Senate debates

Monday, 29 July 2019


Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019; Second Reading

9:03 pm

Photo of Louise PrattLouise Pratt (WA, Australian Labor Party, Shadow Assistant Minister for Manufacturing) Share this | | Hansard source

I rise to speak on the Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019. I indicate to the chamber today that Labor is supporting this legislation. The bill amends the Health Insurance Act 1973 to legislate for a new Bonded Medical Program. This program was announced more than a year ago in the 2018-2019 budget. Under the program, up to 850 medical students a year will be offered Commonwealth-supported places at Australian universities. This is in exchange for completing return-of-service obligations in currently under-serviced areas.

The new Bonded Medical Program will open in January 2020 and gradually replace the two existing bonded programs. We note on the Labor's side the government's assurances that, compared to the existing schemes, the new program is designed to streamline administrative arrangements with one statutory scheme to replace individual contracts and deeds with each participant under the current program; standardise return of service obligations with each participant to serve three years in an underserviced area within 18 years of completing their medical degree; standardise penalties for not completing return of service obligations with sanctions including repayment of Commonwealth support and nonpayment of Medicare benefits for six years; and be more responsive to changing workforce requirements with underserviced areas to be defined in new rules to be made under the act. This will allow governments to update eligible areas over time.

We note that the government is making separate but related reforms as to how underserviced areas are defined. The government has introduced a new Distribution Priority Area system, replacing the District of Workforce Shortage System for GPs. While Labor supports the reasons for the change, it was implemented with little notice to GPs and patients on July 2020, and its impacts on particular areas are still, we think, to be understood. So, we sought a briefing on this new system, including on whether it addresses workforce shortages in outer metropolitan areas as well as regional and remote and rural areas.

We welcome the fact that this bill includes transition provisions for participants in the existing programs. Some 10,000 participants are undertaking a medical degree training or return of service obligations under the current program and, with some exceptions, these participants will be able to opt into the new program from 1 January 2020.

We support this bill because it is intended to help address the shocking health inequalities in regional, remote, and rural Australia. As Labor's national platform recognises, Australians living in regional, rural and remote areas, typically, have poorer access to health services, poorer health outcomes and a lower life expectancy than those living in Australia's cities.

The Australian Institute of Health and Welfare figures show that rates of health risk factors are higher in outer regional and remote Australia, with 22 per cent smoking daily, compared to 13 per cent in cities; 68 per cent being overweight or obese, compared to 61 per cent in cities; 72 per cent doing low or no exercise, compared to 74 per cent in cities; and 24 per cent drinking at risky lifetime levels, compared to 16 per cent in our cities.

Access to health care is also poorer with lower rates of almost every health profession, including medical specialists, dentists and a range of allied health providers. I note that this also translates to the amount of Medicare rebate that's spent in Australia's rural and remote areas. As a result of these factors, the overall burden of disease is around 10 per cent higher in regional areas; 30 per cent higher in remote areas; and 70 per cent higher in very remote areas. Many of these deaths are preventable, with 2½ times as many potentially avoidable deaths in very remote areas than in Australia's cities.

So, while we welcome it, this bill is patently not a silver bullet for the issue of the health disparity between metropolitan, regional, rural and remote Australia. We call on the government to do much more on rural health in its third term than it's done in its first two terms. Labor stands ready to work with the government to improve the health of seven million Australians, or close to 30 per cent of all Australians, who live in rural, regional and remote Australia. Thank you.

9:09 pm

Photo of Malcolm RobertsMalcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | | Hansard source

As a servant to the people of Queensland and Australia, I rise to applaud and support the Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019. The health of bush and rural communities is important; their sense of community is so strong and appealing. I can recall being in Charleville just a couple of years ago. I had suffered an injury and was made to feel very welcome by all the staff in that small hospital. I noticed a nurse there who had lived all her life in Brisbane, in the big city, and she loved being out at Charleville. The Charleville Parade—I was there for the 150th anniversary parade, with kids running around at night, free, unhindered, and very, very safe. The townspeople, properties—very friendly, get along well together. The same can be said of Longreach and Camooweal and many other towns in rural Queensland.

After suitable consultation the government has tabled a bill that creates one single system for bonded education. That fixes a mess that Labor concocted. The provision of an increased number of places—850 annually—with a three-year service obligation, to be completed within 18 years, is a very good outcome. The longer period allows specialists to train and skill before going bush. In turn, rural and regional Queensland, and Australia, will benefit from medical professionals who have completed the long professional development that is so necessary for many specialties. Now, at first it seemed to us that three years wasn't adequate, but then we found out in our research that six years had been tried and failed—with six years, people just didn't apply, and with one year, too many applied. So, it looks like three years is a handy compromise. And 18 years seems a long time to fulfil one's bond, but when one realises that it can be very arduous to fulfil a special training area, then we were happy with that 18 years.

There were measures at first, then, that seemed to be impractical. Yet this bill covers for the many varied circumstances across our diverse and large nation. We know that governments have tried, as I said, five-year service, and that deterred doctors, and one year caused a flood. Three years seems a handy compromise. One of our concerns is that medical colleges are aiming to maintain high fees for specialists, and that minimises enrolments. They choke down the number of specialists that can emerge—for example, four to six dermatologists each year. That's why we have an 18-year bottleneck. It's needed to get specialists through. Yet for real support of regions we need more-ambitious changes to address these bottlenecks.

I note that another initiative that One Nation supported—the National Rural Health Commissioner—has been successful in introducing 'rural generalist' as a career path. We look forward to the commissioner progressing next into nursing and midwifery. We like the practical changes. They're necessary. As I alluded to in my opening comments, the bush—the rural areas—are inherently a great place for raising families. Ask the owner-managers of the Chinchilla McDonald's, who moved here from Western Australia and love it in Chinchilla. The people of many regional towns and centres echo the same.

With regional centres being such wonderful communities, people may wonder why the regions are declining. the answer is easy: their livelihood is being gutted. Their productive capacity is being gutted. And what's doing that? Liberal and Labor federal and state governments are doing that. They're killing the productive capacity of our rural and regional areas—indeed, our nation. Economic mismanagement is taking many forms—for example, electricity prices hindering the Charleville abattoir, which is a wonderful innovation in killing small animals, such as goat and sheep. In Mackay we notice people suffering from high electricity prices. And it's not just families, not just individuals; it's businesses, it's clubs in North Queensland, paying huge amounts for electricity, and stores and restaurants that have freezers are really doing it tough, going out of business. Farmers in a severe drought are not planting fodder crops. That's insane.

And we've got tax policies that allow multinationals to not pay their fair share of the burden while farmers, small business, employers, families and individuals pay enormous amounts of tax. Tax, in fact, is the most destructive system in this country. I recall reading figures around the start of this century that a person on an average income, around $80,000 per year now, typically pays 68 per cent of their income to government. That's taxes, rates, fees, levies, charges, special fees, and on and on. People thought that housing was the most expensive purchase in their lives; it's not. Government is our most expensive purchase. And are we getting value? No.

Look at water policies right now, with the productive capacity of our country being eroded and the Murray-Darling Basin Plan leading to charging exorbitant prices for water. Then we've got capricious federal government acts that hinder the rural sector. These are all driving people away from making a productive lifestyle in these areas. They're under pressure, under stress. Under the Labor and Liberal governments over the last couple of decades we've had the Murray-Darling Basin Plan, horrendous, really hurting the bush; the live cattle ban under Julia Gillard's government, hurting the bush not just in the north but throughout this country; and property rights stolen by the Howard government, of all people—the Howard government. I already discussed that earlier today, but the Howard government is responsible through its agreement, first, with Rob Borbidge as National Party Premier of Queensland in 1996, following the UN Kyoto protocol; then Peter Beattie signing a deal with John Howard in 1998; then Bligh, and Palaszczuk-Trad; and also Bob Carr mirroring this in New South Wales.

Centralised bureaucratic control is another problem, with little accountability in this country. The federal government, as it gobbles up more and more of states' rights and states' duties and responsibilities, has no competition, and that means no accountability. We need to restore competitive federalism. I quote from Rebuilding the Federation, written by Richard Court, a former Liberal Premier of Western Australia, in 1994. He says: 'The driving of Commonwealth-state financial relations is the states' heavy reliance on Commonwealth funding to supplement their own source revenue. Currently, the states receive approximately 50 per cent of their total revenue from the Commonwealth.' That proportion has since increased.

In fact, I was at Balonne Shire Council in early 2017 and asked a simple question: 'What percentage of your annual revenue at the Balonne Shire Council comes from the federal government?' I was told it was 73 per cent, almost three-quarters of their revenue, and every cent comes with strings attached, with conditions. So who is really running the councils? It's the federal government. Who is running the states? It's the federal government.

The Murray-Darling Basin itself covers an area that is about 80 per cent of New South Wales. The government is allocating resources, controlling vital expenses in water and controlling property rights—indeed, separating property rights from water rights, under the 2007 Howard government act. And then we look further. As Richard Court said, 'The Commonwealth is using the external affairs power to govern Australian citizens, often rushing to sign international covenants which trample on their existing rights.' They trample on our existing rights. He said: 'These international agreements are made primarily by people outside Australia. The terms and conditions are set by officials from other countries. While Australia takes part in the negotiations, it does not exercise a dominant influence. The foreign countries do.' 'The foreign agencies do', I would suggest, is more accurate. Richard Court goes on: 'We never see them, we never meet them and we cannot question them. Yet international covenants dictate to our Commonwealth government and the High Court and the state governments and the people what passes for governance and sovereignty in this country.'

As Marty Bella, a Central Queensland councillor and cane grower—very active now he's realised what is happening—said, and he echoed what Senator Hanson has been saying for 23 years and what I have said since learning of it around eight years ago, there is 'an ideological assault on rural Australia'. This is the result of federal agreements with UN treaties, protocols and declarations—agreements such as the Lima Declaration, signed in 1975 by Gough Whitlam, the Labor Prime Minister, and ratified the following year by his supposed archenemy, Malcolm Fraser, as Prime Minister. Then in 1992 we had the UN's Rio declaration for 21st century global governance, signed by Paul Keating's government. I will quote from the UN Agenda 21 document in a minute. Then we had the 1996 UN Kyoto agreement, under which John Howard, as Liberal Prime Minister—

Photo of Wendy AskewWendy Askew (Tasmania, Liberal Party) Share this | | Hansard source

A point of order, Senator Pratt?

Photo of Louise PrattLouise Pratt (WA, Australian Labor Party, Shadow Assistant Minister for Manufacturing) Share this | | Hansard source

My point of order relates to the senator's remarks, in relation to relevance. I may be misunderstanding the business before the Senate, but I thought we were debating the Health Insurance Amendment (Bonded Medical Programs Reform) Bill. I haven't heard any reference to the legislation before us in Senator Roberts' remarks.

Photo of Zed SeseljaZed Seselja (ACT, Liberal Party, Assistant Minister for Finance, Charities and Electoral Matters) Share this | | Hansard source

On the point of order, whilst I may not agree with much of what the senator is saying at the moment, there has been a tradition in this place. I've heard many, many times senators from the opposition in particular being given a fair degree of latitude on debates of legislation. That has been the practice in this place. As much as I may not agree with Senator Roberts on much of what he was saying just then, often debate in this place goes a fair way from the absolute substance of every bill that we debate.

Photo of Wendy AskewWendy Askew (Tasmania, Liberal Party) Share this | | Hansard source

Thank you. I call Senator Roberts.

Photo of Malcolm RobertsMalcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | | Hansard source

Madam Acting Deputy President, through you, I'd like to address Senator Pratt's comments. It is quite clear that I referenced and referred to this bill at the start and commended the government on its actions for fixing some of the problems that Labor governments in the past have caused. I am talking particularly now about the core of that bill, which is trying to get doctors into rural areas. We know of some areas where doctors are being enticed with salaries of $500,000 and it's still difficult to find doctors. What I'm saying is that we need to do much more than just tidy up the errors that the Labor Party developed in its past—impractical errors. I'm going to the heart of the problem with rural communities right now: the abandonment of them by the federal government.

The 1996 UN Kyoto Protocol, which I have discussed, led to the theft of property rights. If anyone wants to know the relevance of property rights, then look at any rural community in Queensland or in New South Wales. Then we had the 2015 UN Paris agreement, under Prime Minister Abbott and Prime Minister Turnbull. That was not just an agreement for every nation to do what they wanted to do. Australia legislated severe cuts while China said they would consider doing something in 30 years, maybe. Meanwhile, we destroy our industries and economy and hand the jobs to the Chinese and others.

I'd now like to quote from the UN Agenda 21 book that is driving this. Maurice Strong, the Secretary-General of the United Nations Conference on Environment and Development, said in the foreword to this instruction:

There is much to be done. And I look to the new United Nations Commission on Sustainable Development to be the focal point for the massive effort needed to create the new era of international cooperation, the new global partnership, that will make this shift possible.

We're talking here about global governance from the UN. Then we have the words of the manual itself. These are the UN's words:

Agenda 21 stands as a comprehensive blueprint for action to be taken globally—from now into the twenty-first century—by Governments, United Nations organizations, development agencies, non-governmental organizations and independent-sector groups, in every area in which human activity impacts on the environment.

That means every area of human livelihood, human existence. It goes on to say:

The Agenda should be studied in conjunction with both the Rio Declaration—which provides a context for its specific proposals—and the statement of forest principles—

which is embraced by the UN—

It is hoped that the forest principles will form the basis for a future international-level agreement.

The United Nations and Maurice Strong, who was the head of that particular part of the UN at the time, has admitted to pushing for unelected socialist global governance.

How do they get away with it—stealing our country's sovereignty and destroying constitutional governance? It's easy. It preys on the party system in which both failed old parties seek to grow their parties at the country's expense. I will read from Simone Weil, the French philosopher, and her On the abolition of all political parties. Simone Weil says:

To assess political parties according to the criteria of truth, justice and the public interest, let us first identify their essential characteristics. There are three of these: 1. A political party is a machine to generate collective passions.

We can see that.

2. A political party is an organisation designed to exert collective pressure upon the minds of all its individual members.

We can see that.

3. The first objective and also the ultimate goal of any political party is its own growth, without limit.

And that is how they do it. Each party follows an agenda.

The leftovers, known as the Greens, are the UN's foot soldiers—what Lenin used to call the 'useful idiots'. And political correctness following this familiar pattern of the leftovers, known as the Greens, is thus: fabricate a problem, concoct a victim, conjure an oppressor, pretend a solution, identify an ideology to control it all, wrap it in smoke and mirrors, rope in and align potential allied victims, use political correctness to shut down debate—

Photo of Wendy AskewWendy Askew (Tasmania, Liberal Party) Share this | | Hansard source

On a point of order, Senator Watt?

Photo of Murray WattMurray Watt (Queensland, Australian Labor Party, Shadow Minister for Northern Australia) Share this | | Hansard source

I realise I've only been in the chamber for a short time but I have been watching Senator Roberts's speech quite intently for some period of time. My point of order is relevance. I'm just wondering which word in the title of the bill is he speaking to, because I haven't heard anything about health, or insurance, or amendments, or bonded, or medical, or programs, or reform, or even a bill. We heard quite a lot about Agenda 21, one world government and conspiracies, but I'm failing to see the relevance to any bill that we've discussed today, let alone this bill.

Photo of Wendy AskewWendy Askew (Tasmania, Liberal Party) Share this | | Hansard source

Thank you. I was going to say—

Photo of Slade BrockmanSlade Brockman (WA, Liberal Party) Share this | | Hansard source

I rise on a point of order. As Minister Seselja pointed out earlier, these debates are wide-ranging, and Senator Roberts did link this to disadvantage in the bush. I think that the point of order is not in order.

Photo of Wendy AskewWendy Askew (Tasmania, Liberal Party) Share this | | Hansard source

Thank you. I ask that Senator Roberts stay generally within the terms of reference.

Photo of Malcolm RobertsMalcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | | Hansard source

Through you, a comment to Senator Watt: if he had been listening, rather than following what happens with traditional parties, he would have understood that I'm talking exactly about the core of this bill. I'm talking about rural communities that his party has neglected and, in Queensland, is neglecting right now. Shame on the Labor Party in Queensland. They use political correctness to shut down debate and silence people using labels like racist, sexist and misogynist, all in the names of victims yet designed, ultimately, to control the same victims. In this way, UN policy is taken as the basis of Greens policy. Labor piles on to get preferences, The Liberals pile on, and the Nats meekly kowtow.

Secure property rights are fundamental to freedom, fundamental to survival in the bush, fundamental to the productive capacity of the bush, and yet these are destroyed through ignorance, cowardice and gutlessness. So much for today's so-called Liberals ignoring and opposing the classical liberalism of Ludwig von Mises, Friedrich Hayek and Frederic Bastiat, to name just three, when their hero Prime Minister John Howard and his government were the very government that stole farmers' property rights to implement socialist UN policies. Worse—and I'm coming to the end—they did it in a way that deceitfully bypassed the Constitution to avoid paying farmers compensation. That's why we call for restoration or compensation on just terms, restoration or compensation from the theft of property rights. Going around the Constitution and using Labor premiers and a Liberal prime minister—these are the things that destroy the bush. These are the things that make it difficult to get doctors out into the bush. These are the things that make it difficult to get services adequately in the bush.

I didn't learn about these at the University of Chicago doing my MBA. I leaned about it studying the climate scam that led to unravelling the UN's agenda to undermine the fundamentals of democratic government and Australian values, something the Labor Party doesn't stand up too proudly on.

I have made a list of eight keys to human progress. First of all is freedom, which is going backwards. The rule of law is going backwards as statutes replace common law. Constitutional succession is going backwards. Secure, free property rights are going backwards. Honest, efficient, fair taxation is going backwards. Honest money is going backwards. Strong families are being undermined by family law from Gough Whitlam's Labor government and from the UN's 'unsafe' schools. Low-cost, affordable, reliable, environmentally responsible energy is being gutted.

We have much to repair and restore. While the bonded medical programs reform is heading in the right direction, the tide of destructive economic policies is swamping the bush and regional Australia. I'm proud to say we need to reverse the flow. If we really are serious about getting doctors, medical services and other services back into the bush to support the people who have the productivity of our country at heart, we need to reverse the flow that is undermining our national sovereignty and governance. One Nation is pleased to support this bill and to work with the Liberal and Labor parties to restore our nation's productive capacity to make sure that the people right around our country have adequate medical services. Thank you.

9:30 pm

Photo of Slade BrockmanSlade Brockman (WA, Liberal Party) Share this | | Hansard source

I rise to make a contribution on this bill, the Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019, and to address the contribution from Senator Roberts briefly. Talking about disadvantage in the bush, you almost had me, Senator Roberts. I agree with you fully on that issue. But then you talked about a farming family moving from Western Australia to Queensland and loving it. Now, that's where it just went completely off the rails.

On this bill though, seriously, there is a problem in rural and regional Western Australia. And all those who come from Western Australia are aware of the problem. All those who come from rural and regional Australia know there is an issue that needs to be addressed. I note there are three senators from Western Australia in the chamber at the moment on this side. All of them would know very, very well indeed some of the problems and challenges we face in rural and regional Western Australia, and I note the contribution of Senator Pratt as well in regard to some of the problems that we have in rural and regional Western Australia with attracting and retaining skilled medical professionals, in particular doctors but also nurses and allied health professionals.

This has a far-reaching effect. It obviously impacts on people requiring health care in their local communities, but it also impacts on those communities themselves. When the community loses or cannot attract a doctor or a nurse, or an allied health professional in the larger centres, that reduces the size of the community. It makes it less likely to be able to attract a doctor or nurse or medical professional in the future, as the community contracts over time, as communities have done across parts of rural and regional Australia. With the effectiveness of farmers in farming the land with fewer people and with the decline of some industries, the numbers of people in certain parts of rural and regional Australia have declined, the centres of those communities have been affected and their ability to attract and retain medical professionals and therefore access adequate medical services has declined over time.

In Western Australia alone there are just over 300 medical vacancies, 115 of them being GP positions, in regional areas. I come from a regional part of Western Australia. In fact I was born in the Manjemup hospital in the deep south of Western Australia—a hospital, incidentally, that Liza Harvey, the Leader of the Opposition in Western Australia, was also born in, and I'm sure a lot of the relatives of Senator O'Sullivan were probably born in that hospital as well. It's a fine, small, regional hospital.

GPs in those country towns are of absolutely vital importance. They're such a central part of a small town's life and existence. In the city it is easy to ignore or forget or not realise what a central component to life in the bush those GPs are. And, sadly, as I've started to outline, there are towns across Western Australia where, unfortunately, attracting a GP is proving to be difficult if not impossible.

Wongan Hills in Western Australia is a town—as Senator O'Sullivan and Senator Smith would know—not very far from Perth. In fact, it's very much within driving distance: only 2½ hours away. Wongan Hills does not have a doctor to run their $1.5 million surgery. They've been trying to attract a GP since March of this year. Hopefully, that situation has been solved in the last few days and what I have in front of me here is out of date. I sincerely hope that is the case; sadly, I suspect it's probably not, because these small regional communities have a very difficult time of finding people who want to move to the bush. This is despite an extremely attractive financial package that includes a cash component, free use of a house and, of course, access to that very well-equipped $1.5 million doctor's surgery. There are around 1,400 residents living in that shire. The next closest medical centre is around an hour's drive away. This is not something that we have to deal with when we live in a major urban centre, even a major regional urban centre. But it is something that those who live in—I don't even think you could call this a remote community—a regional community have to deal with; let alone those who live in even more remote circumstances.

There are, sadly, many other areas in Western Australia struggling to find medical professionals to meet their needs. In the north, in Derby around half a million dollars a year is on offer to attract a GP. In Kalgoorlie, they cannot get enough medical professional services, and, incidentally, there's a great availability of jobs as a whole in Kalgoorlie at the moment, and a wonderful opportunity for younger Australians who want to enter what is a wonderful and dynamic community in Kalgoorlie to take a step, perhaps, out of their comfort zone, and experience a part of Australia that many wouldn't even consider in that light, because of their lack of knowledge of what it means to live and work in a regional centre. Dalwallinu is another small country town that's seeking to attract a GP, is offering a very attractive financial package, and cannot get someone.

The Bonded Medical Program, as set out in this bill and in the changes that this government is introducing, is designed to try and address some of these very real problems that are faced by Australian communities in the regions. In short, the bill amends the Health Insurance Act 1973 to introduce a statutory scheme to streamline existing bonded medical places—so this isn't reinventing the wheel—and the Medical Rural Bonded Scholarship schemes. It will require participants to complete a return-of-service program in return for a Commonwealth-supported place to study medicine. The proposed amendment promotes access and equity to health services in rural, regional and remote Australia, where there are currently less-than-adequate services. It is, in fact, part of a much larger, $500 million Stronger Rural Health Strategy announced by this government. The bill has support of key stakeholders, such as the AMA and the Australian Medical Students' Association. This is about streamlining and modernising an existing framework, and it brings existing schemes together under a single framework to move towards a single bonded medical scheme in future years. It replaces the need for individual contracts or agreements with each participant in a bonded medical program. It reduces the administrative burden by reducing and standardising the number of conditions and sanctions. It better targets the bonded medical workforce by changing workforce distribution requirements. It will also introduce and mandate the use of a web portal to improve the administrative management of the program.

It also introduces the ability for participants to seek review of certain decisions by the Administrative Appeals Tribunal. Obviously, this is something where people take these roles on, and perhaps they don't fully understand what they may be getting in for. I hope they do. From my discussions with a number of medical professional who have been through these kinds of programs, they certainly find it a very valuable and rewarding experience. But we understand that things can sometimes not go 100 per cent according to plan, and therefore a review of certain decisions by the Administrative Appeals Tribunal is an important part of these changes.

As I have stated, these changes come to schemes that have been in place for some time. The Medical Rural Bonded Scholarship Scheme commenced in 2001. It provided 100 Commonwealth-supported places each year in a medical course at an Australian university with an attached scholarship. It began its iteration as a six-year contract requiring participants to work in rural or remote areas once their fellowship was achieved. This has been closed to new entrants, but the 100 places have been added to the bonded medical places from 2016. Bonded medical places commenced in 2004. This provides a Commonwealth-supported place in a medical course in exchange for agreement to work in an underserviced area for a length of time equivalent to the length of the medical degree. For those who joined between 2016 and 2019, the return of service is only 12 months. It is currently delivered through a complex series of contracts—in my understanding, there are around 20 contracts and deeds of agreement—which makes the system complex and makes the system outdated.

As the program has changed over time, significant differences in contractual arrangements have been developed within and across various streams. This affects the majority of participants who commence their return of service obligation. The new statutory scheme modernises and consolidates to ensure that the program is responsive to current and future workforce needs, as well as offering a modern and flexible arrangement to support the future rural medical workforce. It will not affect existing participants unless they choose for it to, so it's a voluntary, opt-in system. Participants will be required to work as medical practitioners in eligible locations for a total of three years, which must be completed within 18 years from when the participate completes their course of study.

I will note here that I think one of the key things that's been shown over the years—as various governments have quite genuinely tried to address this problem, with mixed success—is that what has proved to be successful is either training people who originated in the bush and then getting them to return to the bush or perhaps giving people who have never spent time in the bush a taste of bush life and then they find they do actually like it. That's why those three years are very important. It's important for people who commit to this program to be able to get out there into the regions and spend some time in the bush. A lot of them will fall in love with rural and regional Australia, as many of us in this place have as well.

On withdrawal costs from the scheme, if a withdrawal occurs after the second year of study or they do not complete a return of service within 18 years—if either of those conditions are met—then the participant must pay the Commonwealth costs of the person's cost of study, less the pro rata proportion of service completed, as well as the interest or cost of scholarship. Obviously, there will be those who, for whatever reason, choose not to or cannot fulfil their obligations. Medical benefits will not be payable for six years from the day a breach occurs if return of service is not completed within 18 years. There is also the potential for an administrative penalty to be imposed.

Wrapping up: a second reading amendment has been circulated. Those opposite, who have abandoned the bush for a very long time, should think very carefully about criticising this government for its level of support for those in rural and regional drought affected communities. This government over a period of time has been extraordinarily responsive to the needs of those in the bush, including through the farm household allowance, which this second reading amendment mentions. We have ensured its ongoing availability for those in drought affected areas, ensured that the length of time people are able to stay on it was increased where appropriate and ensured that those drought affected communities and drought affected shires had some direct financial assistance, assistance for fodder and the like. This government has been extraordinarily focused on and responsive to the needs of drought affected communities across Australia. I think it is slightly churlish of those opposite to propose this second reading amendment on this bill—a bill unrelated to drought relief; a bill about getting more doctors into the bush. On that, I thank you.

9:46 pm

Photo of Dean SmithDean Smith (WA, Liberal Party) Share this | | Hansard source

I also rise this evening before the adjournment debate to make some comments on the Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019. Before I go to the substantive matter I want to reflect on some comments that Senator Roberts made. Senator Roberts shared with the Senate chamber a scorecard for human progress when it comes to respecting and upholding civil liberties. I'm not too sure I agree with Senator Roberts. On a number of scores he talked about things going backwards. There was an important score that he failed to mention, and it goes to the heart of this bill and to the heart of regional representation in this chamber. It goes to the backwards performance of the Australian Labor Party in Queensland. I make this contribution knowing full well that Senator Watt is in the chamber tonight.

Photo of Murray WattMurray Watt (Queensland, Australian Labor Party, Shadow Minister for Northern Australia) Share this | | Hansard source


Photo of Dean SmithDean Smith (WA, Liberal Party) Share this | | Hansard source

I have woken Senator Watt from his slumber. It's worth reminding the Senate chamber that the ALP returned 13 senators nationally—

Photo of Murray WattMurray Watt (Queensland, Australian Labor Party, Shadow Minister for Northern Australia) Share this | | Hansard source

I was reading about the terrible things you were doing with robodebt.

Photo of Dean SmithDean Smith (WA, Liberal Party) Share this | | Hansard source

No, sorry. I apologise. He's definitely awake. The ALP returned 13 senators nationally, returning only one senator from Queensland. Queensland recorded its worst Senate result since when? 1949.

Photo of Murray WattMurray Watt (Queensland, Australian Labor Party, Shadow Minister for Northern Australia) Share this | | Hansard source

Madam Acting Deputy President, I have a point of order on hubris. I'm not sure that it serves Senator Dean Smith very well to be demonstrating this level of arrogance. I ask him to reconsider.

Photo of Wendy AskewWendy Askew (Tasmania, Liberal Party) Share this | | Hansard source

I don't think there's a point of order on that.

Photo of Dean SmithDean Smith (WA, Liberal Party) Share this | | Hansard source

On this side of the chamber we call it humility. It is important to make this point because it goes to the heart of this issue—regional representation and the extent to which people who come to the Senate representing regional areas either mock the contributions of people like Senator Roberts or fail to make solid contributions of their own.

I have two other points on the performance of the Australian Labor Party in Queensland. We all know that Queensland is one of the most regionally diverse states in Australia—I think probably second only to Tasmania. So the issues that we're talking about in this particular bill, which is about addressing workforce shortages in rural communities, are very important. When people listen to the contribution of Labor senators tonight and tomorrow they should bear these electoral statistics in mind. I have two final statistics before I go to the heart of what we're talking about here.

The first point is that the ALP received their lowest primary vote in 85 years, recording only 33.3 per cent in 2019. Their worst result was in 1934 with 26.8 per cent. Finally, the ALP preference flow in Senator Watt's home state of Queensland fell from 57.9 per cent in 2016 to just 50.2 per cent in 2019. The coalition gained the seats of Longman, with a swing of plus four per cent, and Herbert, with a swing of plus eight per cent, leaving the ALP with only six out of the 30 seats in Queensland. That's a very important point when you think about those 30 seats in Queensland and the number of seats that are predominantly regional seats.

Moving to the substantive issue this evening, I'm drawn to this particular debate because I want to reflect on an article that was published—

Debate interrupted.