Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Hansard source

I rise today first of all to acknowledge the extraordinary effort of our medical workforce—particularly over the last 2½ years, as they have single-handedly battled in the frontline response to the COVID pandemic, and there is nowhere where these health workers have worked harder, longer or more diligently than in rural, regional and, particularly, remote Australia. I think all Australians owe a huge debt of gratitude to all of our healthcare workers across the whole country, and I would like to add the weight of our parties, the parties of the coalition, to that, as to their amazing efforts, and to thank them very much for what they have done on behalf of all Australians.

The opposition absolutely acknowledges that there are huge challenges out there at the moment in our health workforce, exacerbated significantly by the challenges that have been put forward by COVID but also because of the changing nature and landscape of rural and regional Australia. That's why, in government, we invested very heavily in making sure that we had started to put in place the things that needed to be done to make sure that we could continue the rebuild on a strong rural, regional and remote workforce. We acknowledge that there is still a long way to go, and we hope that those opposite who are now in government will continue to make sure that they prioritise rural, regional and remote health as one of the priorities of the new government, because it was something that we prioritised as the previous government.

We still find ourselves with great challenges—not the least of which is the fact that we no longer have access to an external workforce from overseas because of our borders having not been open for such a long period of time, and the lack of a response, as to seeing our borders reopen, and the lack of encouragement for people to come to Australia. We are still waiting for the jobs summit before that, apparently, is going to happen.

In government we invested a billion dollars specifically into our rural and regional health sector—including into making sure, through our Stronger Rural Health Strategy, that we were encouraging more health professionals to move into rural and regional Australia. Since we put this in place, in the space of five years over 5,000 GPs, nurses and other allied health workers were recruited to work in rural, regional and remote Australia in support of those people who choose to live outside our capital cities—making sure that they have access to appropriate health services.

Just in this last budget we added another $300 million to the previous investments; things like making sure that we were getting access to MRIs in rural and regional Australia so that people who live there did not have to travel to capital cities in order to get this really important treatment that's able to be accessed through this particular technology. We also made sure that we were continuing to invest heavily in making sure that there were Commonwealth funded places for medical students training to be GPs in rural and regional locations, because we know that people who train in rural and regional locations are much more likely to stay in those locations and support their communities once they have finished their studies.

We established two new university departments of rural health, at Edith Cowan University and in the Goldfields for Curtin University in Western Australia. We also invested through the Charles Sturt University's Rural Clinical School, and we also committed additional funding to the Rural Health Medical Training Program. Another thing that we committed to, understanding that the health outcomes in rural and regional Australia are often challenged by the tyranny of distance, was to continue to invest in Australia's favourite, I think, when it comes to rural and regional health services, the Royal Flying Doctor Service. This means that we have, over 10 years, invested nearly $1 billion in the RFDS, as well as in other flight services that have supported so many sick Australians through CareFlight and Little Wings.

So we stand by our track record of supporting rural and regional Australia, but we also understand that rural and regional Australia continues to suffer under some very significant pressures for workforce. Some of those have been exacerbated by some of the actions of the incoming government—which did not need to happen. Just as an example: one of the first things that the Labor government chose to do was to cut almost 70 telehealth services that had been put in place to enable access by telephone to your GP, recognising that at the time they were put in people often either could not get to a GP or there were health reasons why they did not want to interact in the broader community. So a telephone was one of the ways in which they could interact. In removing the telephone consultations without proper reason, rationale or advice—well, if there is, we haven't seen it—we have now excluded, disproportionately, people who live in rural and regional areas.

For example: many people who live in rural and regional areas do not have videoconferencing opportunities, so they can't video into their doctor. Their telephone line was the lifeline that they had to their health services during COVID. Seventy of these services have been cut, particularly for people with the most chronic need of health support. We condemn the decision to do that without proper advice. As I said, if there is advice it's not something that has been provided for transparency as to why that decision was made at the time that it was made—particularly when we were entering into a new wave of the COVID pandemic when, once again, Australians were needing the support, protections and measures that the COVID measures had put in place. We would also say that one of the great revolutions of the COVID pandemic was telehealth. During the first two years of the pandemic over 100 million consultations took place over telehealth, absolutely transforming Australia's healthcare system. It's something that has been of disproportionate benefit to people who live in rural and regional Australia, because often they are a very long way away from the services that they have to access if they have to do so in person.

Another issue that has been raised, significantly, around rural and regional health has been around the Distribution Priority Area classifications. Previously, this was put in place because we knew of the difficulty in attracting overseas doctors to go to rural and regional areas. By putting in place a mechanism that prioritised rural and regional areas for access to this particular workforce, we sought to try to encourage more people to go to the regions and, in doing so, alleviate some of the pressure that was our health system because of a lack of doctors. The decision by this government to expand those DPA areas means that a possibly unintended consequence is going to be that those outer metropolitan areas and larger regional centres that have now got access to the DPA classification are likely to be sucking the doctors out of those regional and rural communities which are further out and which can least afford to have those health services or those GPs removed from them. These kinds of decisions impact immensely on rural and regional Australia.

Another issue I would put on the record that indicates that this government before us has got no regard for what happens in rural and regional Australia is around their urgent care clinics. They were supposed to be prioritised into areas that had very low numbers of GPs to improve access to GPs for the people that live in those communities. During the election campaign, one of the areas that was nominated as a location for an urgent care clinic was Macnamara. Macnamara is an inner-city Melbourne electorate. Not only is it an inner-city Melbourne electorate but it actually has a ratio of doctors to patients three times higher than the average in rural and regional Australia, so you would have to question the logic behind the rationale of those opposite when, instead of supporting with incentives getting more GPs into areas where there are low numbers, they're actually prioritising protecting their own marginal electorates from an onslaught from the Greens by putting urgent care clinics into an electorate that already has three times the average number of GPs of many of our rural and regional settings.

In relation to the motion before us today concerning the failure of the government to outline any meaningful plans, I would say that the only plans that they've outlined so far have had a detrimental effect on the rural and regional workforce, particularly our GPs, and the only things that we have before us are for strengthening Medicare. What does that mean? We've got $1 billion put against it and we have no idea where that $1 billion is going to go. If our urgent care clinics are any indication of the kinds of activities that that $1 billion is going to be spent on, I wouldn't be holding my breath that it's going to go to rural and regional Australia. I'd be suggesting we'll be seeing it spent in metropolitan areas. I hope that's not the case, and I plead with those opposite: rural, regional and remote Australia needs your help. (Time expired)