Mrs HULL (6:56 PM) —I wholeheartedly support the Medical Indemnity (Prudential Supervision and Product Standards) Bill 2002 and the Medical Indemnity (Prudential Supervision and Product Standards) (Consequential Amendments) Bill 2002. These bills will ensure that health care professionals have access to medical indemnity cover provided by properly regulated insurers. They also outline minimum standards for medical indemnity cover into the future. I welcome the proposals by the Howard-Anderson government to address the many complicated issues associated with medical indemnity and public liability across Australia. These proposals before the House will assist in reassuring doctors and specialists that they can continue to practise in the knowledge that they are adequately covered should problems arise.

After a disturbing year or more and the many challenges associated with the collapse of United Medical Protection, like the rest of the members on this side of the House, I welcome these proposals. These proposals will assist rural and regional communities in particular to access and retain adequate health care services. Many doctors and specialists have left the industry or have been forced to contemplate doing so. My hope is that this legislation will encourage them to remain in practice for many years to come and encourage others who have left the industry to return to practice.

Like many communities around Australia, my electorate of Riverina has suffered from specialist shortages and an increased demand on health care services. In April 2001 general practitioners and specialists in my electorate came to me warning me about the impending collapse of UMP, and together we brought these concerns to Canberra. Some of our points for discussion included the fact that the system was running out of money, the very real concern that obstetrics would no longer be available in Wagga Wagga and rural communities, and the realisation that there would be a similar situation for many cities and towns right across New South Wales. The concern was that action needed to be taken by state governments to legislate for tort law reform in structured settlements and to reduce the statute of limitations, particularly for obstetrics.

I welcome and acknowledge the member for Bruce's discussion of the issue of leadership from the Commonwealth perspective to force states to implement such tort law reform. I suggest in return that the opposition could play a significant leadership role here in ensuring that the states come on board with a uniform package of tort law reform. I think this position forced a lot of doctors out of the industry, and the mere fact of not knowing what lay before them was of great concern for all of our communities. I worked to encourage members from rural electorates in this House to lend their support to solving this issue of concern for rural doctors, specialists and health care professionals because, without adequate health care, many people in rural and regional areas will simply have to leave their communities and relocate to an area which offers sufficient health services.

Some of the issues I have raised in my many meetings include the fact that steep rises in medical indemnity rates by the monopoly provider in New South Wales, United Medical Protection, produced an acute threat to ongoing obstetrics and specialist services in rural and regional NSW—more particularly, in my area of the Riverina. In May 2001 an obstetrician in my electorate, Dr John Currie, and I continued to travel to Canberra to highlight the impending collapse of UMP and the need for states to take urgent action. I repeat that there was a definite need for state attorneys-general to take urgent action, right across the sphere, taking into consideration tort law reform structures and reducing the statute of limitations, particularly in the field of obstetrics. The states needed to take this action so that doctors and specialists could feel more comfortable about their futures.

This issue was and continues to be a source of great concern for people within my rural and regional electorate. Health care is one of the most valuable services for any Australian, especially in regional Australia. In my local communities, health care is the single most important issue. People in my area are concerned for their future and many seriously consider packing up and moving to larger centres where health care services are easy to access. There is a bidding war and a price war taking place, with councils right across my electorate determining how best to attract health professionals into their communities by offering them substantial payments and substantial medical centres and practices. It is heartening to see how well the Howard-Anderson government have got behind their rural health initiatives, ensuring that those communities that have no doctors or specialist services are able to access them, with a variety of enhanced facilities in their communities. One recent addition is the Coleambally medical centre, supported by the Howard-Anderson government, which has provided the impetus for a doctor to continue to service that area—an area that looked like it would have no further doctors.

I also want to talk about Griffith, which has a population of more than 25,000 and is the centre of Australia's food bowl. Griffith has lost numerous specialists. The Griffith City Council and, to an extent, the Greater Murray Area Health Service have worked hard to attract specialists and they are now expanding their search overseas. Many other regional towns and cities throughout the Riverina have lost specialists and access to medical services and are desperately trying to understand how they can regain these services. The impending crisis of medical indemnity did not assist them at all.

Wagga Wagga is a growing city of almost 60,000 people and has recently lost its only ear, nose and throat specialist to retirement. Patients are now relying on the services of a visiting specialist from Albury—a city in the member for Farrer's electorate, more than an hour away—whilst we are hoping we can attract a replacement specialist to service our community. When Wagga Wagga, with its large population, cannot replace an ear, nose and throat specialist, what hope does a city like Griffith or a smaller community have of attracting specialist services or of retaining their GP services, particularly when the indemnity costs for these doctors to practise are so high?

The legislation to be introduced by the government will help to prevent this nationwide shortage of specialists, and it will give many doctors and specialists the peace of mind to continue their practices with affordable premiums for medical indemnity insurance. I am very proud to say that, when the whole crisis formed, the federal government, led by the Minister for Health and Ageing and the Minister for Revenue and Assistant Treasurer, Senator Coonan, came forward with great dexterity and speed to ensure that our people had continuing services and that our doctors were assured of the support of this government.

Each time I rise to speak in this House I remind fellow members of how proud I am to represent a very vibrant and very strong electorate—an electorate with people who are determined to survive and succeed, despite the many obstacles that come their way. I have mentioned many times that health care is the most important issue. This community issue brought people together right across the Riverina in 2000 to raise well over $3 million in a little over a year for the establishment of a radiotherapy unit. It was indeed their proudest moment. The Riverina Cancer Care Centre was opened in March 2002 following a public meeting on 18 August 2000. The centre offers lifesaving radiotherapy treatment to people from across the Riverina, southern New South Wales and beyond. Such is the desire for our communities to ensure the continuation of healthy lifestyles for the people who make up the surrounding district communities.

The Riverina is my home and I love everything about it. I take this opportunity to encourage specialists and medical practitioners to consider the Riverina as a fantastic place to work and live. The cities of Wagga Wagga and Griffith and the towns of Narrandera, Gundagai, Leeton, Temora, Cootamundra, Hay, Coleambally, Darlington Point, Ardlethan, Coolamon and Junee would all welcome you with open arms. I hope that there are doctors who will read Hansard to understand the issues of this bill and who will take the opportunity to come and see what we have to offer in the Riverina. Not only does the Riverina offer many career challenges and opportunities to develop skills but it also boasts a great lifestyle. The reason I support the Medical Indemnity (Prudential Supervision and Product Standards) (Consequential Amendments) Bill 2002 is so that the communities throughout my electorate can have access to specialists and the best health care, which they deserve, while specialists can have peace of mind when they offer these much needed services. I really do not want to see Riverina people forced to leave their homes and way of life because access to a doctor or specialist has become a struggle. They deserve to receive health care equal to that of anyone living in a metropolitan area.

The fear of losing obstetric services in rural and regional areas continues to grow within the medical community. A primary health care facility in my electorate was threatened late last year. Once again, people from Wagga Wagga and right across my electorate of Riverina rallied in support of their sole private hospital and maternity unit, arguing that the loss of choice for many women would have an enormous impact on the region—indeed, it would. In November last year, I witnessed a community come together to protect its health services once again. Calvary Hospital's maternity unit faced an uncertain future as obstetricians threatened to leave due to the fear of the unknown price of medical indemnity insurance.

The maternity unit at Calvary Hospital services an entire region, including towns such as Narrandera, Griffith, Gundagai and Temora. People come from places up to three hours drive away to have their babies in this private facility. More than 30 per cent of mothers-to-be in Griffith currently travel to Wagga Wagga to have their babies. Without the services of Calvary Hospital's private maternity unit, expectant mothers wanting private care would be forced to travel to Wodonga, Canberra or Sydney to have their babies. Six hundred babies were delivered at Calvary Hospital in 2001, an increase of 160 on the previous year. Without this service, the publicly funded Wagga Wagga Base Hospital simply could not cope with the increase in deliveries and there would be a significant strain on its existing services.

A rally was organised and more than 2,000 people marched along Wagga's main street to show their support for Calvary Hospital. In addition to the support shown at the rally, more than 7,000 locals signed petitions, which I presented to this House, and the state Liberal member for Wagga Wagga, Daryl Maguire—who was recently re-elected to the New South Wales parliament—presented petitions to the New South Wales parliament.

With only three private hospitals outside metropolitan New South Wales offering obstetric services, it was crucial that we maintained this service for southern New South Wales. The threat to ongoing obstetric services was wholeheartedly taken up by the community, a testament to the huge importance that we place on such services. Not only was a vital health service under threat but the future employment of 26 full-time and casual midwives employed at the hospital was under threat at a time when the health service is working to attract midwives, nurses and other allied health professionals. These professionals were facing certain doom and gloom.

But through the positive actions of this government and as a result of many meetings that I held with the minister—and through her great concern and also the great concern demonstrated by the Prime Minister's office over this issue—the government made the announcement that they would be able to resolve this issue and ensure the ongoing services at Cavalry Hospital. I welcomed those announcements by the government, including the latest announcement by the minister on increasing assistance to obstetricians from 50 per cent to 80 per cent over and above that which is paid by non-procedural gynaecologists in medical indemnity costs. I think that is most helpful in order for us to retain our obstetric services in rural and regional areas.

After the minister, the Prime Minister and the government became positively involved in this issue, the local Wagga Wagga Daily Advertiser went from stories about rallying and people's concern over the loss of their services to the headline `Maternity ward safe and sound' on 14 December. The obstetricians had received their premium notices. They were affordable, just as the minister for health had assured me that they would be. They were able to continue practising at Calvary Hospital and are still doing so. Not only were obstetricians affected by the problems associated with UMP; orthopaedic surgeons, procedural GPs and district and regional hospitals in my electorate were also affected. There is certainly a great need to also ensure the future of these services through the actions of the government.

On 31 May the Prime Minister announced key elements of the government's strategy for ensuring that medical indemnity insurance was made a viable commercial product. One critical element addressed was improved transparency in the financial reporting of medical defence organisations by bringing all the insurance business of MDOs into the prudential framework for general insurance. And so it should be, because a lot of the problems were due to a lack of transparency in the way in which companies reported and managed their risks.

On 23 October the Prime Minister also announced further details of the government's strategy. He announced that MDOs would be brought into a new regulatory framework administered by the Australian Prudential Regulation Authority and would be subject to a range of prudential safeguards to mitigate insolvency risks. The Prime Minister also announced that minimum product standards would be applied to medical indemnity cover. I believe that this is a great step forward and I congratulate the government on their actions.

This bill requires MDOs to operate on a prudentially sound footing and to provide certain products and information to members, providing general practitioners and specialists with peace of mind—and so it should. Our specialists and doctors of the future should be able to look at how their risk is spread. New South Wales is the most litigious state for medical claims. This issue comes under the realm of the state governments, with a great need for continued action on tort law reform. By enforcing this reform, the spiralling system of medical indemnity could be relieved. How can a company manage risk and strike premiums on a yearly basis with no indication of what might happen in 25 years time? It is unreasonable. It is an unreasonable expectation with respect to the company and it is an unreasonable expectation with respect to the proceduralist obstetrician.

The structured settlements bill, introduced into the House last year, also will provide many benefits for both medical indemnity and public liability insurance. It will reduce the growing tendency for courts to award huge sums of money to parties and instead will make it more attractive for complainants to opt for structured settlements. The introduction of structured settlements will bring a great deal of benefit to those affected by medical indemnity and public liability insurance. It will also allow many organisations, including local governments, to factor in the risk of litigation costs and it will reduce the huge burden on insurers to pay lump sums following litigation.

The government has done and will continue to do an enormous amount to ensure there are medical services right across Australia—that is, in outer metropolitan areas and rural and regional areas. But, if doctors, specialists and proceduralists are continually concerned about the general public taking legal action and suing in the first degree, I think we still have a long way to go. An education process must be undertaken to ensure the public recognises that there is a certain amount of self-accountability that goes with any sickness or any provision of services to a community. I applaud the bills in front of us and urge the public to consider litigation carefully before embarking on it to ensure that it is just and proper.