Ms GERICK (10:39 AM) —I am pleased today to be able to speak on the Health Insurance Amendment (Rural and Remote Area Medical Practitioners) Bill 2000. If it is properly implemented, this bill is going to ensure improved medical access for many rural Australians.

Like many members, I have a large rural component in my seat. Today I want to talk about two issues in particular. The first one is that there is a village, Serpentine, about 20 minutes drive from Perth, from my electorate—if you go from the city, it is an hour's drive. Serpentine are very fortunate in that they are classified as both rural and city depending on what government service they are about not to get! If it is a medical service, they come under the metropolitan city board, which means that they have been struggling to get a doctor now for a number of years and cannot do so. When they approached the federal government they were told it was a state issue; when they approached the state government, they were told, `Oh no, you are close to metropolitan services. It is not our place to provide a doctor for you.' So they went to their local council and the local council, quite fairly, said: `Well, we can't provide the infrastructure for a doctor to come. We have a doctor who wants to come to Serpentine, but we can't do that; it is not part of our role.' So we still do not have a doctor in Serpentine.

The population in Serpentine is about 2,000. The primary school is full. But Serpentine falls into that category now where it has a lot of older citizens and a lot of kids—two of the groups that need lots of medical services or the potential to need them. As I have already said, there is no doctor in Serpentine. One of the community groups in Armadale, which is 20 minutes drive away—the Armadale Home Help—provides a bus once a week to try and help the Serpentine people, because obviously there is no public transport: when it comes to public transport, Serpentine moves back to the rural component! This means that, if you do not have car, you do not get to go anywhere—you have to rely on your neighbours or the Armadale Home Help group. Those home help groups are facing a lot of problems, because legislation has just gone through in WA which means that volunteer drivers have to pay to get a special licence. So there is a lot of pressure on getting enough volunteer drivers. It seems that it doesn't matter what the rural communities try to do, there is no way that they can get that little bit ahead.

The other area that is struggling somewhat is the town of Pinjarra, which is about 1½ hours drive from the city. They have a hospital, but it has been continuously downgraded. The justification of the state government has been, `Well, if you drive to Mandurah',—which is a further 20-minute drive—`you have access to a full hospital.' But the problem is that the South West Highway runs through my electorate and it is, sadly, one of the roads that has the most fatalities in WA—we have lots of road crashes. The emergency services at Murray Hospital have been downgraded, which means that if you have an accident you have to be taken on a further 20-minute drive. We all know that, if you have been in a car accident or any sort of accident, the quicker you get the treatment, the better chance you have of survival and of minimising your injuries.

We also have a number of mine sites in my electorate and, unfortunately, mine sites often have accidents as well. So we have been arguing strongly that we need those emergency services. The Shire of Murray does not have the moving backwards and forwards between metropolitan and rural—almost everyone agrees that that is a rural area. But the argument is kept up: `Well, you're really close to the city, so you should be able to manage.' Just keep hanging in there while they keep downgrading our services.

A lot of people nowadays want to make that lifestyle choice though: they want to be able to move to Serpentine, Jarrahdale or Pinjarra, which are beautiful communities. But, as previous speakers have said, if you are going to move, you want to make sure that there is a school for your kids to go to, you want to make sure that there is a doctor that you can get to, that there is a hospital within a reasonable distance, that, if there is an accident, you are going to be able to get the care you need. Hopefully, the Health Insurance Amendment (Rural and Remote Area Medical Practitioners) Bill 2000 is going to move some way towards making sure we get those services. If we can get families moving back into these areas, we all know that that is going to be the lifeblood of regional Australia. Regional Australia has been through a really rough time. Those who have lived in the country—I spent the first 12 years of my life in the `real outback', as we called it, not just rural areas—know that if the bank closes you lose the bank manager and a clerk, if the school downgrades you lose a teacher; every person is vital to that community. If we are going to build communities, which is what we all should be about, we should be making sure that the basic services are there. I encourage the government to make sure that they carry through on their promises.

There is not much consolation in the short term for the people of Serpentine. We just have to keep fighting and hope that doctors are going to spend the money of their own free will and move down there—but we have to be able to make sure that we can. The other problem that we face in WA is that we have the rather worrying distinction of having had the highest number of medical practices bought out by corporate bodies in Australia last year. The problem is that—as we are faced with frequently—if you are a private enterprise, your sole purpose is to make money, otherwise you would not be tempted into private enterprise. If you move into a rural community, you are not going to have the means to make lots of money. Therefore, those medical bodies are making the obvious choice not to move into regional Australia. That is another area that we need to have a look at and see what incentives we can give for doctors to move out there.

I know that a scheme is operating in WA—and, I assume, nationally—where we are giving scholarships to kids from rural areas to get into medical school. One young lad in Pinjarra missed out by one mark on getting into med school last year. The local doctor put in a plea and said, `This kid has grown up in Pinjarra. He will go off and do his med training and he will come back and live here.' And they said, `Pinjarra is only an hour and a half from the city—it is not worth considering.' You get that situation of a kid missing out by one mark, even though he is committed to the country people, he is obviously smart and he has the skills. If we are going to have these schemes, perhaps they should not be quite so arbitrary whereby they decide that one mark or five marks is going to be the cut-off point.

Those of us who have lived a country lifestyle know that it is a great lifestyle, and there is always the temptation that you are going to want to go back to it. So we should be encouraging young people to go to the city and get their training and then come back to the country, because there is nothing sadder than seeing your country town die because young people have to move away because there are such limited opportunities there for them. Again, that is an area we need to look at to make sure that people are getting what they need.

From personal experience, I know how awful it is when a member of your family has to move away to get treatment for cancer. We went through that when I was fairly young, with my father needing to go away for six months on and off because there was no radiology centre in Geraldton, where I spent my teen years. We need to make sure that, when families go through this trauma—and quite often there is not a happy outcome—they have the support they need and that they can stay together while they are going through that treatment process. Anything we can do to get the treatment centres to regional areas and to make sure that there are support systems there, so that whole families—or as much of the family as possible—can be together, will certainly be a great improvement.

It can also happen in cities. Until recently, children on dialysis who lived in Armadale had to catch the train into Royal Perth Hospital, which is about a 25- or 30-minute train ride, so that they could get treatment. We managed to get a dialysis machine, because—by coincidence—the Premier was on a train coming out to a function and he met a woman taking her child in for dialysis. Until then, there had been no realisation that there was no dialysis machine in my electorate. We now have one, so a certain amount of pressure has been removed.

If we are going to get doctors into country areas, we all know that they are going to need some sort of support and encouragement because, if you live in a country area, you do not just do your job. We all know that it is a much greater commitment and is part of your life. The average number of hours worked by a country GP are going to be higher. They are going to spend more time on call because they cannot share it. The doctor in the Shire of Murray has not had a holiday for over 18 months because he cannot get anyone to come down and be a locum for him. Doctors can suffer burnout. There is a realisation that, at the end of the day, if you move to the city, you are probably going to make a lot more money, and everybody has to make those considerations as well. I support the government in its goals. I encourage it to work hard to achieve them because, certainly in my electorate of Canning, we need more doctors and we would like them as soon as possible.