Mr COULTON (Parkes—Opposition Whip) (18:19): I can’t believe we are debating this matter so soon in the term of a new government. If you went to the dictionary and looked up the word ‘irony’, it would point you to the member for Gilmore’s speech. The towns that she spoke about, where she’s having the problems, would have already been DPA. Now, to get the doctors needed to those smaller, more remote towns, she is going to have compete with peri-urban and larger regional centres. You have a responsibility, when you’re in your party room, to understand what’s being put up. And regional Labor MPs—even though there aren’t many—should be taking notice of this, because this is bad policy.
When I was minister for regional health I had delegations and I visited clinics where you could actually see the skyline of the city, and they were telling me how they needed more doctors, because, obviously, overseas trained doctors are helping those clinics and the profitability of those clinics. Members from capital cities are talking about this. If you’re a woman in Bourke and you want to have a baby, the nearest birthing centre is Dubbo. That’s four hours drive one way. If you haven’t got a doctor in Bourke so you can have prenatal care and care for your young child, that is a serious concern. We had these distribution priority areas so that towns like Bourke and Brewarrina and Nyngan could give doctors an incentive. When I was regional health minister we graduated the payments under Medicare. If you are in an MM 5 area, you get a higher rebate for bulk-billing than you do in an MM 1 or MM 2 area. That came in on 1 January and was a positive step.
We are training country people to do medicine. In Dubbo, 500 students applied for 24 positions in the Murray-Darling medical school. They are brilliant young local people from the bush who are going to overcome this shortage. When I was minister we doubled the number of training places for junior doctors to spend time in regional areas. We increased the number of doctors doing the generalist pathway so that, when doctors are coming out and are trained, they’ve got a broader set of skills. They’ve got the confidence to go to a country town where they might have to deal with general medicine all day and then a horrible event where a car load of teenagers hits a tree on a Friday night. They’ve got the skill set to have the confidence to go to these places.
When I was regional health minister we set up five trial sites looking at innovative models of primary care, combining the resources of the state government, through the local health district, and the federal government, to address the reasons why people aren’t taking up general practice training. We had a model that was comparable to that for staff working in the cities—there’s maternity leave, holiday pay and a whole range of other things. It is about making general practice more attractive for people to take it up.
There’s no doubt there’s a shortage of doctors in this country. There’s no doubt about that. We are looking at all practical measures, and I’ll support the current government on all the practical measures they take to improve that pool of doctors. But taking doctors from the most remote and disadvantaged communities as a sop to larger peri-urban areas and regional centres is not the answer to health care in the bush.
Mr COULTON: You are not the bush, mate.
I’m a region.
Mr COULTON: I’ll take you out to Brewarrina, Bourke, Warialda, Broken Hill. I’ll show you what the bush is. For the member for Shortland, it’s 10 minutes in a taxi and he’s in Newcastle. Seriously, we are talking about really regional areas, and now they are competing with peri-urban and regional centres for doctors.
This is a backwards step. This shows—I’d like to say it’s not disregard—lack of understanding of the issues of delivering health service in the bush. I think we are going to overcome this by following on with positive measures—not these kneejerk, quick responses that actually have negative impacts on the people that need it the most.