Senator SANDY MACDONALD (7:00 PM) —In light of this week's debate about health services, I want to outline the coalition's achievements and our determined commitment to deliver further improvements. In the past three budgets there have been more than 120 targeted health initiatives introduced by the Howard-Anderson government. This year's budget continues the government's commitment to better health outcomes for rural, regional and remote Australians by addressing shortfalls in the rural health work force, particularly in the field of nursing, and strengthens existing measures to provide sustainable rural health services.

These initiatives complement the really inspirational $562 million regional health strategy called More Doctors, Better Services that has been in place since the 2000-01 budget, and it followed the Michael Wooldridge-John Anderson medical outreach tour. This year's budget delivers record funding for Medicare and confirms the coalition's commitment to strengthen and improve our public hospital system. It includes $300 million for increased Medicare rebates for GP visits, particularly benefiting patients with complex health conditions who need longer consultations with their doctor; $104 million over four years for GPs to employ more practice nurses so that they can focus on diagnosis and clinical care; $13 million over four years to provide 110 nursing scholarships worth $10,000 per year targeting students from rural and regional backgrounds to access undergraduate nursing degrees; $120 million for GPs to provide better outcomes in mental health care; nearly $50 million to allow GPs to better treat Australians with diabetes, which is an increasing problem for all of us; funding for GPs to better manage patients with asthma; $72 million to increase the number of women who can be screened for cervical cancer, especially women living in regional and remote areas and targeting migrant women and Aboriginal women; and over $43 million to increase the availability of after-hours and emergency care for 32 new after-hours medical care sites that are being established across the country.

The coalition government has particularly focused on enhancing rural health education and training. This will see the development of nine rural clinical schools and three university departments of rural health in regional areas. I am pleased to be able to say that this includes a department of rural health to be established in Tamworth, where my electorate office is. This will be established in cooperation with the University of Newcastle, which is working in partnership with the University of New England in Armidale. Congratulations to both those universities and to the medical schools within those universities. This initiative will provide specific rural health training and encourage medical and other health professionals to take up rural practice.

Another initiative is the Rural Australia Medical Undergraduate Scholarship Scheme, which aims to increase the number of students with a rural background studying medicine by providing financial support during university. In the year 2000, this provided approximately 430 scholarships, and around 80 further scholarships have been awarded this year.

Further, a total of $33.4 million has been allocated to fund the Commonwealth Medical Rural Bonded Scholarship Scheme over the next four years. Under this scheme, 100 new medical school places tied to the scholarships will be offered every year, with students receiving $20,000 annually while studying, in return for a commitment to work in rural areas for at least six years once they complete their fellowship as a general practitioner or as a specialist. One hundred medical students have already signed up for these scholarships.

The multipurpose services initiative is a joint Commonwealth, state and territory government program responding to the needs of rural families through the delivery of improved health and aged care services. This is achieved through the pooling of funds from various sources to sustain diverse medical services in the one location. To date, 54 of these multipurpose service sites have been approved and operate nationally. These multipurpose service sites also support 1,124 flexible aged care places. The more allied health services initiative provides $49.5 million over four years to boost the range of health professionals, including mental health workers, podiatrists, physiotherapists and dieticians in rural areas. Early estimates indicate there will eventually be more than 130 full-time equivalent health positions funded nationally from this program. The medical specialist outreach assistance program will ensure that visiting specialists, local GPs and health services can work together to improve local health practitioners' skills as well as health care for rural Australians. The enhanced pharmacy package provides funding over four years for a range of allowances to sustain or increase the number of pharmacies in more remote areas and provide work force support.

Other rural health initiatives undertaken in the past three years are continuing. I will mention some key programs. The Rural Retention Program has provided payments to more than 2,000 doctors who have practised in rural areas for a specified period since the introduction of this world-first initiative in 1999. This amount includes a second payment to over 1,600 of those doctors. The John Flynn scholarship scheme continues and provides financial support to enable medical students to form long-term relationships with rural communities and gain a better understanding of rural medical practice. Each year some 600 medical students receive assistance under this scheme, with 150 new scholarships available this year. In the 1999-2000 budget, the rural women's general practitioner service was funded to provide regular female GP visits to more than 60 communities—another world first. The government has funded the Royal Flying Doctor Service for more than 40 years, particularly to help rural and remote communities access a broad range of clinical services and the best aero-medical emergency retrieval system in the world.

The coalition is also working to make the health system better and more user friendly. For example, when Labor was in government, Australians could claim a Medicare rebate only from a Medicare office or by post. Over the last four years the coalition has implemented a number of initiatives to improve access to Medicare, including more than 800 national claiming facilities in addition to telephone claiming facilities. Over the next year advances in technology should in fact allow patients to claim their Medicare rebate on the spot from the doctor's surgery.

In contrast to Labor, the coalition believes in a strong private health sector to complement the public system. The private health sector allows Australians the freedom to choose their own doctor and hospital and helps alleviate pressures on the public system. The coalition will continue to improve Australia's health system by reforming Commonwealth-state relations and by emphasising quality care and preventive treatment. If Labor were serious about providing better health services to Australians, even in opposition they have the chance to do something constructive—for instance, by urging the New South Wales state Labor government, which gets around $8.3 billion this year from the GST arrangements, to spend more of that money on the public health services that are desperately needed in New South Wales. The coalition will continue to provide Australians with a choice of private care combined with a quality public hospital system. This means that Australians, particularly those who live in regional Australia, will have affordable, high quality and world-class health care.