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Wednesday, 22 August 2012
Page: 6141

Senator FAWCETT (South Australia) (17:27): I rise to support the comments of my colleagues on this report, which is a very important report for people living in rural, regional and remote Australia. I am not going to repeat all of their comments in detail except to say I strongly support the comments around classification systems. Statistics do indeed lie. They do not necessarily reflect the reality on the ground and we need those improved systems such as the ones identified and recommended in the report. I support the comments on specialisation and the lack of incentives that are available for allied health professionals compared to GPs.

I would like to touch on a couple of things that have come up during the inquiry from a South Australian perspective specifically. Firstly, states are different, particularly if you look at demographics and the distribution of population. Policy that is developed at a national level that may well suit the larger east coast states, with larger populations and larger regional centres, may not suit South Australia. A number of pieces of evidence came to light during the inquiry that highlighted that sometimes things occur quite differently because of the different arrangements within states.

For example, in South Australia the largest regional town, Whyalla, is around 21,000, Port Augusta is around 13,000, and Port Lincoln is around 14,000; then we have a number of other smaller places. So in South Australia there is no regional university. Flinders University, for example, has taken a great initiative with the Parallel Rural Community Curriculum in Renmark and Mount Gambier. They are having terrific success and there is good longitudinal evidence showing that students who spend a long period of training as an undergraduate in country areas do in fact have a higher probability of returning and remaining in the country as a GP.

What is important, though, is that we look at it as a whole system. It is not just the universities; it is also the training placements for interns and people in their second year after graduation. What we see in South Australia is that there are only some six places available in the country and yet we need some 56. Allowing for international medical graduates, perhaps we only need 24; but that is still a fourfold increase in what is available at the moment.

So there needs to be alignment between the state government as well as the federal government and the providers, such as universities and colleges, to find a way to make this transition smooth and effective so that the communities who need the support get it, as opposed to the buck being passed or just reaching dead ends in trying to get people to flow between the various stovepipes.

The federal government also has a role to play in looking at how they work with the state government around things like incentive payments for GPs or the provision of locum services to support GPs in country areas who wish to provide training for medical students or, indeed, for interns. I note the trial that is occurring in South Australia—for example, in Kapunda—where people can come as an intern and GPs can provide a level of training for them post their graduation from medical school. In a state like South Australia, where we do not necessarily have large enough communities to have training hospitals in the community, that is a model that is viable. It is starting to work, but we need the federal government to look at ways to adequately compensate GPs for the time taken away from their business—because at the end of the day it is a business; it pays their bills—to provide that support.

I thank a range of people for their support in South Australia and for making me aware of the issues in South Australia. Steve Holmes, you can take your stockwhip and put it back on the wall. I think this inquiry has done a fair bit to round up of some of the issues. Dr James McLennan at the Clare Medical Centre showed the way in terms of sustainable rural practice. Dr Anthony Page in Gawler highlighted a number of the areas of difference between state and federal policy that can have an impact. I also thank Scott Lewis from the RDAA, as well as my federal colleagues Rowan Ramsey, Patrick Secker and Senator-elect Anne Ruston who helped out with the inquiry.

One of the recommendations that has come out of a lot of the work in South Australia is to look at having a function within DoHA that aggregates the information collected by Medicare locals so that on a regular basis we assess the gaps that are emerging between federal and state policies and very deliberately put those onto the COAG agenda so that they can be dealt with in the interests of sustainable health care for people living in rural and remote Australia.

I seek leave to continue my remarks.

Leave granted; debate adjourned.