Santo Santoro (Queensland, Liberal Party, Minister for Ageing) Share this | Hansard source

I thank all contributors to this debate: Senators McLucas, Sterle, Ian Macdonald and Adams. I express appreciation for the constructive and cordial way in which this debate has taken place. I could be tempted to follow on from the contribution by Senator Ian Macdonald in relation to Queensland matters with great ease, but I suspect that I would be taking a point of order on relevance from Senator McLucas and perhaps you, Madam Acting Deputy President Troeth—maybe question time would be a more appropriate time—so I shall sum up. I will make some general statements in relation to the Health Insurance Amendment (Medical Specialists) Bill 2005 and then address some of the specific contributions made by senators opposite, particularly those by Senator McLucas, who is representing the shadow minister in this place.

The proposed amendment will reduce unnecessary red tape for medical practitioners seeking recognition as specialists and consultant physicians under the act in order to provide services which attract Medicare benefits at the appropriate rate to their patients. Currently, the administrative process for recognising medical practitioners can involve unnecessary duplication and lengthy periods. This has been the source of regular complaints from medical practitioners, specialists, medical colleges, employers and recruitment agencies. Applications for specialty recognition by certain medical practitioners must be referred to state or territory specialist recognition advisory committees, known as SRACs. All applications seeking recognition as consultant physicians must also be referred to an SRAC.

Referrals to SRACs may have been effective in the past by providing a structure for the assessment of specialists who are not eligible for automatic recognition. However, since these committees were established, specialist medical colleges and medical registration boards have developed and implemented assessment processes which are now used by the SRACs in making their determinations. Because SRACs rely on the assessment advice of specialist medical colleges and medical registration boards in making their decisions, the committees now add a redundant administrative layer for processing applications. This unnecessarily extends the period of time between the registration of specialists and when they can provide services which attract Medicare rebates.

The amendment will disband the SRACs in order to streamline the recognition process. Applicants will apply to the Minister for Health and Ageing’s delegate in Medicare Australia for recognition as a specialist or consultant physician. Transitional arrangements have been provided to ensure the continued recognition of specialists and consultant physicians previously recognised by SRACs. Provision has also been made for the delegate to immediately consider applications that are with SRACs at the time they are disbanded.

This bill represents a minor procedural change. The objective of the change is to reduce the complexity currently involved in the recognition of medical specialists and consultant physicians under the Medicare system. It is anticipated that the amendment will significantly reduce the time between the receipt of an application from a medical practitioner and the granting of recognition for the purpose of Medicare. The legislative amendment does not bestow specialist or consultant physician status on medical practitioners. Medical practitioners are identified as specialists or consultant physicians by medical boards when they are registered on the advice of specialist medical colleges.

With Australia experiencing shortages in the medical workforce, the streamlined administrative process will mean that the specialists and consultant physicians enter the workforce as quickly as possible. I note that all of the speakers generally expressed support for the legislative amendments that we are making, and I thank them for that indication of support.

Senator McLucas in her substantial contribution made mention of several aspects of the medical system, including her contention that there is a lack of formal planning by the Australian government. She made comments in relation to her belief that the government fails to show leadership on quality and safety, especially with regard to the accreditation of GPs. She also made some comments in relation to overreliance on overseas trained doctors. I will briefly make some comments about those three contributions.

In response to Senator McLucas’s suggestion that there is a lack of formal planning by the Australian government: she would obviously be aware that, since 2000, there has been an increase in the number of medical schools. In fact, we now have 15 medical schools. The number of medical graduates will increase from 1,500 in 2003 to approximately 3,400 in 2015. As part of the 2006-07 budget, 400 medical school places were announced and, following the COAG meeting, another 205 places were announced. I will come back to that and outline in a little bit more detail the increase in the number of medical school places.

Senator McLucas also suggested that the government failed to show leadership on quality and safety, especially with regard to the accreditation of GPs. The recent COAG announcement included new processes for the accreditation and registration of medical professionals, and my advice is that those announcements were very well supported by all governments, including state governments, represented at the COAG meeting. That is something that can be recognised in this place as a step forward.

I am sure that Senator McLucas would acknowledge that the government takes its quality and compliance responsibilities for aged care very seriously, as demonstrated by measures that I have previously announced for which we are currently drafting legislation and which we have funded to the extent of approximately $110 million. We take our responsibilities seriously. I always say that there is always more that one could do, but that statement is made within the context of the very heavy competition for government funds.

In relation to a point that I think was made by Senator Sterle on the reliance on overseas trained doctors, honourable senators would appreciate that it can take up to 11 years before a student can become fully qualified to practise. Given that that is the case, we also need measures to boost doctor numbers in the short term. I am sure that all senators would welcome the range of measures which the Howard government has put in place in order to address the short-term situation.

The government has started addressing that short-term situation by increasing the number of appropriately qualified overseas trained doctors practising in Australia, through international recruitment strategies. It has reduced red tape in the approval processes and also changed some of the immigration arrangements. I think all senators would welcome into the medical system in our country the arrival of overseas trained doctors who are able to assist in taking care of the health of Australians.

We have had unfortunate cases, such as that of Dr Patel, but we will not dwell on that situation at this point in time. I, like Senator Ian Macdonald, have been visited by a number of overseas trained doctors since the Dr Patel situation came into public focus, stressing that they regard it as an honour and a privilege to be in Australia and to work with their Australian colleagues. They believe, I believe and the government believes that they make a very valuable contribution to the health and welfare of Australians.

In addition to that, the government is supporting more than 1,600 general practices to employ practice nurses and is allowing all GPs to claim Medicare items for certain services undertaken by practice nurses. Again, feedback I have received, particularly in my local area of North Brisbane—I live in the North Brisbane area and have come into contact with GPs, including with my own GP—is that this is a very welcome move. I think that can be put on the record with some justification and pride.

The government is also assisting by making funding available for 280 short-term placements each year for junior doctors to work under supervision in general practices in outer metropolitan and rural and regional areas. When the government made the decision, it again demonstrated its commitment to Australians who live outside the major cities, including and in particular the major capital cities. I am a proud member of a government that does not forget that Australia does not stop at the boundaries of our major cities, including our capital cities. I am sure all senators in this place believe that the food baskets and the great economic, cultural and social hinterlands that rural and regional Australia represent need and deserve attention such as that shown by the Howard government in its emphasis on improving medical services within regional and rural Australia. Increased support has also been provided for rural general practitioners who provide procedural services such as obstetrics and minor operations.

Only a few months ago I visited several centres in western Queensland, and it was very clear to me that some of the measures I have just mentioned in this summing-up speech were appreciated. They were commented upon certainly to me, and to some of my other senatorial colleagues, including Senators Ian Macdonald, Mason and Brandis, who accompanied me on that trip. The measures were appreciated, and vocally so, by many of the people we met.

I would like to conclude by again bringing to the attention of senators that, at its 14 July 2006 meeting, COAG announced its support for the key directions of the Productivity Commission report Australia’s health workforce. COAG agreed to a range of health workforce reforms to address key issues raised in the report. I will not go through all the components of that agreement, because to outline that would go beyond the scope of the bill we are considering here today. But I think it is important to again acknowledge in this place that the Australian government’s contribution to the package of reforms is $300 million, and it includes funding for 605 new medical places, with 220 going to Victoria, 150 to Queensland, 110 to New South Wales, 60 each to Western Australia and South Australia, and five to Tasmania. As an aside, a commitment was also made at that COAG meeting for 1,000 new nursing places.

I listened very carefully to the contributions to the debate, particularly those of opposition senators. I think it is fair that they do raise issues of concern to them in terms of what they perceive to be deficiencies within Australia’s medical system. But I also think it is important to acknowledge that the Howard government does provide as much as it can to the improvement of health services right across Australia and, through this bill, is eliminating what is now considered to be unnecessary red tape which has hitherto hindered the efficient processing of matters related to the registration of doctors. I commend this amendment bill to the Senate.

Question negatived.

Original question agreed to.

Bill read a second time.