Emma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | Link to this | Hansard source

I rise to speak on the Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021.

In the middle of a global pandemic, health care saves lives. People should be able to book an appointment with their GP and receive care straightaway—whether it's COVID related or for a regular health check-up. Unfortunately, this isn't the case for many people in my community on the Central Coast of New South Wales. Like many regions of Australia, the coast is battling an acute GP shortage. Locals are waiting weeks for routine appointments, practices have been forced to close their books and doctors are struggling to keep up with demand. People often say that Australia has a universal health-care system, but we don't. A two-tiered system has developed, where access is increasingly determined by where you live and how much you earn, and communities outside big cities are finding it harder and harder to see a GP.

People living with chronic health conditions, such as heart disease or diabetes, find they're made worse by longer waiting times and are facing the barriers to care of high out-of-pocket costs exacerbated by a shortage of health-care workers. As a pharmacist and local MP, I know that if people delay care their condition will only get worse, which is worse for them, worse for our health-care system and worse for the economy. They'll end up in emergency departments, clogging up an already-overwhelmed hospital system, when a trip to the GP could have helped them sooner. This is the case for too many people on the Central Coast. The lack of doctors on the coast is largely because of the government's refusal to recognise most of the northern end of the coast as a priority; it's not a distribution priority area. I have been calling on the government to give our region DPA status for a long time now. Changing our classification would allow practices to recruit and retain more GPs, and would help people in my community get access to quality health care close to home when they need it.

Fortunately, Wyoming-Ourimbah, which is part of my community, was granted DPA status on 1 July. This has meant that after a chronic shortage on the Central Coast, the Central Coast Community Women's Health Centre has finally been able to recruit a GP, who is now working two days a week. I spoke to Theresa Mason, the manager of the Central Coast Community Women's Health Centre today after their AGM. They, like many others in my community, made a submission to the Senate inquiry that Labor pushed for. As she said in the submission: 'Recruiting and retaining GPs to our health service has been a long-term challenge, a challenge which hasn't been improved by the government's stubborn refusal to act on the DPA status, which has meant a chronic shortage on the Central Coast of New South Wales. It's just not good enough: health care should be a priority, especially in regional communities.'

When a young mum notices that her son is sick, she should be able to take him to a GP straightaway. She shouldn't have to wait days to make an appointment while her son's condition only gets worse. Sadly, this was the case for Kristy. Kristy's son ended up in ICU at Westmead Hospital in Sydney for a month with a collapsed lung when he was just 16 months old. Thankfully, he has fully recovered but this should never have happened and it could have been avoided. It might not have happened if Kristy had been able to get her son into a GP sooner.

Then there are people like David. David lives in Wyong, my hometown on the Central Coast, but he used to live in the Hawkesbury. He told me that he needs to make an appointment at least a week in advance if he wants to see a doctor on the coast, but that it isn't the case further south. He says he's better off making the trip to the Hawkesbury because he can see a GP within an hour there, where he used to live. No one should have to drive that far to get quick access to health care, especially, he told me, during the middle of lockdown. Locals should have timely access to care close to home, in their own community.

I heard a similar story from Leonie. Her husband tried to get in to see a GP in their local area of Toukley after he became unwell. Every single practice told him they couldn't take on new patients, and then they were forced to send him away. He had to make a half-hour trip to his old neighbourhood where he could get into a GP, only to be told that he was in the middle of a cardiac event. In Australia today this is unacceptable. If Leonie's husband had been able to see a GP close to home he would have known what was happening sooner and could have got the essential health care at the hospital straightaway, and the emergency treatment he needed. Any delay in treatment can mean lives. This is all happening because there aren't enough GPs in our community and the government refuses to help. The critical lack of doctors on the north end of the coast has gone on for too long.

That's why, on this side of the House, we had to take things further. Together with Labor MPs and senators, we pushed for a Senate inquiry to be established to investigate GP shortages in outer metropolitan and regional areas across Australia, including on the Central Coast. The inquiry is now up and running, and there are already 110 published submissions. I have one here that I referred to earlier, from the Central Coast Community Women's Health Centre. From speaking with the secretariat, I understand they are struggling to keep up with the sheer volume of submissions. Over the next few months, this inquiry will investigate the lack of doctors in our area and reforms to the DPA classification system and GP training, as well as the impact of COVID-19 on GPs. This is good news for people on the coast. It's a step forward in our fight to secure more GPs and an opportunity for locals to be heard, and I will be pushing for a hearing in our region, because the voices of local people on the Central Coast deserve to be heard, not to be overlooked, ignored or pushed aside by this government.

In the meantime, the minister has announced a new exceptional circumstances review—and I have a copy of his media release on it here—for the Department of Health DPA classification, where anyone in a non-DPA area, such as a clinic, can apply for an assessment. It goes on to say:

… the following factors would be considered alongside an area's non-DPA status:

…   …   …

…   …   …

…   …   …

After eight years, the best the government can do on is to put out, on 2 September, a media release which says there will be a new exceptional circumstance review for the department of health's distribution priority area classification. That is the best they can do. I think the minister is genuine, and I know he's acting in good faith. I have provided letters of support for practices who are trying to access this review. But a case-by-case review will not fix a systemic, systemwide problem. Everybody knows that. After eight years in government, it's just too little, too late, and, as I said, it will not address the underlying systemic problems that are afflicting people, particularly anybody living outside big cities.

As a footnote to the minister's announcement on 2 September, the minister said:

We are aiming to ensure the process is a speedy one, to quickly help address any GP service shortfall arising from those additional factors—

the ones I mentioned before: changes to health services, workforce, or health system; patient demographic changes; and absence of services. Well, I hope so too, Minister. A belated Zoom meeting on the Central Coast will not fix years of neglect.

I'm pleased the minister has come into the House, because I've called him about this myself. I've spoken to him about this urgent problem in our community. More action needs to happen, and it needs to happen now for people like Kristy, who couldn't get her son in to see a GP, with the result that he ended up in the ICU at Westmead Hospital when he was 16 months old; David, who had to drive to Sydney to get access to health care when he couldn't get any access close to home; or Leonie's husband, who, in the middle of a cardiac event, couldn't get health care on the Central Coast.

Minister, you said yourself that, as a health practitioner, you understand the urgency. I urge you to push the government to advocate strongly for regional communities like the one that I represent and the ones that you represent. It must be better. It has to change. It's risky. It's risking people's lives. We need practical solutions to fix this shortage so we can improve health care for all Australians. It's gone on for too long. Anyone who lives outside a big city—anyone living in regional, remote or rural Australia—is feeling this.

We support the intention of the DPA changes, which were meant to get doctors to the bush. But do you know what doctors have told me across Australia? It hasn't fixed the problem in the bush; it's just spread the problem further, so that everyone living outside a big city is now impacted by this, whether it's the outer suburbs, the regions or the bush.

Minister, you said in your media release on 2 September:

The Australian Government is also preparing a formal review of the DPA indicator. Further details of the review will be announced soon.

Well, I really hope so, because I understand that, in my community on the Central Coast of New South Wales, close to 150 local practices have lost DPA status over the last three years. Some of them have closed. Others have been forced to close their books. Do you know what that represents, Minister? Forty per cent of practices in our region, on the northern end of the Central Coast, have lost their DPA status.

At the same time, as you would know, we're seeing an increase in low-urgency presentations at Wyong and Gosford hospitals' emergency departments. I worked at Wyong hospital; I worked there for almost 10 years. The staff there are dedicated, they're capable, but they are under enormous strain, and the emergency department doesn't need to be clogged up with low-urgency presentations which would be more quickly, and safely, seen in a GP surgery. Minister, it is not good enough. It has to change, and a belated case-by-case review process and a yet-to-be-announced wider review of the DPA indicator are not good enough.

I know, Minister, you are genuine in your intentions, but our community, the community on the northern end of the Central Coast, has been left behind, overlooked by this government for eight years. People in my community are feeling the impact of that. It is risky. It's impacting people's health, mental health and wellbeing. It's not good enough that people on the Central Coast are being overlooked and left behind. As I said earlier, I've spoken to you about this personally, Minister, and I've raised these issues with you countless times. I believe you are genuine in your desire to do something—but there is no urgency, and it needs to happen now. People are missing urgent health checks. Somebody I heard from today has missed a breast-screening check. People are missing checks for melanoma. People are missing urgent health-screening checks at the same time as being unable to get care, and it's clogging up our emergency departments.

Minister, this is not good enough. The people of the Central Coast deserve better. You've said you're aiming to ensure that this process is a speedy one, to quickly help. I hope so. You've also said that you'll announce a wider review of the DPA indicator soon. I hope so. But, Minister, a review is not good enough. What's needed is action, what's needed is action now, for people in my community who have been overlooked and forgotten and whose health is at risk because of this government.

Lucy Wicks (Robertson, Liberal Party) Share this | Link to this | Hansard source

I rise to also speak on the Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021, because it does provide some additional flexibility to help improve the operation of the statutory Bonded Medical Program and the Medical Rural Bonded Scholarship Scheme contracts. The amendments will ensure that the program continues to benefit participants and ensure that its key objectives are achieved.

The government currently funds a range of initiatives to help attract medical professionals to and retain them in rural areas across Australia, including this program, the Bonded Medical Program, which commenced on 1 January 2020. The program provides a Commonwealth supported place in a medical course at an Australian university in exchange for participants completing a return-of-service obligation by working as a medical practitioner in a regional, rural or remote community. This helps to deliver higher numbers of GPs and specialists to areas of workforce shortage, which is particularly important in areas like my electorate of Robertson and right across the Central Coast—and I note the member for Dobell referred to this earlier, in her contribution—where there has been a shortage of medical professionals, and particularly GPs, for some time.

This has been going on for much longer than the eight years the member for Dobell referred to. It has been going on for a very long time on the Central Coast. There have actually been a number of reasons for that, and the government over the last eight years has been taking a number of steps to specifically look at addressing the shortage of GPs on the Central Coast. We have had success in the areas that we have been tackling, including, thanks to the now minister, a task force to help address the shortage of GPs on the peninsula, for example. That task force helped to deliver a number of additional GPs to the area. But we know that there are challenges, not just simply in relation to DPA status. We have seen suburbs that have been given DPA—or district of workforce shortage, as it was called a couple of years ago—status, and then the shortage cleared up; it was no longer. There were sufficient GPs in that area. Then, if DPA status is given to another suburb, we actually find that that doesn't necessarily keep GPs in our local community.

I have a personal interest in health and wellness and making sure that our system is not only the best in Australia but the best in the world, and one of the things that I know is the importance of long-term primary care. Having long-term GPs here on the Central Coast is an important part of being able to solve this very challenging issue. It's one of the reasons why the government delivered the outstanding Central Coast Clinical School and Research Institute in the heart of Gosford, which opened earlier this year. It's a world-class medical research institute and university, which means young students will be able to train to be GPs and nurses. We want them to stay. We want them to love the Central Coast lifestyle so much that they actually stay, and over time I believe this will help address some of the shortages that we face in particularly challenging like the Central Coast.

As I was saying before, this bill will provide more flexibility to consider the personal circumstances of participants, such as allowing individuals to cease being a part of the program without penalty in the event of serious disability or death. This is one of the issues that key stakeholders and doctors have helped identify and seek to address. The amendments in the bill will also allow some legacy scheme participants to allow for more time to complete the return-of-service obligations. This will apply to certain long-term participants who would otherwise not be able to complete this program in the 18-year period allowed if they opted into the program. The changes also allow for breaches under the program to be more appropriately managed. It reduces the administrative penalty for each relevant breach from $10,000 to $1,000, assuring that it's appropriate and proportionate in the circumstances. The bill will also allow for appropriate administration of breaches of legacy Medical Rural Bonded Scholarship contracts by allowing the minister to waive penalties accrued by participants for breaches of arrangements prior to the start of the amendments. The changes will also enable the minister to determine if an individual who breaches their contract after the introduction of these amendments should have a Medicare ban applied.

We do know, as I referred to before and as the member of Dobell also outlined, there has been a real challenge in attracting and retaining GPs to the Central Coast for many years now. Since the coalition government came to office in 2013, we have been working on a number of important initiatives to help resolve this problem. I have been advised by the Hunter, New England and Central Coast Primary Health Network that the Central Coast currently has 339 general practitioners working in 92 practices. For a population of 337,000, this means there are only 100 GPs per 100,000 people on the Central Coast, which I understand is below state and national averages. This challenge will only become greater as several GPs in the Central Coast are retiring or are looking to retire in the next few years. Some general practices have advised they've got no other option than to close their doors because they can't find new GPs to fill these vacancies. As I said before, we do need a number of initiatives to help address this particular issue. We need short-term solutions to bring the required number of GPs to the Central Coast. We also need medium- and long-term solutions to make sure we're not always playing catch up—so when we solve the problem in one suburb or area it doesn't pop-up in another area. We actually want to address this in a holistic way.

While there are over 3,500 GPs graduating in Australia each year, very few end up deciding to live in a regional or rural area, and this is one of the problems we face in the Central Coast, and that is why the Bonded Medical Program is so important. It gives students the opportunity to live and work where they are needed most. In my own electorate, suburbs like Woy Woy, Ettalong and Umina Beach are classified as distribution priority areas, making them eligible for this initiative, along with Mangrove Mountain, Somersby, Kariong, Calga, Kulnura and also Wyoming. I know many GP practices in other suburbs across my electorate would welcome changes to the classifications of the Central Coast to enable more and future GPs to access this program because of the very real impact that it has.

The program also has a number of benefits for the higher education sector. I'm told the University of Newcastle normally hosts between 30 and 35 students with a bonded place, with some of these students entering their first year on the Central Coast. A spokesperson for the university told me: 'The changes in the bill are very positive in terms of increased flexibility for students and the long-term effectiveness of the scheme. We understand that they provide students with more flexibility and are more family friendly, which is very important for a university like Newcastle, where the majority of our students are mature age.'

The Morrison government is also investing in other projects to boost our medical workforce. Recently, as I referred to before, the Central Coast Clinical School and Research Institute building welcomed its first 170 medical students. This is something that was made possible following a joint investment, with the Australian government contributing $32.5 million and the New South Wales government and the University of Newcastle contributing $20 million each. In addition, the Australian government provided $12.5 million of transitional funding through the Department of Education and Training to help cover the costs of establishing the new medical and clinical schools. The school has recently welcomed over 700 students from the nursing program. This is just the start, with graduate entry nursing for international students, a master's in health economics, a master's in clinical exercise physiology and a master's in clinical psychology expected to be on offer from 2024. The University of Newcastle is also looking to offer a bachelor of public and community health, a new program that focuses on the integrated and community health needs of the Central Coast. The Central Coast Clinical School and Research Institute puts our region on the map as an area of medical excellence as well as forming part of our long-term strategy to attract and retain more doctors and professionals in our region.

The federal government is also undertaking an exceptional-circumstances review process for the Department of Health's distribution priority area classification system. I know this is very, very much welcomed on the Central Coast. It's going to provide an opportunity for changes to the Central Coast population and other factors to be assessed, and it allows GP clinics in non-DPA areas to apply for an exceptional-circumstances review, which is something that I know is very welcome at a number of local GP practices on the Central Coast. This review will help clinics recruit doctors to care for communities like the Central Coast.

In addition to this work, the Hunter New England and Central Coast Primary Health Network has been working to attract and retain GPs to our region with a number of bespoke incentives, support networks and programs. I'm delighted that from August this year the Central Coast has now become home to 33 new GP registrars commencing in our region. These new doctors have been distributed across the Central Coast region, and they will help to deliver better health services for local residents.

This bill allows for more appropriate and efficient administration of the Bonded Medical Program to meet and support the needs of the modern workforce, a workforce of medical professionals providing crucial health services in regional, rural and remote Australia. This couldn't be more important at a time like this. I commend the bill to the House.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

I am very pleased to rise in support of the amendments moved by Labor to improve the bill currently before the House, the Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021. I will come to some of the comments made by the previous speaker, the member for Robertson, with regard to the University of Newcastle shortly. I want to take this opportunity to, at least in the beginning, try to map out the intention of this bill. It is an effort to amend the Health Insurance Act that would try to provide some flexibility into the Bonded Medical Program and the administration of those related scholarships and contracts there. The government says the bill is designed to address the doctor shortage across the regions, including in rural and remote areas. I take issue with that claim. I seriously think that is overstating the work of this bill. Whilst this might provide some relief to one small component of the reasons why we continue to have doctor shortages in rural, regional and remote parts of Australia. But it is not only those parts, as you would have heard many members on this side of the House say, including now me, as the member for Newcastle. We are suffering doctor shortages in metropolitan and outer metropolitan regions. Don't for one minute think this is a problem only for remote or rural parts of Australia. Why is that? It is because of deliberate policy decisions made by this government over the last eight long years.

There are aspects of the bill that Labor is absolutely supportive of. We do welcome these small changes to the way in which the Bonded Medical Program is going to be administered. It is welcome that there will be increased flexibility around the administration of the program. We don't have any beef, we don't have any problem with the proposed changes being made there. What is at issue is the notion that this will somehow address doctor shortage issues in this country, because it's not going to, and I don't think we should be pretending otherwise. That is really the reason why Labor pushed so hard to establish the Senate Community Affairs References Committee inquiry into the provision of GP and other health care services in outer metropolitan, rural and regional areas. We needed to be able to consider the performance of programs like the one that is the subject of this legislation, the Bonded Medical Program.

The Bonded Medical Program has been in operation for some time. It needs a thorough review, I would suggest. It has not met expectations by any means, but let's not for one moment think this is the sole reason for doctor shortages in our nation. Indeed, it is worth reminding the House that it is the Morrison government's decision to remove areas like Newcastle and the Hunter region from the new distribution priority area classification that means that doctors in thee Bonded Medical Program cannot meet their return of service obligations in areas like Newcastle and the Hunter. That just makes our GP shortage even worse.

I said at the beginning that I wanted to come back to some of the comments made in relation to the University of Newcastle by the member for Robertson. I'm not disputing the fabulous work that the university is doing and the big efforts being made to establish yet another medical school, this time on the Central Coast, but I warn this government that just creating new medical schools is not going to be the panacea either. Do you know why? I went through this argument when the government, and the National Party in particular, led the charge to create the new Murray-Darling Medical Schools Network. The government dedicated nearly $75 million to establish this network of medical schools. I believe there was a bit of celebration this year with new students starting in some of those medical schools, but let's not kid ourselves that this government, in setting up new schools, provided a single extra medical place to go into those schools. What they did was to rob universities like Newcastle, which already had the oldest and most successful regional medical training program in Australia, of medical places. We have since 1978 had a partnership with the University of New England in Armidale, training doctors for regional and remote regions of Australia, way above the national average for universities. You—not you, Mr Speaker, but this government—took medical places from successful universities like Newcastle in order to stump up on a promise from the National Party to deliver a new set of medical schools around the Murray-Darling region. It is terrific that people from Orange, Wagga and parts of Victoria get access to medical schools closer to home, but they weren't new places; you robbed existing programs in the country of those places.

If you were serious about addressing medical workforce shortages in Australia, you wouldn't just build new medical schools; you would be properly resourcing them, and you would be backing in programs such as those that the University of Newcastle wishes to implement now. We already run a really fantastic nurses training course: the Bachelor of Nursing program at the University of Newcastle. But we know that there are low numbers of First Nations nurses in Australia. For example, people from the Aboriginal medical services in Walgett and Brewarrina have come to Newcastle to say, 'We want you to run a Bachelor of Nursing program on country.' What a terrific idea! The University of Newcastle is flexible and innovative enough to be able to deliver a Bachelor of Nursing program on country, but it needs some support from this federal government to do so. So, if you were really serious about trying to address GP shortages and medical workforce shortages more broadly in rural, regional and remote Australia, you would be backing in, 100 per cent, universities such as Newcastle, which are seeking to deliver bachelor programs on country for First Nations people.

The university is not resting on its laurels. We know that the University of Newcastle is already training more than 50 per cent of First Nations doctors; they will be trained and coming out of the University of Newcastle. It is a phenomenal course that's taken 30 years to build. But, not content to just sit back, pat ourselves on the back and say, 'Good job,' we now realise the challenges of delivering bachelor programs on country, where we can increase the numbers of nurses coming through tenfold or more. So I really hope that the government is listening today and is prepared to back in a great program like the nursing-on-country program.

As I said, you can't just take from existing programs, plop them over the country and expect that all of a sudden you will have more doctors and they are going to stay in rural and regional areas. You should be turning to places like Newcastle, which has been running that regional medical training, as I said, since 1978. So it's not as if we're newbies in this field. Thirty-six per cent of the students coming through those programs come from rural and regional communities in the first place, and that compares to the 20 per cent currently coming through other medical programs. We know that graduates of that joint medical program between Newcastle and the University of New England at Armidale are twice as likely to seek work in the rural and regional areas as the national average.

So, as a program with the highest proportion of graduates working in rural and regional areas, I think there is a lot to be learned from programs that have a lot of runs on the board already.

I want to highlight a couple of case studies that show how detrimental the continuous freezing of the Medicare levy over the last eight years has been. There is this change now, where you carve out the Newcastle and the Hunter region and take out the incentives for bulk billing payments, carving us out of the Distribution Priority Area classification list—all of this means that you are making it less and less possible for people to be able to see a GP in a timely and affordable manner in my community of Newcastle.

I want to raise the case of the Fletcher medical centre in my electorate. It's one of many GP clinics across Newcastle affected by this government's callous disregard, really, for what is happening to the health and wellbeing of Australian families in nonmetro, non-capital-city communities. Madison, who is the practice manager at the Fletcher clinic, recently reached out to me, because they are desperately trying to fill GP vacancies in their clinic. The clinic is working overtime in order to try to meet demand. It is not sustainable. It has been made worse by the COVID-19 pandemic, of course, yet they know that the Newcastle catchment area is only one per cent over this mythical catchment benchmark that means they now have to apply for an exemption in order to be able to recruit an additional GP. As I said, they're only one per cent over this benchmark, but the government hasn't been able to see its way to providing them any kind of break: no exemption for you to go out and find the GP that you so desperately need, for what is a vast and fast-growing area in the western part of my electorate.

I also want to highlight the recent closure of a practice at West Wallsend. This was a practice that existed for over 30 years. Again, in an area of growing families, six years of Medicare freezes followed by this decision to reclassify our area out of the DPA list was the final straw for this GP clinic; they had to shut their doors. They serviced a low-socio-economic part of my electorate, with more than 50 per cent of patients being concession card holders. That practice no longer exists because of the inaction of this government over the last eight years. You cannot just say that you want to see more doctors out in regional areas if all you do suggests otherwise. (Time expired)

David Gillespie (Lyne, National Party, Minister Assisting the Minister for Trade and Investment) Share this | Link to this | Hansard source

The Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021 provides additional flexibility to support the ongoing administration of the Bonded Medical Program. The bill supports achievement of the program's objectives. Amendments support participants in the program and their interest in seeking to be part of the program. While in the program, it ensures fair and reasonable application of legislative penalties by making them quite appropriate and, most importantly, proportionate. It also supports better administration of breaches of the legacy Medical Rural Bonded Scholarship Scheme, again in the interests of participants, where breaches may be inadvertently incurred.

Overall, the bill enhances the Bonded Medical Program. It allows for more appropriate and efficient administration of bonded programs, and, above all, to meet and support the needs of a modern medical workforce providing crucial health services in regional, rural and remote Australia. The program is one important element of this government's broader Stronger Rural Health Strategy. A highly skilled, well dispersed regional workforce reduces the prevalence and impact of disease, allowing better primary care to be delivered and a better distribution of the medical workforce. It's important that individuals get access to services in their local community, without the burden of travelling large distances and establishing continuity of care and trust. There are many advantages to practising medicine in country Australia rather than metropolitan Australia, and I encourage more doctors, whether they're bonded or not, to choose the rural option.

I'd like to thank all the members for their contribution, including the member for Dobell and the member for Newcastle. There are so many moving pieces in the medical workforce dilemma facing the nation. We have a lot of other policies. They mentioned the Murray-Darling Medical Schools Network, which is extending existing Commonwealth supported places to be trained for much longer, from the beginning to the end of their medical school degree, in regional centres where they're getting, I think, better training than they do when they're based in a metro high-level teaching hospital, because they see much more regular-type medicine and they get much closer clinical experience, tutoring from senior medical practitioners and a great appreciation of country life. The Medical Schools Network is also a great workforce attractant and retention factor, keeping senior medical professional people staying in country areas, because they can be involved in the rural clinical schools, of which we have 21 around the country. They are a great asset and give better training.

However, there is competition amongst all the professions. Way too many people have started going into medical specialties, and that's a dilemma that we are trying to change. General practice is an incredibly important part of the health system. It's the rock and the pillar on which everything stems from, and that's why Australia has got good public health outcomes compared to many other health systems, including well-known ones like the NHS and the American system, which isn't as good as what we have in Australia, which is a mix of private medical practice and salaried medical practice inside a very structured system. Anyhow, these issues are beyond the Bonded Medical Program, which is a good program, but we look forward, with these changes, to delivering better outcomes. I commend the bill to the House.

Trent Zimmerman (North Sydney, Liberal Party) Share this | Link to this | Hansard source

Order! The original question was that this bill now be read a second time. To this, the honourable member for Cooper has moved an amendment that all the words after 'That' be omitted with a view to substituting other words. The immediate question is that the amendment be disagreed to.

Question agreed to.

Original question agreed to.

Bill read a second time.