states, represents the single largest investment in the health workforce in this country ever made by Australian governments.

Five hundred million dollars of the Commonwealth’s contribution will be spent on undergraduate clinical training and that will increase the clinical training subsidy to 30 per cent for all health undergraduate places. There will also be $175.6 million spent over four years in capital infrastructure to expand teaching and training places. This particularly will have a focus on regional and rural Australia where the shortage of GPs and indeed other medical practitioners is felt most acutely. What we know is that students who train in rural areas tend to practise in rural Australia.

The health education sector in Geelong has become an area of enormous activity within our town. But we remain in a desperate need for trained practitioners. As I stated, the GP Association estimated that we are 40 GPs short of an optimal level. There are 18 medical practices across Geelong right now which are currently looking for GPs. We are also experiencing a shortage in other health professional fields—nursing being another case in point.

The Deakin University School of Nursing is a fantastic example of a part of the education sector which is going from strength to strength. It is now one of the largest nursing schools in Australia. It is the largest nursing school in Victoria and it is growing. Last year across the three campuses of Deakin which do nursing training—Burwood, Warrnambool and Geelong—540 nurses graduated, and of that number 200 graduated in Geelong. Most of those 200 has clinical placements in hospitals in and around Geelong and the vast majority have a placement at the Geelong Hospital, which is increasingly becoming one of the busiest hospitals in this state and, indeed, a major teaching hospital within the state.

Last year we had the opening of the Deakin Medical School. It was open on 1 May last year by the Prime Minister, Kevin Rudd. There are right now 136 first-year students at the Deakin Medical School and 114 second-year students. The first year of graduation will be 2011. All of that is going to help significantly deal with the issue of the health workforce in Geelong. But as student numbers grow, without any intervention we are going to find that the system will strain to place those students in clinical training places. That is why this bill is being put in place to establish Health Workforce Australia to manage the $1.6 billion investment in this area, and that will expand the scope of training opportunities. It will help find new and varied places for medical students, nursing students and allied health students to train. It will usher in a new era in health training within our country.

Importantly, the bill will open up the private sector, such as private hospitals or private practices, to training students. It is very costly for those private practices and hospitals to take on a student and that is particularly the case when we are talking about allied health students such as physiotherapists or speech therapists. It is particularly difficult for those areas because they have never had, until now, an identified funding stream for their clinical training. Most of the training does occur in private practices and it requires time and effort. There are of course many practitioners who are happy to take on students, through their sheer love of teaching on the job, but in many cases educational institutions find themselves in the position of needing to beg practitioners to take on students in these clinical training places. Health Workforce Australia and the funding that it will administer will help cover the cost of taking on students in private practice, which is a very important and needed resource intervention in this country.

Another added benefit associated with Health Workforce Australia is that it will have a research function. For the first time it will be gathering very important data around the health workforce which can assist in informing public policy makers about how to improve the situation of the health workforce around Australia.

In terms of the practicalities, this bill establishes Health Workforce Australia, which will administer the new funding and provide an overarching organisational structure. The bill provides for $125 million over a four-year period for the work of Health Workforce Australia. The governance structure of Health Workforce Australia will involve one representative from each state and territory, an independent chair and up to three independent members. That is a very important governance structure and will provide the proper advice to the constituencies that Health Workforce Australia will provide for.

At present, there is a division in the responsibilities for health between state governments and the Commonwealth government. Indeed, for many years this country has been experiencing a blame game, particularly under the Howard government, where blame would be shifted from one tier of government to another and, in the process of doing that, problems that needed to be solved within the health system fell through the cracks. Far from describing an extra layer of bureaucracy, as the member for Dickson was intimating in his contribution, Health Workforce Australia will provide a way of breaking through that barrier between state and Commonwealth responsibilities, it will have an overarching responsibility across the state and the Commonwealth and it will assist in removing that blame game.

It will also assist in providing something of a bridge across both the education and the health sectors. In doing that, it will meet the future challenges of the health system through workforce reform. There will be put in place a mechanism which will allow health ministers around the country to direct the work of Health Workforce Australia; there will also be put in place a mechanism to allow Health Workforce Australia to report to health ministers. There is a need to get on with the business of this bill. Health Workforce Australia needs to be established from 1 July this year in order to be fully in place to administer the funding that exists for the coordination of clinical places from 1 January next year.

In summary, this is a very important bill which provides for an overarching governance structure of a very important and extensive initiative to provide funding for health training in this country. I say this from the point of view of a regional MP in this place and particularly from the point of view of Geelong: we hope that through this additional funding in relation to the training of health professionals we increase the numbers of health professionals practising in regional Australia and address the current shortfall. For those reasons, I very much commend this bill to the House.

Robert Oakeshott (Lyne, Independent) Share this | Link to this | Hansard source

I wholeheartedly support the Health Workforce Australia Bill 2009 and say the very simple word: hallelujah! If this is the moment in time when we see the Australian government, regardless of its political persuasion, step up to the plate and start to take some authority with regard to health planning generally within this country, it is a moment that is long overdue and will be welcomed by many into the future.

I am sure all of my fellow local members—there are 150 of us in this place—see what I see on a daily basis when working in the electorate and working on the issues around health services on the ground: a disconnected and fractured arrangement between state and federal government in the delivery of health services and a constant passing of the buck—for want of a better phrase—between the two tiers of government in what should be the provision of health services for the greater good. If this is the moment that creates the entity that allows the various Council of Australian Government ministers to come together and start, in a very practical sense, to deliver outcomes in the public interest rather than in the state’s best interest or the Commonwealth government’s best interest, then this is a good initiative, a welcome initiative and one I strongly support.

It is potentially the start of the conversation with community on some of the language we have heard from government over the last 12 months and in some of the reviews, including the Garling review, that we have seen in the last 12 months with regard to the hopefully increased role that the Commonwealth could and should take in health services in this country. If this is that moment, I place great significance on it. Perhaps in the future we will see the High Court case of 2006, called the WorkChoices case—ironically used to test the corporations powers with regard to the entity that is being created by the Commonwealth—pushing the issue with the states on who ultimately has authority in the decision-making process in workforce planning and health services generally. I do not think that is a moment that any of us in public planning should shy away from; rather, all of us in public planning should be fully supportive of a minister and a government if that is part of the agenda that we are seeing with this bill.

The mid-North Coast of New South Wales is covered by an entity called the North Coast Area Health Service, whose operating budget this year has a deficit of between $30 million and $40 million. In response to this situation, it is looking to lay off up to 400 staff across the region—from Johns River in the south to the Queensland border in the north. That is a significant change in the way health services will be delivered within our region. The financial pressure on the area health service is due to the resource distribution formula. The resources are supposedly allocated on fairness and equity principles, but in reality the allocation is both unfair and inequitable.

The allocation of funds to the North Coast Area Health Service under the RDF is, I am sure, a concern shared by my colleague the member for Page. Because the mid-North Coast is a high-growth area, the state government has traditionally underfunded the North Coast Area Health Service by between two and four per cent of the resource distribution formula. That might not sound like much, but in real dollar terms it means that between $20 million and $40 million per annum is going not to our region but to other areas of New South Wales on an inequitable and unfair basis.

If the North Coast Area Health Service were receiving equitable funding from the state under the resource distribution formula, we would not be facing the workforce issues that we are currently facing in the Hastings-Macleay region. The CEO of the area health service is talking about laying off 40 staff in a number of different roles across the entire area health service. As I said previously, up to 400 staff are potentially going to be laid off as part of this budget deficit.

If the state were providing equitable funding under the RDF, we would not be in this situation and the budget would be balanced. The area health service has been left in the extremely difficult position of having to lay off a large number of its workforce. Communities will suffer the inevitable service delivery issues within the health sector as a consequence of the state government’s unwillingness to make the hard decisions in other areas of New South Wales to establish equity and fairness in their own resource distribution formula.

That is why this bill, if it allows the Commonwealth to start to mobilise in regard to workforce planning, is not just a piece of paper that we are never going to see anything more of again. It is vitally important work being done by the Commonwealth, and hopefully it will be a trigger for very real action in the future and for the Commonwealth to have significant involvement in this problem.

The New South Wales government is dysfunctional, disconnected and doing a disservice to communities on the North Coast. It is not willing to make the difficult decisions that it should make, particularly about the traditional sandstone hospitals in the Sydney CBD. They are difficult decisions but that is exactly the role that governments need to and should play. We have a half-a-dozen sandstone hospitals smack in the centre of the CBD that are essentially money for the region. Whenever these issues arise, the regions should have a stake in these conversations. Unless they do, we will continue to see inequitable and unfair delivery of government budgeting, which is what we are currently seeing.

The government has been quite open about it. On the North Coast—and it would be a similar story in other areas with high growth rates—we are at least $20 million, and up to $40 million, per annum behind on our fair slice of the pie based on the government’s own funding formula. The area health service is incredibly frustrated, as are all the communities on the North Coast. If we only got fairness—and I stand here and ask only for fairness—it would significantly alter the workforce issues and health service delivery issues in one of the fastest-growing regions in Australia.

This is important legislation. I hope that the government’s intent in creating this entity, and the authority attached to it, is honourable, whether it be pursued through the informal processes of the COAG negotiations and the conversations between ministers and the various stakeholders or, as I previously said, used in the more legal and formal context we have seen through pushing issues such as Corporations Law and issues of a constitutional nature. Whatever it takes, health service delivery and health workforce issues can be done better in this country. I think there would be general agreement on that.

I am pleased that the government has recognised that. I am pleased that we are seeing this bill go through. My request now to the government, to the executive and to the minister in particular, is to make it work practically and to use this legislation and the powers of Health Workforce Australia to create a better health system for all of us in Australia.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to speak today on the Health Workforce Australia Bill 2009. This bill establishes Health Workforce Australia, a national health workforce authority. It forms part of the package agreed to by the Council of Australian Governments in November 2008. Health Workforce Australia will be responsible for implementing the majority of initiatives under the COAG workforce package, which I will detail and outline shortly.

I represent one of the oldest electorates in the country and, as chair of the House of Representatives Standing Committee on Health and Ageing, I have a very keen interest in health issues. I believe that Australia’s health system is one of the best in the world. This is mainly due to our highly competent professional health workforce—our nurses, doctors, allied health professionals and researchers—who are among the best qualified and most professional in the world.

When I was on the last parliamentary health and ageing committee inquiry into public hospitals, we saw figures that showed that $1 billion was slashed from public hospitals under the previous government. We had a decade of neglect. But this government is stepping up to the mark and is determined to deliver dramatic improvements in health care. The state of our public hospitals, June 2008 report was based on figures from when the previous government was in power. I will read out some of those figures. In 2006-07, public hospital admissions increased by around three per cent. That is more than twice the rate of population growth. When did this happen? In 2006-07. Who was in government then? The Howard government.

Again in 2006-07, there were 6.7 million presentations to emergency departments. That is equivalent to a third of Australia’s population. When did this happen? It happened under the former government. Yet at that period of time when we asked questions all that we heard was the blame game. All we heard from the other side during question time when these questions were raised by us when we were in opposition was, ‘Blame the states.’ The number of patients presenting to emergency departments between 1998-99 and 2006-07 increased by over 34 per cent. Three in 10 emergency department patients were not seen within the recommended time. This all happened under the watch of the former Howard coalition government.

At the same time, we were suffering chronic shortages and underinvestment in the health workforce. The end result of this neglect by the previous government is that there are now chronic shortages in general practice, various medical specialties, dentistry, nursing and certain allied health professions. The ageing of the population will also have significant implications on the demand for health resources and the healthcare workforce. That is why we need action now.

This government has stepped up to the plate and is working collaboratively with the state governments on solutions. The government is investing in the whole health system across the whole country to deliver better health outcomes for all Australians. Despite the major challenges caused by the global recession, health and ageing remains one of the top priorities for the Rudd Labor government.

We saw this the other night in the recent budget, which delivered the landmark amount of $64 billion to the healthcare agreement with the states and territories. That will provide record levels of funding for public hospitals and reduce pressure on emergency departments. It provided a $1.3 billion Health and Hospitals Fund and investment in cancer infrastructure as part of a $2 billion package focused on tackling the wide disparity in cancer treatment outcomes for cancer patients in rural and regional areas. It also provides a $1.5 billion investment to upgrade hospitals and clinical training infrastructure across Australia and invested $430.3 million in state-of-the-art research and clinical training facilities.

It also provided more funding for training doctors, including a 35 per cent increase in GP training places. That is significant growth. It also provided funding for growing the nursing workforce, including through enhancing the role of the highly skilled nurse practitioner workforce. These reforms help tackle the health workforce shortages which are the legacy of the inaction of the previous government. The budget also provided more funding for provision of health services in rural areas to address severe health workforce shortages, which again the previous government neglected over its 11 years in office.

In November 2008 the Council of Australian Governments signed off on the historic $1.6 billion health workforce package. This package forms part of the National Partnership Agreement on Hospital and Health Workforce Reform. This was signed by all states and territories in March 2009. The package, comprising approximately $1.1 billion of Commonwealth funding and $539.2 million from states and territories, is the single largest investment in the health workforce ever made by Australian governments. This investment will improve health workforce capacity, efficiency and productivity. It will do this by improving clinical training arrangements, increasing postgraduate training places for medical graduates, improving health workforce planning across Australia and enhancing training infrastructure, particularly, I stress again, in regional and rural areas.

A significant part of the COAG package is the establishment of a national health workforce authority—or Health Workforce Australia, as it will be known—to produce more effective, streamlined and integrated clinical training arrangements and to support workforce planning and policy. The Health Workforce Australia Bill 2009 establishes Health Workforce Australia and implements a majority of the COAG health workforce initiatives. The bill specifies the functions, government and structure of Health Workforce Australia. It enables the health ministers to provide directions to Health Workforce Australia and it requires Health Workforce Australia to report to the health ministers. Health Workforce Australia will be responsible for: funding, planning and coordinating undergraduate clinical training across all health disciplines; supporting clinical training supervision; supporting health workforce research and planning, including through a national workforce planning statistical resource; funding simulation training; and providing advice to health ministers on relevant national workforce issues. The authority will also ensure best value for money for these workforce initiatives and a more rapid and substantive progression of the necessary policy and planning activities.

HWA, or Health Workforce Australia, is to commence management of undergraduate clinical training from 1 January next year. This bill is required to establish Health Workforce Australia by July 2009 to ensure that it is operational within the time frames agreed to in the COAG national partnership agreement. The COAG health workforce package is a major investment in making the necessary and much-needed improvements to the health workforce through effective planning and policy development. It will work with and across jurisdictions and with the education and health sectors, and it is pivotal for the success of the COAG package. For the first time, there will be one single body responsible for the delivery, funding, planning and oversight of all clinical training in this country. This is the creation of a new single body which can operate across both the health and the education sectors and which will have responsibility in health. It is critical to devising national solutions that effectively integrate workforce planning and policy.

I am proud to say that the Rudd Labor government is committed to addressing the chronic shortages which are affecting our health system and is providing support to the dedicated and hardworking professionals that are the backbone of our health system. I am pleased today to be able to support the Health Workforce Australia Bill 2009.

Janelle Saffin (Page, Australian Labor Party) Share this | Link to this | Hansard source

I strongly support the Health Workforce Australia Bill 2009 and in fact welcome it because it will address some major gaps in health workforce planning and service delivery. I commend the Minister for Health and Ageing, Nicola Roxon, for her good work in getting this bill to the stage where it is before the House and for the work she has done through COAG in securing those agreements, which will be vital for the operation of the HWA when it is set up.

Through this bill, the Rudd government will establish a national health workforce authority. It is an example of the cooperation that is required between the Commonwealth and the states to address some of the outstanding, long-running issues around health—around demarcation, who does what where, who is funding what and some general service delivery issues. It will be called Health Workforce Australia, HWA—another acronym, I know. I am afraid every area is replete with them. HWA is part of the $1.6 billion health workforce reform package agreed to by COAG in November 2008. HWA will, among other things, manage the majority of initiatives under this particular COAG package. The character of HWA will be that of a statutory authority under the Commonwealth Authorities and Companies Act 1997, commonly referred to as the CAC Act.

I now turn to why this new body, HWA, is needed. I will then move on to its specific role and comment on its salience to, and impact on, rural and regional Australia. I will then make some general comments. Before I do that, I would like to associate myself with some of the comments made by the member for Lyne in his contribution, particularly about the Garling inquiry. I appeared before that inquiry and gave a written submission on what the member for Lyne was talking about—the resource distribution formula. Under this formula, the North Coast, of which my seat of Page is a part, will be underfunded by a certain percentage—that is, according to the information on the New South Wales Department of Health website. This has an impact on service delivery for the North Coast Area Health Service. The figure is somewhere between $20 million and $40 million—because there is no absolute agreement on the percentage by which we are underfunded. Over the years, there has been a ratcheting-up of the North Coast in that area, but it is not enough. It would be good to see NSW Health make some announcements on corrective action in that particular area.

Health workforce planning has suffered generally from a lack of targeted planning, a lack of coordination and a lack of a unitary body that can operate across sectors and jurisdictions. Over the years, I have seen some well-meaning projects aimed at securing more doctors and nurses for rural areas. Some of them have been successful and some of them have not—most often, they are in the latter category. There have been some state and territory schemes, but there is no overarching national approach—particularly over the last decade, when the need for doctors, nurses and other health professionals was escalating. There was an axing of GP training places and a big reduction in the amount of money that the Commonwealth put into the Australian healthcare agreements. The contribution from the Commonwealth went down from 50 per cent to about 43 per cent. This reduction in funding certainly had an impact on the public health system, particularly the public hospitals, to which a lot of the dollars from the Australian healthcare agreements go.

We have all seen in our own local areas and nationwide a doubling in the number of presentations at hospital accident and emergency departments. All local members would be familiar with that. The numbers have almost doubled in most places. There are a number of reasons for that. It is about the lack of funding that is available, but it is also about changes in the work practices of GPs and medical health professionals in our communities. There was a time when some doctors were always on call and you were able to access them out of hours, but that has changed in a lot of areas as well. There is so much in health that needs to be redressed, addressed, corrected and fixed up. There are matters that have been left unattended by a range of governments, particularly the previous government, whose policy laziness astounds me. Since we came to government , that is one of the things I have been discovering more and more of.

The creation of this new single body, HWA, will address some of the gaps that I have outlined above. It will address them in a formal sense and I hope that it will address them in an informal sense as well. That discussion needs to happen on a daily basis so that some of these issues can be addressed in our communities. HWA will operate across both the health and education sectors, sharing jurisdictional responsibilities. It is essential to have effective coordination and integration of workforce planning and policy, running in tandem with the complementary reforms to education and training. This will cover integrated clinical training arrangements and, critically, support workforce policy and planning for the future.

In addressing why HWA is needed, I have covered some of its role but I take this opportunity to elucidate on this point. HWA will comprehensively plan, coordinate and fund pre-professional entry clinical training across all health disciplines. This training will, among other things, provide key support for coordination and supervision at regional and local health service levels. There will be new arrangements that attach clinical training funding to students in a range of settings—and they can be private or community—with payments to service providers. To support the training to universities and other accredited training providers, they can enter into arrangements with HWA so their own students are able to secure appropriate clinical training places. This has been one of those areas, one of those gaps.

For the first time, we will have a national body charged with taking a national approach to health workforce policy and that will be able to provide advice to ministers on health workforce issues. We will also have improved national health workforce information and a national workforce statistical resource developed that will have some cogency and some credibility to it. Back in early 2008, when I was pursuing the matter of Lismore’s status as an area of need vis-a-vis doctors, I found that the figures that the previous government used for health workforce planning—particularly in rural areas—were based on 1991 census figures. That says it all, really. The figures were so out of date that they had no relationship to reality.

Finally, and most importantly to me and the people of Page, will be the impact of the establishment of HWA on rural and regional Australia. One, HWA will assist and improve access to services in rural areas by delivering more doctors and nurses. We know that is what we need, but we need a range of other specialties and allied health professionals as well. I hope that HWA will be able to work on these areas. Two, it will provide those doctors and nurses with better support while they train. Three, HWA will facilitate more opportunities for expanding clinical training arrangements in rural locations, and that is a good thing. Four, HWA will provide greater opportunities for skills development in the rural based workforce. I will give an example of a local issue I am dealing with, in Urbenville. The honourable member for New England and I share Urbenville.

Michael Danby (Melbourne Ports, Australian Labor Party) Share this | Link to this | Hansard source

Who?

Janelle Saffin (Page, Australian Labor Party) Share this | Link to this | Hansard source

Urbenville. It is a great place. It is one of those small country towns that you, Mr Deputy Speaker Schultz, would know very well.

Alby Schultz (Hume, Liberal Party) Share this | Link to this | Hansard source

I do.

Janelle Saffin (Page, Australian Labor Party) Share this | Link to this | Hansard source

It can be difficult to attract doctors to those areas. We do have two wonderful doctors—they are a couple—and they needed particular help with the upgrading of the Tenterfield Shire Council owned facility they use. I am pleased to say that in the budget there was a grant of $295,000 for them and the council to provide the medical practice service to the local community. Areas like that will be addressed by the new HWA.

Honourable Members:

Honourable members interjecting—

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

Order! The member for Page has the call.

Janelle Saffin (Page, Australian Labor Party) Share this | Link to this | Hansard source

Thank you, Mr Deputy Speaker. There is lots of activity on my left. I am not sure what it is, but everyone seems a bit excited.

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

I am not quite sure whether you are comfortable with them being on your left, but never mind!

Janelle Saffin (Page, Australian Labor Party) Share this | Link to this | Hansard source

I am not sure, Mr Deputy Speaker. The left are very active! For the reasons that I have outlined in my contribution, I strongly support this bill and commend it to the House.

Craig Thomson (Dobell, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the Health Workforce Australia Bill 2009. This is a very important bill because it allows for the first time proper workforce planning throughout Australia. We have heard from pretty much every contributor so far about their own local situations and the difficulties that are there. I, too, want to start with my local situation, because I think it gives a good reason as to why the HWA is so important and why we do need to actually plan our health workforce better than we have in the past. Wyong Hospital, which falls in the beautiful electorate of Dobell, happens to have the fifth busiest emergency department in New South Wales. Yet we struggle to have emergency doctors at the emergency department and rely regularly on locums. While the popular press is quick to blame the state government in terms of these issues, it is not nearly as simple as that. It is really about planning to make sure that our health workforce is there and available. Wyong Hospital has been substantially rebuilt under the state Labor government. But there is no point having a brand spanking new hospital if you cannot get fixed when you go there and there is no-one there to see you. That is the importance of making sure that we have proper planning for the health workforce.

We recently at Wyong Hospital had the maternity ward close down for some months because there were no obstetricians that could be attracted to the area. This was not a fault of the local area health service. It was not a fault of the state government. There were widespread advertisements trying to attract them. There just were not enough doctors because there had not been enough planning to make sure that our hospitals are properly staffed. This is one of the key motivating forces as to why Health Workforce Australia is being established. In the end, with the maternity ward, they had to look at alternate ways of delivering maternity. In Wyong we adopted a midwifery model, which is working tremendously well. My partner and I are soon to avail ourselves of the services of Wyong Hospital, in July of this year. So we are pleased, from a personal point of view, that that is going well, too. What it illustrated was that because of a lack of planning over many years the model needed to change and we needed to plan better for the future, and that is precisely what this bill does.

There is also a very different approach to the way in which the Rudd government will be working with the states compared with the approach of the previous government to these things. Unlike the previous government, we actually intend to work with the states. There cannot be a better and more important example of this than Health Workforce Australia being established. This came out of COAG, where we were able to reach agreement with the other states to make sure that we do plan properly in terms of our health workforce. There is no point setting up different regions of Australia or different states in Australia to compete for the limited pie in terms of the workforce that exists there at the moment. We need to increase the pie, and we need to do that by properly planning where they go. For too long we have seen different health professionals being lured away from one state, and there has been a temporary situation where that state or that particular region may be better off. But it is only temporary if you are not actually increasing the numbers overall and you are not taking a position that looks at the workforce needs across the country. That is precisely what this package intends to do.

The Commonwealth will provide $125 million over four years for the establishment and the operation of Health Workforce Australia. A further $1.2 billion in combined Commonwealth, state and territory funding will be administered through the HWA for the majority of the initiatives under the COAG health workforce package. Given the tight time frames to implement the COAG health workforce package, the HWA needs to be established by July 2009 so it can start managing clinical placements from the start of the 2010 academic year.

Let us have a look at the background of Health Workforce Australia. In November 2008, COAG agreed to a $1.6 billion health workforce package. The Commonwealth is contributing $1.1 billion to the COAG package, with the states and territories providing $539.2 million. The COAG package forms part of the national partnership agreement on hospital and health workforce reform signed by all states and territories in March 2009. This package gives the Commonwealth greater involvement in the health workforce, traditionally an area managed by the states and territories. It means that we take a national position in terms of health workforce rather than setting states and territories to compete against each other in relation to where the workforce should be best utilised.

The package includes establishing a national health workforce authority to produce more effective, streamlined and integrated clinical training arrangements and to support workforce planning and policy development. The authority will implement the majority of the initiatives under the COAG package including funding, planning and coordinating pre-professional entry clinical training across all health disciplines; supporting clinical training supervision, health workforce research and planning, including through a national workforce planning statistical database; funding simulation training; providing a national approach to workforce planning; and providing a secretariat and research support to an independent advisory council for the National Registration and Accreditation Scheme. The authority will also ensure best value for money for the workforce initiatives, more rapid and substantive planning for future workforce needs and will provide advice to health ministers on relevant workforce issues.

I can recall in the late 1990s in New South Wales when linear accelerators were first coming into hospitals to provide vital cancer treatment. We had the terrible situation of these very expensive machines in some parts of Sydney not working to capacity not because the state government had not provided the machines and the capital but because they could not get the staff to operate these machines. That clearly adversely affected the treatment and ongoing rehabilitation of cancer sufferers. That is something that we should be able to avoid through proper planning of the workforce.

The Commonwealth will also fund the establishment and operation of the authority at $125 million over four years, and the authority will administer around $1.2 billion of Commonwealth and state and territory funding for workforce initiatives. Health ministers have agreed to the authority being called Health Workforce Australia. Health ministers also agreed to Health Workforce Australia being established under the Commonwealth Authorities and Companies Act, therefore providing governance arrangements that reflect the shared funding and policy interests of all jurisdictions.

The bill is required to establish the HWA as a statutory authority under the act and to specify the functions, governance and structure of the HWA. Given the functions and level of funding for which HWA will be responsible, it is essential that there is a legislative basis for its operations. The bill will also enable mechanisms for health ministers to provide directions to the HWA and for the HWA to report to health ministers. The HWA will be governed by a board comprising a nominee from each jurisdiction represented on the Australian Health Ministers Advisory Council, a chair and may include up to three independent members selected by health ministers. The board’s responsibilities will include advising and reporting to health ministers and developing policies and operational plans as required. A chief executive officer will be responsible for the day-to-day administration of Health Workforce Australia and will report to the board. Expert committees and consultants will be engaged to assist with the HWA functions as required. HWA is to commence management of pre-professional entry clinical training from January 2010. This bill is required to establish HWA by July 2009 to ensure it is operational within the time frames agreed to in the COAG health workforce reform package.

The Rudd government is committed to dramatically improving Australia’s health system, and setting up Health Workforce Australia as a statutory authority is just one small part of that. In the 2009-10 budget we are delivering a vital boost to our hardworking doctors, nurses and midwives with a series of major investments to expand and modernise our health workforce. The Rudd government is delivering more training places for GPs, providing Medicare Benefits Scheme and Pharmaceutical Benefits Scheme access for nurse practitioners and midwives and reforming support scholarships and training programs. The budget initiatives build on the government’s unprecedented $1.1 billion package of COAG reforms to expand Australia’s health workforce.

The COAG package increases funding for undergraduate clinical training and postgraduate training places and establishes a national health workforce agency to drive a more strategic long-term plan for the health workforce. The budget workforce initiatives will invest $148 million over five years for additional GP training places in 2009 and 2010. It will provide training for remote vocational training scheme GP places in 2011. In addition, there will be a further 212 GP training places provided through the COAG package by 2011. This will permanently increase the number of GP training places to more than 800 per annum from 2011 onwards—a 35 per cent increase on the cap of 600 places imposed since 2004.

The budget initiatives will encourage more junior doctors to become GPs by investing an additional $41.2 million over four years in high-quality supervised general practice training under the Prevocational General Practice Placement Program and will establish the first medical school in the Northern Territory with a strong focus on increasing the number of Indigenous doctors. The government will invest $27.8 million in capital funding to establish the medical school plus $4.4 million over three years from July 2010 in ongoing funding. The government will recognise the valuable role and skills that nurses bring to the health system and to the broader community through providing access to the MBS and PBS for nurse practitioners, at a cost of $59.7 million over four years. This will improve the flexibility and the capacity of Australia’s health workforce, improve patient access to services and provide eligibility for midwives to access MBS and PBS for the first time, expanding choice for women at a cost of $66.6 million over four years. These measures will improve the flexibility of the health workforce and facilitate better access to services for patients.

There are currently significant workforce shortages affecting both pathology and diagnostic imaging. To address this, the government will fund an increase of $10.8 million over four years for pathology places. There will be an additional $5.7 million over four years for radiologists. The government will also introduce a mentoring and academic support initiative for rural pathologists at a cost of $6.2 million over four years. You can see that there is a significant range of additional dollars that are going from the budget to supplement and improve the delivery of health care across Australia. This piece of legislation that helps to plan our workforce is an integral part of that whole package.

I recently had the pleasure of breaking the news in my electorate of Dobell on the central coast that a very capable and experienced partnership of doctors had successfully tendered to establish a super GP clinic in the key growth area of Warnervale. This current doctors’ partnership runs a Toukley medical practice, where there are 17 doctors working along with a range of other health professionals, and another practice at Tuggerah where there are an additional seven doctors. A shortage of GPs is a real issue in my electorate, as it is in many electorates around Australia. In fact, the most common problem in the electorate of Dobell is not about how much you pay when you get to a doctor, it is actually being able to get in to see one because many of them have closed their books. The Rudd government in relation to its program of opening up super GP clinics across the country has again contributed in a major way in my electorate to making primary health care more accessible to the people of Dobell. This, along with providing these additional training places for GPs in the coming three years means that we are going to have more doctors available on the ground to be able to see to the people of Australia and to make sure their health is better looked after.

This is an important piece of legislation, because it means that for the first time across the country we are able to plan and look at the way we deliver our health care, matching up the demand for health care with the training that is required for health professionals and making sure that they are not only trained but sent to the places where they are needed in the numbers that are needed. It is long overdue in this country. We have had many commentators on the health system speaking for many years about the silos of health care that operate in this country. This is a significant step towards making sure that these silos are broken down, that we can go across state borders and that we can plan properly so that the health care of all of our citizens is better planned for and better looked after. I commend this bill to the House.

Kerry Rea (Bonner, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to support the Health Workforce Australia Bill 2009, which was introduced by the Minister for Health and Ageing in the parliament not so long ago, and I am very pleased to have the opportunity to not just speak on it but also support it. The Rudd government was elected in November 2007 most particularly on a platform of restoring the community’s confidence in the government’s ability to deliver vital services and much-needed basic community and social infrastructure. In fact, it was elected on a platform to support the needs of all Australians. For too long the previous government had culled services, selectively funded its pet projects and underfunded very basic and vital services. Nowhere is this better exemplified than in the $1 billion that was cut from the federal health budget—an indictment on the previous government but unfortunately also a major challenge for the newly elected Rudd government to restore funding for our health system and to restore the confidence of the Australian people in our health system. This bill is a significant step in restoring that confidence.

The Rudd Labor government also promised to end the blame game. Nowhere was the blame game more evident than in the debate about health and health funding across this country. We all know that we need a health system that will support all Australians, particularly those who are most vulnerable and in need of public services. I come from Queensland, so I know too well how the blame game played out in that state. We all know—it is no secret—that our health system is under challenge. We all know that the taxpayer’s dollar is finite and that governments are always struggling to find a way to put more resources into all of our services—particularly in health—and to ensure those resources are spent as effectively as they can possibly be. The Queensland government has been trying to do that through its support for the public health system. It would have been nice, I think, to have had a federal government over the last 10 years that was in fact prepared to work in partnership with the state government to support our health system and to see that resources coming from both levels of government were used most effectively to ensure that Queensland has the health system that they deserve. But, unfortunately, the health system in Queensland was simply used as a political football, and those who fell through the cracks were simply considered collateral damage as far as the federal government was concerned.

We know that one of the biggest pressures on our public hospital system is the lack of services in our suburbs and our local communities—the lack of trained health professionals and the lack of GPs, particularly in after-hours services and particularly on weekends and in the evenings. We all know that a baby with an ear infection does not confine it between the hours of nine and five. They get ear infections many a time—in the case of my children, most often at about one o’clock in the morning. It is then that you actually need a doctor. Unfortunately, in most cases these days, the only place you can find that emergency treatment is a public hospital. So the best way to support public hospitals in the state of Queensland, and indeed across the country, is to support and resource more doctors and more GPs in our local communities.

The Health Workforce Australia Bill is a fundamental part of the COAG agreement of health ministers to provide health services and health professionals to our communities where they are needed most. That is why I believe this bill is of great significance. It is a commitment of $1.6 billion in combined funding from both the Commonwealth and the states. The Commonwealth will put in $125 million over four years to run Health Workforce Australia. It will be a statutory authority established under the Commonwealth Authorities and Companies Act 1997. It will consist of a board of directors, a nominee of each state and territory and the Commonwealth, an independent chair and may include up to three independent members selected by health ministers. It is important that the governance is right, and I believe that this representation from both the Commonwealth and the states and territories will indicate quite clearly that there is a partnership between those two levels of government to ensure that our health resources and our precious health dollars are used most effectively and most wisely.

What I believe is so important about this authority is that its focus is on training, on planning and on policy development. Why do I say that? I say that because of the comments I have already made. If we had had a coordinated and cooperative approach from the Commonwealth and state governments over the last 10 years, we would not be in the situation we are in now. We would have had the clinical staff on the ground. We would have had the resources put into the training that is needed to build up our health professionals across the whole of the health profession. That is not just doctors but allied health professionals as well. We would have had a body that was able identify areas like my own electorate of Bonner. South-East Queensland is one of the fastest-growing areas in the country. We would have had an independent body that understood the pressure on population growth and was able to plan the health workforce and the services required to meet the demands of that growing population before it was too late. That would have happened before people could not find a doctor at one o’clock in the morning and before the emergency section of the local hospital was understaffed and over-pressured because people were waiting for routine medical assistance that they should have been able to get through their local GP—if it was not after five o’clock in the afternoon.

What is also very important about this bill is that it combines the critical elements of training, planning and preparing ourselves for the needs of the future with policy development. We all know, as I said earlier, that the taxpayers’ dollar is finite. We have to spread it across many services, many needs and many demands on the government. We all know that in the health debate, if you talk to doctors on the ground and if you talk to the nurses in the hospital wards, they will tell you that money is not the only solution. They will say that, yes, of course more funds could always be used in our health system but that just as effective as more money is how the money we have is spent. That is why this authority is so important to delivering a better health service. They will tell you that the critical part of our health system is not just the bricks and mortar—that is, the hospitals, the physical structures—but the staff, the trained workforce. It is the numbers in those hospitals, the GPs on the ground, the quality of the training and the number of trained people in this country to provide health services to our community.

That is why this bill is so important. It does not just say, ‘Let’s throw money at the problem.’ It says: ‘Let’s spend the money where it’s needed, in developing our trained staff. Let’s plan for the future and let’s make sure that we’ve got the right people developing the policies that we need to make our health system even better.’

I know that the good people of the electorate of Bonner will certainly welcome this. We have a small local hospital in the electorate of Bonner, the Wynnum Hospital, which of course provides an essential service to our local community. We also, as part of Brisbane, rely on the three major hospitals in Brisbane, particularly those on the south side, the Princess Alexandra Hospital and the Mater Private Hospital, to provide the much needed services that are required in the city. It is so important to that very fast growing area of Brisbane, one of the fastest growing areas in the country, that we have the health workforce and the planning and policy development that will be able to cater for that growth into the future.

I also have many very good, committed and dedicated local health people working in that area—in particular, the general practitioners who I meet with regularly through the South East Alliance of General Practice that covers the Bonner electorate. They know what is needed on the ground, they know what is needed to support the health needs of our community and they know what the demands in the future will be. I am sure that they will be very pleased to see that this government has actually listened to what they are saying and has said, ‘We are prepared to put money into supporting you and giving you both the policy and the health workers that you require.’

This Health Workforce Australia Bill is also, as I said, part of the overall health agreement that has been discussed and agreed to by the health ministers at COAG—the states and the Commonwealth working together. It will be part of delivering the very important Health Workforce National Partnership. Some significant dollars will see major improvements to our health system across this country: $500 million to support the expansion of undergraduate clinical training places; $86 million to provide 212 additional ongoing GP training places, a 33 per cent increase on the previous government’s cap; 73 additional specialist training places in the private sector; $28 million to help train 18,000 nurse supervisors, 5,000 allied health and VET supervisors and 7,000 medical supervisors; a $175.6 million investment in capital infrastructure to support training of our workforce; construction of new and mobile high-tech stimulated learning environments; expansion of education and training facilities at our major regional hospitals; and $264 million for other important initiatives, including the national health workforce agency.

In conclusion, whilst the establishment of a health workforce authority may not get a lot of publicity out there in the community, I take this opportunity as the member for Bonner to say that this particular initiative will go a long way to supporting the health needs of the people in Bonner and fellow Queenslanders, but more importantly it will see the education sectors, the health sectors, the health workforce, the people on the ground, those in government, including ministers, and those working in bureaucracies for the first time in a long time working together to develop a health strategy for our country that will improve our health system, end the blame game and stop health being nothing more than a political football.

James Bidgood (Dawson, Australian Labor Party) Share this | Link to this | Hansard source

I commend the Health Workforce Australia Bill 2009 to the House. With regard to my colleague the member for Bonner, who just spoke, I acknowledge the passion and the conviction that she has about healthcare services in Queensland. I totally concur with her comments and commend her passion and conviction. We have also heard from the member for Dobell and the member for Page, and we will be hearing from the member for Kingston and the member for Blair, who I know also share a deep conviction of the importance of providing top-quality health care to all Australians, regardless of wealth, position, creed or background.

This bill establishes Health Workforce Australia, known as HWA, as a statutory authority under the Commonwealth Authorities and Companies Act 1997. The principal provisions in the bill specify the functions, governance and structure of the HWA, and the HWA will manage the majority of initiatives under the $1.6 billion health workforce package agreed by the Council of Australian Governments, known as COAG, in November 2008. The Commonwealth will provide $125 million over four years for the establishment and operation of HWA. A further $1.2 billion in combined Commonwealth, state and territory funding will be administered through the HWA for the majority of initiatives under the COAG health workforce package. HWA will implement the majority of initiatives under the COAG health workforce package, which is expected to positively impact the community, including through improvements in clinical training arrangements that will help maintain the quality and safety of the future health workforce and policy and planning directions to support the Australian health workforce.

The Health Workforce Australia Bill 2009 establishes a national health workforce authority, which is part of the $1.6 billion health workforce reform package agreed to by COAG in November 2008. The package forms part of the National Partnership Agreement on Hospital and Health Workforce Reform signed by the Prime Minister and all states and territories in March 2009. The Commonwealth is contributing $1.1 billion to the health workforce reform package, with states and territories providing $539.2 million. The national health workforce authority will implement the majority of initiatives under the COAG package.

The authority, to be known as Health Workforce Australia, will establish more effective, streamlined and integrated clinical training arrangements and support workforce planning and policy. Its responsibilities will include comprehensively planning, coordinating and funding undergraduate clinical training across all health disciplines. On this point I would like to bring to the chamber’s notice that the Anna Bligh state government has made a very good decision in its creative accounting to sell off the Mackay, Cairns and Mount Isa airports and to invest in new hospitals. That is good news for the people of Dawson. Particularly, a new Mackay Base Hospital will be built alongside the old Mackay Base Hospital. Because of population expansion, there is a greater need for healthcare services. There will be $405 million provided by the state government. It is good that the federal government can come in and help facilitate clinical training and turn it into a training hospital for future nurses and doctors. That is something on which we are working across different boundaries. The federal government is working with the state government—and I recognise the effectiveness of local government in providing roads and bridges around the area—to the great benefit of the local community.

HWA will ensure this training occurs in the most streamlined, integrated and educationally effective manner, with appropriate support for coordination and supervision at the regional, local and health service levels. This will include new structural arrangements that attach clinical training funding to students in a range of service settings and support for clinical supervision administered through the HWA. The HWA will lead and support health workforce research, planning and policy development to inform policy decisions on workforce supply, demand, distribution, utilisation and design issues. This will include continually improving national health workforce information and the establishment of a national workforce statistical resource. Also, it will provide a coordinated approach to both the use and financing of simulation training, including the establishment and operation of simulated learning environments. Also, we will be taking a national approach to workforce policy and providing advice to health ministers on relevant workforce issues.

HWA will be legally and financially separate from the Commonwealth. It will be established under the Commonwealth Authorities and Companies Act 1997, the CAC Act, thereby providing governance arrangements that reflect the shared funding and policy interests of all jurisdictions. The bill is required to establish HWA as a statutory authority under the CAC Act and to specify the functions, governance and structure of HWA, including the interaction with ministers and ministerial committees.

HWA will be governed by a board comprising a nominee from each jurisdiction represented on the Australian Health Ministers Advisory Council and a chair and may include up to three independent members selected by health ministers. The board’s responsibilities will include advising and reporting to health ministers and developing policies and operational plans as required. A chief executive officer will be responsible for the day-to-day administration of HWA and will report to the board. Expert committees and consultants will be engaged to assist with HWA functions as required.

In November 2008 COAG agreed to spend $1.6 billion on the health workforce package. The Commonwealth is contributing $1.1 billion to the COAG package, with the states and territories providing the extra $539.2 million. The COAG package forms part of the National Partnership Agreement on Hospital and Health Workforce Reform signed by all states and territories in March 2009. The package gives the Commonwealth greater involvement in the health workforce, which is traditionally an area managed by the states and territories.

The package includes establishing a national health workforce authority to produce more effective, streamlined and integrated clinical training arrangements and to support workforce planning and policy development. The authority will implement the majority of initiatives under the COAG package, including: funding, planning and coordinating pre professional entry clinical training across all health disciplines; supporting clinical training supervision; supporting health workforce research and planning, including through a national workforce and planning statistical database; funding stimulation, as I have said; having a national approach to workforce planning; and providing the secretariat and research support to an independent advisory council for the National Registration and Accreditation Scheme. The authority will also ensure best value for money for the workforce initiatives and more rapid and substantive planning for future workforce needs and will provide advice to health ministers on relevant workforce issues.

The Commonwealth will fund the establishment and operation of the authority at $125 million over four years. The authority will administer around $1.2 billion in Commonwealth, state and territory funding for the workforce initiatives. Health ministers have agreed to the authority being called Health Workforce Australia. Health ministers also agreed to HWA being established under the CAC Act, thereby providing governance arrangements that reflect the shared funding and policy interests of all jurisdictions.

As I said, the bill is required to establish HWA as a statutory authority under the CAC Act and to specify the functions, governance and structure of HWA. Given the functions and level of funding for which HWA will be responsible, it is essential that there is a legislative basis for its operations. The bill will also enable mechanisms for health ministers to provide directions to the HWA and for HWA to report to health ministers.

HWA is to commence management of the pre professional entry clinical training from January 2010. The bill is required to establish HWA by July 2009 to ensure it is operational within the time frame agreed to in the COAG health workforce reform package. In conclusion, I wholeheartedly endorse and recommend this bill to the House.

Amanda Rishworth (Kingston, Australian Labor Party) Share this | Link to this | Hansard source

I am very pleased to rise to support the Health Workforce Australia Bill 2009, because there is no service in our community that is more important than health services. Hospitals play a central role in that, but health goes much further than this. In fact, primary health care also offers some very important services to the local community, including GPs, dentists, nurses and allied health professionals. I think we need to acknowledge that a healthy society requires a whole-of-government approach, whatever level of government it is. In my previous job as a psychologist, one thing that I was able to see firsthand was that there is no better resource for our health services than the people who work in them; the people who work every day, and often nights, to keep the rest of us healthy, happy and safe. That is why this bill is particularly important.

Australia has a very good health system. There are a lot of areas in which we lead the world. The people within this system need to be congratulated and acknowledged. We have top-quality people in our clinics, hospitals and community medical centres. These people, whether they are doctors, nurses, midwives, allied health professionals, paramedics or researchers, are truly the backbone of our health system. Yet when you read the Productivity Commission’s Report on Australia’s Health Workforce, it becomes apparent that there is a shortage of trained personnel in this area:

• Australia is experiencing workforce shortages across a number of health professions despite a significant and growing reliance on overseas trained health workers. The shortages are even more acute in rural and remote areas and in certain special needs sectors.
• With developing technology, growing community expectations and population ageing, the demand for health workforce services will increase while the labour market will tighten. New models of care will also be required.
• Expenditure on health care is already 9.7 per cent of GDP and is increasing. Even so, there will be a need to train more health workers. There will also be benefits in improving the retention and re-entry to the workforce of qualified health workers.
• It is critical to increase the efficiency and effectiveness of the available health workforce, and to improve its distribution.

To put it bluntly: there is now a chronic labour shortage in general practices, various medical specialties, dentistry, nursing and certain allied health professions. These shortages, combined with the inflexibilities and inefficiencies in our training and service delivery, contribute to poor health outcomes for Australians.

Unfortunately, in the past we have not collected any national data about our health workforce, and this makes it even more difficult to plan in response to these shortages. I have to say that, in hindsight, perhaps this was a failing of the previous government. They did not plan for these workforce shortages and, now, when it has become critical, I am very pleased that it is this government that will take up the mantle and try and address this very pressing issue. This problem represents a real challenge for healthcare policy in this country, and I want to take this opportunity to congratulate the Minister for Health and Ageing for her hard work in meeting this challenge, because it is difficult. After a decade of underinvestment in health, after the ignoring of this issue and after the ideologically driven policy of the previous government, this government really is stepping up to the plate.

This bill establishes Health Workforce Australia, a national workforce authority, to produce more effective, streamlined and integrated clinical training arrangements and to support workforce planning and policy development. This authority is part of the National Partnership Agreement on Hospital and Health Workforce Reform, which was signed by all the states and territories at COAG. This agreement represents COAG at its best, with the Commonwealth and states working together to achieve real reform and direction for our health system. Because of this arrangement, there will be $1.6 billion in a health workforce package, with $1.1 billion coming from the Commonwealth government. Due to this significant investment, the Commonwealth will become more involved in supporting the health workforce, which has traditionally been an area of state responsibility. The form of that involvement is represented in this bill. Health Workforce Australia will take over from the National Health Workforce Taskforce and assume the responsibility of its work program, encompassing workforce planning and research, education and training, and innovation and reform.

This new agency will have a significant mandate and will oversee the improvement of capacity and productivity of the health sector in the provision of education and training places for the health workforce. The authority will also review the system’s funding and payment mechanisms, the roles of different professionals within the workforce and the opportunity to develop strategies to create incentives for productivity and performance in our health care system. Health Workforce Australia will play a pivotal role in the creation of future health policy in this country and in ensuring that Australians are able to continue to enjoy the world’s best health system that we currently enjoy.

The authority will ensure that our health dollars are spent on the best possible workforce initiatives and that our health workforce is trained, recruited and provided in a way that addresses the health needs of the community. The authority will also provide a valuable font of advice to health ministers both state and federal on relevant workforce issues. It is expected that this function will often be performed by the board of Health Workforce Australia, which I will talk about soon. The bill also enables health ministers to provide directions to Health Workforce Australia and for Health Workforce Australia to report to health ministers.

The bill establishes Health Workforce Australia under the Commonwealth Authorities and Companies Act and also specifies its governance and structure. It is necessary that this authority and its structure are determined by legislation because of the importance of its objectives and because of the substantial budget of the programs it will be overseeing. This bill provides for a transparent and accountable governance structure for the authority that will serve HWA well. Health Workforce Australia will be governed by a board comprising a nominee from each jurisdiction represented on the Australian Health Ministers Advisory Council. This indicates that the body is a creature of cooperative federalism and is as much an endeavour of the states as it is of the Commonwealth government. Hence there is a strong place for state interests to be heard on the board.

The bill will also provide for up to three independent members of the board to be selected by all health ministers—not just the Commonwealth minister—which again reflects the cooperative nature of this proposal. As is normal practice for government authorities, a chief executive officer will be responsible for the day-to-day administration of Health Workforce Australia and will report to the board and to the committees and consultants that will be engaged to assist Health Workforce Australia in its functions as required.

As our average population age continues to rise there can be no better time to get serious about planning our health workforce. Australia needs to respond to the challenge of an ageing population and a shortage of healthcare professionals. I commend the Council of Australian Governments for coming together and making a commitment to address this very important issue. The establishment of Health Workforce Australia and the investment of $1.6 billion in its program show that this government and the governments across the country are serious about tackling this potential crisis in our health system.

For Health Workforce Australia to commence management of the pre-professional entry clinical training from January 2010 this bill must pass by July 2009 to ensure that we can get the best outcomes operational in the time frame COAG has agreed. A comprehensive strategy to address workforce shortage has been welcomed by electors in my electorate of Kingston. Being a seat in the outer metropolitan suburbs, my constituents often cannot get access to services such as general practitioners, public dentistry and allied health. This is often because there is a workforce shortage. Addressing health workforce shortages will be critical to ensuring that Australians and indeed the local residents in the southern suburbs of Adelaide will be able to have access to the health services that they need. Therefore, I commend the bill to the House.

Shayne Neumann (Blair, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in support of the Health Workforce Australia Bill 2009. If Australia were to be federated today, I am sure that we would construct our federation in a different manner to that which we constructed at the end of the 19th century. The situation is that the Commonwealth government’s powers have been expanded through a number of different mechanisms over the years. We have seen referenda put to the Australian public, most of which have been voted down. We have seen High Court of Australia decisions interpreting section 51 of the Australian Constitution, which enumerates the Commonwealth government’s powers, and we have seen a more expansive approach—two steps forward, one step back—with respect to the Commonwealth government’s powers as a result of the High Court’s decisions in relation to constitutional matters.

I think the Australian public expects us as a government, and expects governments of all persuasions, to take a more national approach to health. But the way in which the Australian federation has changed the most, I think, has been in the cooperative federalist approach undertaken by COAG agreements. That is when state, local and federal governments get together to agree on outcomes, which results in legislative and funding arrangements which change. We have seen magnificent reforms as a result of this sort of approach—for example, in the area of corporations law, defamation law, family law and also in the area of health.

I really support this bill because I think it is extremely important for my local community. I represent the seat of Blair, which is based on Ipswich and the rural areas outside the Fassifern Valley and the Lockyer Valley. In my area some years ago the Ipswich and West Moreton Division of General Practice, under the then CEO, Kevin Pittman, undertook a study in relation to the health needs of the local community. It found that health needs were great. Obesity was a challenge, diabetes was a challenge and heart disease was also a challenge. It also found that our workforce of doctors and nurses was ageing. About a third of the GPs in my local area will retire in the next five to 10 years. It found that there was one GP for every 1,609 people living in the Ipswich and West Moreton area. That is a particular challenge.

We have addressed this issue of the shortages of doctors and nurses at a national level. This issue was created, I might add, by the deliberate and intentional policies of the Howard coalition government. We have addressed this with 457 visas. One of the biggest users of 457 visas, if not the biggest user, has been the New South Wales health commission. It has used the visas to get more doctors and nurses to work in New South Wales. In Queensland we also have many fine doctors coming from overseas, but we simply have not trained enough doctors and nurses and other allied health professionals. Certainly not enough paramedics and researchers have been engaged.

These people do not just form the backbone of our system; they actually form the blood, the tissue and the muscle that allow us to do what we need to do. So we need to support the health workforce not just in education but in financial support to induce people to work in these areas and to work in rural and regional Australia as well. We also need to support them to achieve the necessary outcomes in job satisfaction, familial satisfaction and also vocational development. We need to have the research and the information available to us which will enable us to work out where we need to place our doctors and nurses. It sounds like indicative planning, but it is important for us to do it because the forces of the market have not always worked successfully, as we have seen.

We need to really look at planning and research and development, and we need a cooperative approach. That is why I am very pleased that we have talked about $1.6 billion for the health workforce reform package. That was achieved by COAG in November 2008. I commend the Minister for Health and Ageing and all the various state ministers for what they have done. Coordinating planning, funding undergraduate clinical training places, supporting our health workforce and supporting research, planning and policy development are just crucial. It is amazing that the Howard government failed in this regard. The Institute of Health and Welfare in October 2008 came up with a study which the previous Minister for Health and Ageing, the member for Warringah, had to admit was correct—the Howard coalition government had failed to invest in health and hospital infrastructure and funding and the much-vilified states had taken up the slack. The states, which at that stage mainly had Labor governments, had increased their funding at the same time as the Howard government had underinvested in this area.

This area is vital. People on low incomes or from low socioeconomic backgrounds simply need to have access to a good public hospital and a GP clinic where they can be treated. That is the front line of our health system. They need that, and the shortages are particularly acute in rural and regional communities around the country, particularly in the state of Queensland, where the pattern of settlement is very different from that in any other state. Workforce shortages and inflexibilities have aggravated that and mean that people in rural and regional Australia have not got access to the kinds of health care they deserve or expect—in a First World country. So this sort of funding and this sort of authority, where we can take a national approach governed by a board comprised of a nominee from each jurisdiction so no-one misses out and everyone has a place at the table, is simply a sensible way to go about a national approach to health funding research and development. A national partnership agreement is a sensible way to ensure that we invest properly and appropriately and take into consideration not just the demography but the regional development of the country.

Many speakers have gone through in detail the background, the functionality, the coordination and the membership of Health Workforce Australia. I want to concentrate on a more local aspect and make a more Queensland based response. In my electorate we have about 15,000 people who are over 65 years of age. In terms of the pension payments, we received in the first economic stimulus package a lot of money—about 44,000 people actually received either the $1,400 single rate or the $2,100 couple rate. In the budget we saw 23,505 people receive the increase in the pension. There are people with a veteran background. I have many veterans in my community because we have the RAAF base at Amberley. They like to come and settle here. We have nearly 8,000 people on disability support type pensions in my electorate. For these types of people, their GP and their public hospital are vital.

The Rudd government have made a major investment in our public health system—$64 billion over five years, an increase of $20 billion and nearly 50 per cent over the previous Australian Healthcare Agreement. That is an enormous increase in health expenditure, and it is a Labor government that is doing it. Labor governments, when it comes to things like education and health, are the ones that really matter to the Australian public. We are the ones who invest for the benefit of this country. We are delivering vital reforms at a time of great economic crisis—investment in public hospitals, health infrastructure, our workforce, maternity and midwifery services and health services in rural and regional Australia. We are upgrading our hospitals. We are training more doctors—a 35 per cent increase in GP training places. It is to the absolute shame of those opposite that they actually froze the number of training places. We need more highly skilled GPs and nurse practitioners to tackle the workforce shortages left as a legacy of the previous government. That is the tragedy—they simply failed to invest.

Investing also in medical and health research is simply vital. This government will invest $430.3 million to upgrade and build health and medical research and training facilities across this country. There is $596 million to expand cancer research facilities drawn from the Health and Hospitals Fund, including $14 million for a smart therapies institute in Brisbane—a collaboration between the University of Queensland, Mater Medical Research Institute, Princess Alexandra Hospital, the Queensland University of Technology and the Queensland government. That is simply vital for my constituents, many of whom travel to Brisbane for cancer treatment. That is simply the case.

We are investing $1.5 billion to upgrade key hospital infrastructure across the country. For my constituents, many of whom have really challenging problems in terms of oral health, the $104 million for the oral health centre in Brisbane, which will treat 17,000 patients a year, is simply crucial. Investing in our health and hospital system is important for its lifeblood. It is our responsibility. It was the responsibility of the previous government and it is a tragedy that they did not take it up.

The situation is that we will care for our people. We will provide options for women as well. One of the things that I am so happy about is what we have done in terms of maternity care, the access to Medicare and the PBS for midwives. The budget includes a $120.5 million package for measures to include choice for women and access to maternity services for pregnant women and new mothers in Australia. I have met with the local group involved in advocacy in this area, and I commend them for their work. Cas McCullough, the National President of the Maternity Coalition, lives locally in my area. I have spoken with her, and she is a great contributor to the Natural Parenting magazine. The midwifery association of Queensland has been strong in its advocacy for these types of reforms. I think this is a commendable reform, and I think it gives women birthing experiences and options which they did not have before. Surgical interventions are not always in the best interests of women, and it is not always what they want. Often they want qualified midwives with sensitivity, understanding and tenderness, someone with whom they have developed a relationship over a long period of time, to assist them in this wonderful experience for them. Women deserve to be empowered, and this reform of the Rudd Labor government is a terrific reform.

The local expression of that in my electorate, of course, is the University of Queensland Ipswich campus, where you can choose to study nursing or midwifery. Ipswich campus has become well known as a campus of excellence where people come to learn how to become not just nurses and midwives but doctors also. We have taken in our first cohort this year, the first graduates from the Bachelor of Health Science. What we are going to see are doctors trained through the University of Queensland Ipswich campus. I think that is important. I have spoken to Pro-Vice-Chancellor Professor Alan Rix about this, congratulated him and commended him on the work that they have done in this regard for Ipswich. I want people to actually study in Ipswich, live there and practise there.

For nearly a decade I served on the Health Community Council, as an employee of the Queensland government. One of the challenges we had was getting doctors to come to Ipswich General Hospital and practise locally. We did that in rural areas as well. We gave them a right of practice in places like Boonah, Laidley and Esk in the electorate of the member for Dickson. We did that. But it was difficult getting them into those rural communities. So getting them locally trained means they are more likely to live there. They study there, they live there, they make friends and they get involved in the life of the community, and that is tremendously important for my constituency.

Ipswich campus also has become known as a centre of excellence with respect to research and innovation. There are a number of important things that have developed there as a result of the initiative of the Queensland state Labor government but also as a result of the Australian Cancer Council funding, and with the support of the Ipswich Hospital Foundation. What has been established in Ipswich, at the University of Queensland, is a Healthy Communities Research Centre. That has been involved in important social research undertaken with respect to the Ipswich study. It is undertaken by the University of Queensland Boilerhouse Community Engagement Centre.

Allied with this, we saw the Queensland government undertake a great initiative last year. That was the establishment of the Centre of Excellence for Behaviour Support. What will happen there will be a great deal of study, innovation and research undertaken in the local area to establish what is needed for people with disability. How can we help them? What can we do to improve the health and cardiorespiratory medicine needs of the local area? What about whiplash nursing? What about people who have come from backgrounds where they were institutionalised, in, say, the Challinor Centre in Ipswich, and are now living in community? What are their challenges? What are their needs? What are their health needs? These two research centres in my local constituency will make a big difference. That is the sort of planning and research we are talking about under this legislation. The Rudd government is committed to it.

If you do not think it is accepted well by the universities, just have a look at what Professor Peter Coaldrake, the new Chair of Universities Australia, said just today, commenting about the implication of the federal budget provisions for higher education. He is the Vice-Chancellor of the Queensland University of Technology. He said:

Vice-chancellors—

that is, the vice-chancellors of the various universities in Australia—

examined two recent studies by Access Economics and KPMG that identified education as a lead industry providing immediate economic stimulus, long-term gains in skills and productivity and contributing significantly to GDP.

Professor Coaldrake commended the government for the substantial capital infrastructure funding available as part of the budget for studies and research facilities. These are the kinds of research facilities that I am talking about in my electorate, on the University of Queensland Ipswich campus, which you can imagine Health Workforce Australia will be really interested in. They will be really interested in the kind of information that comes out as a result of the research that develops there. So it is not important just in terms of the budgetary stimulation for jobs, economic development, productivity and skilling. We are really talking about caring for our community when it comes to disability and health needs as well.

This bill seems as though it is about the creation of a statutory authority and the Commonwealth Authorities and Companies Act 1997, but I can imagine that Health Workforce Australia will be particularly interested in what the University of Queensland Ipswich campus is doing, because the studies that come from that institution will go a long way towards establishing the real needs of people not just in Ipswich, not just in Queensland, but in Australia and internationally. A coordinated approach to this type of thing is simply vital for our community. It is vital to establish what our needs are locally, state-wide and nationally. This is one of those bills that I am warmly supporting, and I commend it to the chamber.

Maxine McKew (Bennelong, Australian Labor Party, Parliamentary Secretary for Early Childhood Education and Child Care) Share this | Link to this | Hansard source

I would like to thank all members who have participated in this debate on the Health Workforce Australia Bill 2009. I thank the member for Blair in particular who brought together all the important strands that this bill is seeking to achieve. I am very pleased today to have the opportunity to sum up the debate on the bill on behalf of the Minister for Health and Ageing, who has been called away to an urgent teleconference with her state and territory colleagues about the swine influenza situation.

As has been acknowledged during the debate, there are existing workforce shortages and factors such as population ageing and increasing levels of chronic disease that will exacerbate pressures on Australia’s health system and its workforce in the near future. I note the contribution of the member for Dickson, who seems to have some concern about the need for and the role of this health workforce agency. What the community is concerned about, I would say, is the lack of planning by the former government for the needs of the health workforce. This has left many communities around the country with shortages of doctors, nurses and allied health professionals. We know that improvements to clinical training arrangements are needed, along with strategies for maximising productivity and improving the efficiency, effectiveness and responsiveness of the health workforce to ensure that the health needs of Australia can be met into the future.

The $1.6 billion health workforce package of the Council of Australian Governments—the single largest investment in health workforce ever made by Australian governments—was developed in recognition of these issues. A linchpin of the COAG package is the development of Health Workforce Australia, HWA, a national health workforce authority that will work with and across jurisdictions and the education and health sectors to produce more effective, streamlined and integrated clinical training arrangements and to support workforce planning and policy development.

Among other critically important functions, HWA will fund, plan and coordinate pre-professional entry clinical training across the major health disciplines from 2010. It is not intended that this agency usurp the functions of accreditation agencies or universities in relation to clinical training accreditation. These bodies will remain responsible for accreditation, although it is important to note that the clinical training subsidy is likely to assist training organisations with the quality of their placements.

The agency will finally allow for proper workforce planning so that we can fix the longer term issues on the health workforce right across Australian governments. The governance arrangements for HWA reflect the shared funding and policy interests of all jurisdictions and provide for directions from and reporting to Australia’s health ministers.

Passage of the bill is required to establish HWA and to ensure that it is operational within the time frames agreed to in the COAG health workforce. Essentially, passage of the bill will instigate the immediate activities needed to improve the health workforce and therefore the health system for the Australian population.

I would like to thank once again all those who directly or indirectly have been involved in the development of this package and this important legislation. I have been delighted by the strong support of all governments and the health and education sectors, all of whom have recognised the significance of this package and the need to get on with the job of improving Australia’s health workforce.

Question agreed to.

Bill read a second time.

Ordered that the bill be reported to the House without amendment.