Helen Haines (Indi, Independent) Share this | Link to this | Hansard source

I move:

That this House:

(1) recognises that:

(a) 28 per cent of the Australian population live outside major cities;

(b) people living in rural and remote areas have higher rates of hospitalisations, deaths and injury and also have poorer access to, and use of, primary health care services, than people living in major cities, yet investment in regional and rural health is falling behind, leaving regional communities with outdated facilities, insufficient training places and healthcare students struggling to train locally; and

(c) the lack of open, competitive and needs-based hospital infrastructure funds means regional and rural hospitals have no transparent, competitive Commonwealth funding pathways to build critical infrastructure to deliver health services for the growing border population into the future;

(2) notes that premiers are calling for increased funding from the Commonwealth Government for hospitals, including specifically for infrastructure; and

(3) calls on the Government to establish a $2 billion Building Regional and Rural Hospitals Fund to provide competitive and needs-based investment for new buildings, equipment and planning, so health services in regional, rural and remote areas classified as MM2 and higher can apply for hospital infrastructure funding to meet the needs of their communities now and into the future.

Regional and rural Australia is in desperate need for more investment in our health, including in our health infrastructure. The stats don't lie. The National Rural Health Alliance estimates that rural Australians received $8.3 billion less in healthcare funding compared to urban Australians in the 2023-24 financial year. This funding gap has grown by almost $2 billion since 2021-22, and this has consequences. Rural and regional Australians die younger and have longer term, worse chronic disease than their metropolitan counterparts. This data matches stories from my local electorate of Indi. I hear time and time again about health infrastructure failing to meet the needs of communities right across Indi. When it fails, rural Australians endure unnecessary suffering and trauma.

Elise, whose father lives on the border, recently wrote to me concerned about a four-day delay in her father's surgery at Albury Wodonga Health. The delay led to serious complications, including a gangrenous gall bladder, sepsis and her father being placed in an intensive care unit on a ventilator. Thankfully he survived. This was not caused by a lack of will or expertise on behalf of the incredible staff at Albury Wodonga Health. The family were told the delay in treatment was due to there being only seven operating theatres between Albury and Wodonga hospitals—an absolutely appalling situation when we know that we need 13 new additional operating theatres. This region has a population of over 100,000 residents, and it's one of Australia's largest and busiest regional health centres.

The New South Wales and Victorian state governments are investing more than half a billion dollars in redevelopment of the Albury hospital; however, the upgrade is not fit for purpose. NSW Health expects the scope of the project to include new surgical and operating theatres. I'm pleased to hear that, but it came to light—and the ABC's 7.30 recently showed—that they will be constructed not as operating theatres but as empty shells without the internal fit-out and equipment required to make them operational. Can you believe it? When the two state health ministers wrote to the federal health minister seeking additional funding for Albury Wodonga Health, they were told there was not a Commonwealth grant available for this purpose. Health facilities need to be built to meet our region's growing health needs now and into the future—not with corners cut, not scaled back to retrofit a budget.

I've done the work to address this and give rural hospitals a pathway to seek additional funding from the Commonwealth to deliver the care their communities so desperately need and deserve. My proposed $2 billion Building Regional and Rural Hospitals Fund offers a vital funding lifeline for regional and rural health hospitals right across Australia. Through this fund, regional health services like Albury Wodonga Health will have the opportunity to apply for open, competitive and needs based funding to deliver health infrastructure in partnership with the states that meets the community's needs. In Indi, this would also mean places like Bright district hospital, Mansfield hospital and health precincts right across rural and regional Australia would have a pathway to seek legitimate, fair and transparent funding from the Commonwealth. This policy puts transparency back into health funding and addresses the dire underfunding in rural Australian hospitals.

The federal government has a clear role in funding health infrastructure because—you know what—they already do it. The problem is that it's often not transparent, competitive or needs based spending of taxpayer dollars. In the last election, both major parties were guilty of pork-barrelling promises for health and hospital infrastructure. Both major parties promised $200 million for a hospital in the seat of Hasluck. They promised $120 million for a Rouse Hill hospital on the border of the electorates of Greenway and Mitchell. And $150 million was promised to Flinders medical centre, which is on top of Labor's 2022 election commitment of $200 million at the same hospital in the seat of Hindmarsh. Labor promised $80 million to Fairfield hospital bordering the electorates of Fairfield and McMahon. I have no doubt these health services need this money to meet their community needs, but the real problem here is a lack of transparency. There is no open, fair process to assess need; there is no opportunity for other hospitals facing equally urgent pressures to apply for funding. I call on this government to close the stark gap in regional health funding and adopt my proposal for a $2 billion 'building regional and rural hospitals' fund.

Zaneta Mascarenhas (Swan, Australian Labor Party) Share this | Link to this | Hansard source

I call for a seconder for the motion.

Andrew Wilkie (Clark, Independent) Share this | Link to this | Hansard source

I second the motion by the member for Indi, and I reserve my right to speak.

Trish Cook (Bullwinkel, Australian Labor Party) Share this | Link to this | Hansard source

Today I rise to speak on the motion from the member for Indi and thank her for bringing this critical issue for rural health to the floor of the House. For my constituents in the rural portion of the seat of Bullwinkel, this isn't a theoretical debate; it is a matter of daily importance. It's about ensuring our families can get a doctor's appointment when they're sick. It's about having the confidence of quality care, knowing that it is available locally without a long drive to the city. It's about supporting our dedicated local clinics and hospital staff, who do such a fantastic job in the rural communities.

As a former rural and remote area nurse myself and a general practice nurse, I know that our rural communities deserve to be able to get the care they need, when they need it and close to home. The Albanese Labor government understands this, and we understand that a strong Medicare supports people. It eases cost-of-living pressures, and it takes pressure off our hardworking hospital staff. That is why we're getting on with the job of strengthening Medicare for all Australians, especially those who live in regional and rural communities. Through the 2025-26 budget, we're investing $7.9 billion to strengthen Medicare. This includes $644 million for more Medicare urgent care clinics and $660 million to build upon our health workforce.

You can't have a strong health system without a strong health workforce. For too long, communities across Bullwinkel have struggled to attract and retain doctors and health professionals when they need it. That's why I'm proud of our government's work in formally recognising rural generalism. It's a new specialty field within general practice, and this is a game changer. We aren't just training more doctors; we're training the right doctors for our communities—doctors with specific advanced skills where they're needed in primary care, in emergency medicine and often in obstetrics and mental health. This year, Australia will see the largest cohort of future GPs in our history. More than 1,800 doctors are commencing training. And, crucially, at least a quarter of these doctors are GPs in training in that new specialty of rural generalism. These are the doctors who will staff our local clinics and hospitals for years to come, and our government is funding their training.

And, of course, finding a doctor is only half the battle—affording one is the other. Our $7.9 billion is designed to make it easier for people in Bullwinkel to see a bulk-billing doctor. For the first time, from 1 November, we're expanding bulk-billing incentives to all Australians and creating an incentive for practices that bulk-bill every single patient. Here is the crucial part for my community: those incentives are higher in the regional and rural areas. This means any Medicare-eligible patient in Bullwinkel bulk-billed for a standard consult will attract a higher Medicare payment for their GP than a patient in the city would. A GP at a rural practice that bulk-bills every visit is expected to earn $24,000 more than a mixed-billing practice that provides the same services. So this is the direct, practical and funded incentive to make bulk-billing more viable for our local clinics. And we're already seeing the results. Since Labor tripled the bulk-billing incentive for our children and concession card holders last November, Australians in regional and remote areas have had nearly 2.5 million additional bulk-billed visits to the GP.

We are delivering a record $1.8 billion for our public hospitals on top of the workforce incentives, and we're committed to finalising the new five-year National Health Reform Agreement to give our hospitals long-term funding certainty. This is in stark contrast to the cuts and neglect of those opposite when they were in government. For the people of Bullwinkel, this means more doctors, lower costs and a stronger public health system, because, in Australia, your health care should be determined by your Medicare card, not your postcode.

Andrew Wilkie (Clark, Independent) Share this | Link to this | Hansard source

I'm delighted to second the member for Indi's motion because it hinges on equity, access and dignity for every Australian. Healthcare facilities in rural and regional areas have long been neglected, leading to an urgent need for dedicated federal funding. Of course it's unacceptable that, in a country as rich as Australia, rural Australians receive $1,090 less healthcare funding per person each year than city residents. Indeed, according to the National Rural Health Alliance, that shortfall now amounts to over $8 billion annually, resulting in longer wait times, a lack of specialist services, staff shortages and, of course, outdated infrastructure.

In Tasmania, where most of the state is classified rural and remote, the impact is especially acute, because, while Tasmania's four major public hospitals provide vital services, they're also supported by13 district hospitals, from King Island to New Norfolk, from Smithton to St Marys. These facilities are the backbone of their communities. But, when you talk to families or health workers across Tasmania, you hear the same concerns: facilities are outdated, emergency departments are cramped or overflowing, diagnostics are limited, and, too often, care is delayed. Remember—in places like St Helens or Ouse, where private providers have withdrawn services or closed, the public system is not the safety net; it's the only net. We must be honest about the problem here: federal funding has not kept pace with the realities on the ground.

In February this year, Australian governments did extend the National Health Reform Agreement by one year. Under this agreement, Tasmania will receive $754 million in federal health funding this financial year. But, when you consider that Tasmania's public hospitals are said to cost over $3 billion annually and that our hospital costs are growing at nearly three times the national average, it becomes clear that this agreement does not go far enough. Clearly, a renewed multi-year NHRA agreement must remain a priority. But let's not pretend such funding absolves the federal government of responsibility to those living in regional and rural areas of Australia.

The fund the member for Indi is proposing, however, would allow for targeted, needs based investment that lifts up rural and regional communities. Let me be clear: this is not about asking for more than our fair share; it's about fairness. Quite simply, it costs more to build and maintain healthcare infrastructure in regional and remote areas. Moreover, workforce shortages and geographic isolation can also create real barriers to effective care. For example, as of September, over 9,000 Tasmanians were on the elective surgery waitlist, and only 63 per cent were seen on time. Another 10,700 Tasmanians are waiting for public oral health care. At the Royal Hobart Hospital in particular, bed block has led to major surgery cancellations, and ambulance ramping continues. Adding to the pain, in August, Royal Hobart Hospital staff were informed that a planned $130 million redevelopment of the emergency department was being shelved due to budgetary issues, replaced instead with a 'lower scope design' that management itself acknowledged is not fit for purpose. There's also the closure of the St Helens hospital and the broken-down BreastScreen Tasmania bus, which leaves women in remote areas without access to vital early detection services.

With private health services in Hobart in trouble, including the collapse of smaller GP clinics and storm clouds over the Hobart clinic and Hobart private hospital, we're only going to see more pressure build on the public health system. Again, that comes with painful human impacts—for example, the heartbreaking case of a Hobart child that suffered devastating burns as a baby. He is only two years old now and in a critical recovery phase. His parents have fought for laser therapy that could drastically improve his lifelong recovery, only to be told that the laser machine at the Royal Hobart Hospital had broken down, and would not be replaced due to cost.

Sadly, while other states have invested in new health infrastructure, the Tasmanian government is still patching up what should have been replaced a decade ago. It's a false economy, and it's hurting people.

Clearly, we need a dedicated rural health infrastructure funding arrangement and commitments to upgrade or rebuild our district hospitals. We also need fit-for-purpose facilities that can recruit and retain staff and deliver timely care as well as support modern services. This is not about politics; it's about people. Governments owe it to them to deliver a system that works, no matter where they live in this country.

Zaneta Mascarenhas (Swan, Australian Labor Party) Share this | Link to this | Hansard source

The allotted time for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.