House debates

Wednesday, 11 September 2019


Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019; Third Reading

5:20 pm

Photo of Greg HuntGreg Hunt (Flinders, Liberal Party, Minister for Health) Share this | | Hansard source

by leave—I move:

That this bill be now read a third time.

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

I rise to speak in support of the Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019. This bill amends the Health Insurance Act to establish a new bonded medical program. It is worth noting that this is a program that had been announced back in the 2018-19 budget. It is an important measure to try and improve access to health care and, in particular, medical professionals in regional, rural and remote areas. And it will replace two existing bonded medical officer programs.

This is an important program that allows people who are graduating as doctors and also those who are completing their specialist training to work in regional, rural and remote areas. We know from recently published health statistics that there is a stepwise difficulty in accessing medical care in outer metropolitan, regional, rural and remote areas. The life expectancy of people who live in rural and remote areas is significantly lower than the life expectancy of people who live in inner metropolitan areas. Governments of all persuasions have struggled to deal with this over many decades. Unfortunately, what has happened is that governments have looked at many programs to try and improve access to medical care for people who live in rural and remote areas and have wasted a lot of time and money on things like locum programs and medical transport programs without really looking at the bigger issues.

In my electorate of Macarthur there is significant difficulty in attracting specialists, yet we are not seen as a place of workforce shortage—which I think is difficult because we are on the outskirts of a major city and we know that our health statistics are much poorer than for those who live in the more affluent areas closer to the city. I think there is room to expand access to our health service to people who are on the bonded medical scholarships. That's something we certainly should look at.

Our Aboriginal medical service, Tharawal, struggles to get paediatricians, neurologists, cardiologists, ENT surgeons and ophthalmologists to work in the area, yet the area is not seen as an area of workforce shortage. I would strongly suggest that there are ways that access to the outer metropolitan areas could be made available to those who are on bonded scholarships.

I also think it's time we had a look at a bigger picture way of providing services to rural and regional areas. In particular, I think it's time to do away with this idea that medical services can be provided by paying extortionate amounts of money to locums. For example, if I want to work in some of the rural areas as a paediatrician, I can be paid $2,000 to $3,000 a day to provide those services as a locum. That is wrong. It is a waste of resources and a waste of money. What we need to be doing is looking at how our inner city teaching hospitals can provide the higher level medical specialist services to rural and regional areas.

I personally think that it's time for us to look at ways our states can be divided up into areas that are serviced by these teaching hospitals so every tier of the health service, from nursing staff to junior staff to senior medical registrars and senior consultants, is able to provide services from the teaching hospitals to these rural and regional areas. I think that is true of every state in Australia, and it's time for us in a bipartisan way to look at this way of providing service. Whilst these bonded medical people will provide some way of improving services, they are a small number compared to the number of people required in our rural and regional areas, so we need to look further. I also think we need to see how we can provide services through the Aboriginal Medical Services as areas of need, even if they are in the inner city.

I'm grateful for the opportunity to talk on this bill and I could talk for much longer, but districts of workforce shortage are not just in our rural and regional areas; they're in some of our outer metropolitan areas. I think we need to address that. (Time expired)

Question agreed to.

Bill read a third time.