Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Aged Care, Disabilities and Carers) Share this | Hansard source

I am also pleased to support the disallowance of this move by the government to introduce $200,000 medical places in Australian universities. In doing so, can I say that the position we are taking today is consistent with Labor policy that we have held over many years. Senator Trood’s attempt to explain what he thinks has been the history and evolution of this was mischievous. I suppose that is a nice way of putting it, but misleading would probably be more accurate. To tell half a story might be a little bit entertaining for those people who were listening to him, but it goes a long way from the truth. Labor has been opposed to full fee paying students. This is consistent with our policy and there has been no deviation.

The COAG communique from last month recognises the chronic doctor shortage we have in Australia. You could say that it has taken this government a very long time to realise that their actions over the last 10 years have led us to the position we are in today. Ten years of inaction and not responding to what we have known to be a growing doctor shortage by not increasing HECS places for medical students at universities has put us in this position. The blame for that must be sheeted home to the government of the day. We know that it takes 10 years to produce a doctor. The fact is that this government have been in power for 10 years. It is now totally the responsibility of this government in the way they cut medical places over that period of time and also did not allow for growth and keeping up with the known demand that we were going to have. The reason we are in this circumstance is directly attributable to this government and nobody else.

The response to the acknowledged doctor shortage that we face in this nation from the government of allowing universities to increase the number of full fee paying places—that is, people will have to pay up to $200,000 to get themselves a medical degree—is wrong. It is wrong for two basic reasons. It is wrong in principle and it is wrong in effect. The reason that it is wrong in principle is that entry into these places will not be based on the merit or scholastic achievement of the school leaver; it will be based on the depth not of their pocket but probably of their parents’ pocket. That is the entry requirement that we will have for this cohort of doctors coming into our universities.

Senator Vanstone in 1996 was absolutely correct when she said on introducing full fee paying places in Australian universities that the one area that was exempt was medical places at universities. She used then the evidence that said that it was not consistent with good health policy. I would like to know what has happened between 1996 and now. The principle was right then and the principle remains right now. In response to Senator Trood’s comment that these people are going to be equally talented, it stands to reason that a successful applicant who is entering in the knowledge that they are going to have to pay $200,000 for this degree will be less qualified than a person who could have achieved a place but did not have the $200,000. There is just simple logic there. You cannot deny it.

You can say that they will be marginally less qualified to take that place, and maybe that is the case. But is this not a question of equity? How fair is it that someone who is pretty bright but whose parents have a lot of money should become a doctor in this country and not a person who is also pretty bright but comes from the wrong side of the railway track? There is an equity question that this policy does not address, and it is an equity question that I will continue to defend in terms of full fee paying places.

Coming from regional Australia, I know that my university, James Cook University, which is based in North Queensland and increased its HECS places this year, will have to hand back a number of places because it has not been able to fill them. Why, you ask, has it not been able to fill those places? It is because, for people in regional areas who are less used to going to university, cost is a real disincentive. The year that HECS goes up, we know that those students do not apply. There is a direct correlation between increasing the cost of a degree and people from rural areas not applying. That is a truth. That is happening now at the Central Queensland University, it is happening at James Cook and it is happening in regional universities right across Australia. I raise the issue to underline the fact that people who have less money in their pockets will not go to universities. They will not take places in universities if they are going to have the high costs following their graduation.

I said I was opposed to this policy for two reasons. I said it was wrong in principle, but it is also wrong in effect. I am actually interested in solving the doctor problem in Australia. I come from regional Queensland. We are the people who, everyone understands, are finding it hard to attract doctors into our region. I am opposed to this because it will do nothing to solve that problem. I am interested in outcomes in this place, and this policy will not, in my view, put another doctor in Barcaldine, Boulia or Charters Towers. That is what I am interested in doing. Unfortunately, this policy will do nothing to solve that problem. What it will do for those 285-odd students who do graduate in four or five years time is put them into Wickham Terrace. For those people who do not come from Queensland, that is our specialist street. That is the street that the specialists work on. If you graduate with a debt of $200,000, you are interested in paying off that debt. The best way to pay that off is to specialise quickly, get onto Wickham Terrace and charge a lot of money so you can fix up your debt. It is not going to Boulia and working in the state public health system, because you simply do not earn the same amount of money.

We know this not only because it is commonsense but also because, during the inquiry into Medicare that we conducted some years ago, the Australian Medical Students Association told us that they were opposed to the bonded student policy that was being discussed. They said that students who were bonded to go to regional and rural areas would buy out their bond and stay in the cities in order to get through university and then pay back that bond, rather than spend the number of years that they were meant to be bonded to go into the bush. We know that is happening already now. That is what is going to happen. People are not going to end up in rural and regional Australia as a result of this measure.

You do not have to just rely on me and my commonsense approach to this policy. The Australian Medical Students Association criticised the government for its ‘attitude of denial’ regarding the latest attempt to justify its massive hike in full fee medical student places. Teresa Cosgriff, the president of the association, said:

To state that the current funding system provides equitable access for students is ridiculous.

She said:

Full-fee places are simply not an option for most students and it defies logic to argue otherwise.

She went on to say:

While the Government has acknowledged the need for additional doctors to be trained, it has invested nothing into additional HECS places for medical students.

The Australian Medical Association’s Dr Mukesh Haikerwal said on the day that this policy was announced:

... the Government’s plans to increase medical student numbers would be more effective if the places were HECS-funded, not full-fee paying.

He said:

... Government funding of the places would better reflect the Government’s commitment to easing medical workforce shortages, and would give the brightest students, not just the wealthiest students, the opportunity to pursue a medical career.

In his press release he goes on to say that the sort of people who will be applying are the people from wealthier families, rather than people who should get there on merit but simply do not have the dollars in their pockets. He goes on to reiterate my point that these doctors will not end up in rural or regional areas but on Wickham Terrace in Brisbane and in the inner cities of Sydney and Melbourne.

As I said, I am actually interested in solutions. We do have a shortage, but the answer that would truly solve this problem is the increase of the number of HECS places at universities. That is the fair way of doing it. That is the way that will get the best and brightest students into those places—those who have the most motivation to follow their careers rather than pay off their debt.

Can I also say that, if we are actually keen to solve the problem of doctor work force shortages in rural and regional Australia, we should do what is proven to work. Universities in South Australia and James Cook University have proven that if you recruit students from regional and rural areas, if you train them at universities that have a focus on rural health—like Charles Sturt University in South Australia and, certainly, James Cook University in North Queensland—if you train them with a focus on regional health and if you then offer them placements in interesting regional and rural places—for example, lots of students are doing fantastic placements in Mount Isa and on Thursday Island, and I know the Northern Territory has provided great opportunities for these sorts of placements—then the likelihood is that they will apply for jobs and will stay in regional and rural areas.

So, if you recruit from regional areas, if you train students in universities that have a regional health focus and if you give people placements in regional areas, the proven likelihood is that they will end up working in regional areas. The last part of that story is that, if people get married in those regional areas, they end up staying there for life. They are the facts. This policy will do nothing to deliver that outcome. As I said, I am a Queensland senator based in a regional area. I have a commitment to solving this doctor shortage problem. This policy does nothing to solve that problem; $200,000 degrees do nothing to solve the doctor shortage in rural and regional Australia. I am pleased to have been consistent with Labor policy over many years and to support the disallowance of this measure.

Question put:

That the motion (That the motion () be agreed to.