House debates

Tuesday, 28 November 2023

Grievance Debate

Blair Electorate: Health Care

6:45 pm

Photo of Shayne NeumannShayne Neumann (Blair, Australian Labor Party) Share this | | Hansard source

In the area of health, there is no greater priority for the Albanese Labor government than rebuilding general practice, and that's why the centrepiece of the May budget was a commitment to strengthening Medicare, with $6.1 billion of initiatives, including a tripling of the bulk-billing incentive, the largest investment in bulk-billing in the history of Medicare. This historic investment is making it easier for more than 28,000 children and their families and more than 77,000 pensioners and concession card holders—more than 105,000 patients in total—to see a GP at more than 50 GP practices that bulk-bill in my electorate. That's a very important investment in the May budget. On top of this investment in bulk-billing, we have invested a $1.5 billion indexation boost across the board in Medicare rebates, increasing the amount that doctors receive for medical services and reducing the pressure on GPs.

The Ipswich region, in my electorate, is continuing to grow, and it is often difficult to get to see a GP. This is particularly an issue in peri-urban areas and small country towns on the fringes of Ipswich, like Walloon. Prior to July 2022, the Rosewood GP catchment, which Walloon Medical Centre falls in, was classified as a non-distribution priority area, or non-DPA. DPA status allows medical practices to recruit from a large pool of location restricted doctors, including overseas trained doctors, and improves access to GP services in areas of need where there are workforce shortages. The July 2022 update, as part of Labor's election commitment to improve access to GP services in outer metropolitan areas where workforce shortages had been identified, gave the entire Rosewood GP catchment DPA status. That is very welcome. In opposition, I fought to make it easier for the Walloon Medical Centre and others like it to recruit more doctors to service the local area. This was a great outcome after years of advocacy on behalf of these practices.

But, despite the DPA change, it is still classified as being in a metropolitan area under the Department of Health and Aged Care's Modified Monash Model, or MMM, which makes it harder to attract doctors to work long-term at the surgery. What this shows is that the DPA changes the Albanese government made after the election were good for some clinics in my electorate, which are now able to attract more GPs, but not for others. The Walloon example highlights what a complex issue this is. It shows why DPA status in and of itself is not a silver bullet. The government funds a range of programs and incentives to encourage GPs to relocate to rural and regional areas in addition to the DPA, like the Modified Monash Model. So we need to look at other levers like this.

That's why I was so pleased to see the announcement of a wide-ranging government review to urgently investigate how to secure a more equitable distribution of doctors and health workers around the country. The Working Better for Medicare review was announced by the Minister for Health and Aged Care last week and will look at how current policies and programs can be strengthened to make it easier to see a doctor, nurse or other health professional in the outer suburbs of major cities and in regional, rural and remote Australia. The review will look at Medicare's role in locating the workforce as well as the three main policy levers used to distribute the workforce: the MMM, the District of Workforce Shortage classification and the DPA.

The review will identify ways to improve health access for Australians by building a more stable, motivated and properly located workforce. The aim is to have an appropriately located workforce, particularly in areas that find it difficult to attract and keep doctors, so that all Australians can access the care they need when they need it, regardless of where they choose to live. The Working Better for Medicare review will be led by nurse advocate and remote health expert Professor Sabina Knight and former senior health bureaucrat and academic Mick Reid. It will be underpinned by extensive stakeholder engagement, with findings expected to be provided to the government in mid-2024.

The Working Better for Medicare review will build on other work to strengthen Medicare, like Professor Mark Cormack's Unleashing the potential of our health workforce, which will ensure that, whenever they work, every health professional can provide every bit of their skills, training and expertise.

I know that the Albanese government is committed to making Medicare stronger and improving access to health care, which is something I fought for in my electorate for 16 years. The reality is that when we came to government there had been nine years of cuts to and neglect of Medicare from the LNP, including when the opposition leader was health minister, and it was harder and more expensive than ever to see a GP, particularly for people in outer-metro and regional electorates like mine. As I mentioned earlier, we made the largest investment in bulk-billing in the history of Medicare and we made it cheaper to see a doctor. I am hopeful the Working Better for Medicare review will make it easier, not just cheaper, for patients in my regional electorate to see a doctor.

The levers we have to spread doctors and health workers around the country are from very different times, before the COVID-19 pandemic and the global health workforce crunch. The government will use all possible levers to encourage doctors and other health workers to be where patients need them—outside of cities and in areas of need. I'm delighted the minister has initiated the review and I hope it can make it easier for practices like the Walloon Medical Centre to recruit more doctors. But going forward we need to look at a range of other issues that impact the health workforce and the supply and distribution of doctors and health professionals.

We need to encourage more Australian medical students to train as GPs and we need to promote the rewards of serving the community outside inner-city areas. On the weekend I caught up with another GP, who is from Kilcoy in the far north of my electorate, in the upper Somerset region. He told me that unless he can access a locum most days it's just him at the practice and that he struggled to recruit another doctor for about two years, as many young GPs simple don't want to work in rural areas. For him, DPA and MMM are all but irrelevant. He really needs someone who's prepared to commit to a country practice and enjoy that lifestyle.

The recent Royal Australian College of General Practitioners' health of the nation report found that GPs are seeing more patients than ever, that the GP workforce needs an urgent boost and that mental health is a growing issue. The college has said that general practice sustainability needs to be addressed to prevent practice closures impacting communities across the country, with four out of five practice owners concerned about the viability of their practice, and that urgent action is needed to boost the general practice workforce across the country to ensure GPs can meet patient needs now and in the future. The report argues that we are facing a looming shortfall of GPs and that we need to do much more to attract and retain this essential workforce.

The RACGP have put forward a range of suggestions to boost the workforce. They've identified that GPs are hamstrung due to discrepancies in conditions and pay between hospitals and private practices. This is a significant barrier to becoming a GP, but they suggest it could be addressed by investment in three key measures: introducing an incentive payment in the first six months of community general practice training; study leave; and paid parental leave for GPs in training. The college have argued that addressing these three barriers would make an immediate difference in getting GPs training and working in communities like mine that need them.

Others have suggested raising the status of the speciality within our medical schools. The RACGP report found that just 10 per cent of GPs are interested in becoming a practice owner and that four out of five current owners are concerned about the viability of their practices. So we really need more GPs to aspire to become practice owners as well in order to have a strong and sustainable general practice sector. It's the only way we can do it.

One way the government is helping in this area is by wiping HELP debts for doctors and nurse practitioners who live and work in rural and remote areas of Australia. Under this initiative, doctors and nurse practitioners who choose to live and work in areas where they are needed will have their HELP debt wiped or reduced. The HELP debt reduction for a doctor or nurse practitioner will depend on their length of service, their course of study, the amount of HELP debt they have outstanding, and when they commenced eligible services in an eligible location.

While the amount of the benefit will vary, some doctors who live and work in rural and remote parts of Australia could save up to $70,000, and a nurse practitioner could save up to $20,000. These changes are a win-win for doctors and nurse practitioners, and I encourage more of this from the government. They particularly benefit areas like rural Ipswich and the rural Somerset region. Zero HELP debt is a great incentive for young graduates to live and work and build their careers in rural and remote areas.

These measures would make country practice a most attractive long-term career option. We expect it will attract 850 doctors and nurse practitioners every year across the country. Many parts of my electorate experience skills shortages in key professions, including of doctors and nurse practitioners. It would be a huge benefit to communities like Esk, Toogoolawah, Coominya and other areas around, as well as Lowood.

There's more to do, and the Albanese government is working to improve health care. I look forward to the result of this review. I think it will be a game changer and I hope the government listens carefully to the views of the college and rural doctors. (Time expired)