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Tuesday, 26 May 2009
Page: 4371


Mr MARLES (4:54 PM) —I rise to speak in support of the Health Workforce Australia Bill 2009, which is a bill to establish Health Workforce Australia, a statutory authority that will be established under the Commonwealth Authorities and Companies Act 1997. I welcome the opportunity to participate in this debate, particularly after listening to the interesting contribution made by the member for Dickson. What a difference 18 months makes. Listening to the member for Dickson making plaintive pleas about the level of funding for public hospitals, one only needs to remember that just over 18 months ago he was part of a government that had busily over the last 12 years ripped enormous funding out of the public health system.

The member for Dickson talks about the aspiration of the Rudd government to fix the health system in this country, and the reason it needs to be fixed is that it was broken by the Howard government. In his contribution he also seems to have an obsession about spin, and that betrays his own culpability as a member of a government which wrote the playbook on publicly funded spin. One only needs to look at the $60-odd million that was spent on Work Choices paraphernalia to see testament to that fact.

Health Workforce Australia will manage a significant amount of funding around clinical training in this country. It will manage most of the initiatives which are contained in the $1.6 billion health workforce package agreed to by the Council of Australian Governments in November last year. During the 12 long years of the Howard government, the Howard government neglected the health workforce in this country. That is felt no more keenly than in regional Australia. It is felt no more keenly than in Geelong, in my electorate, where there are many private practices that have closed their patient lists and where a simple event such as the retirement of a GP has left, on a number of occasions, many patients without a doctor and struggling to find their way onto a new GP’s list.

Right now it is estimated that the doctor-patient ratio in Geelong is about one to 1,500. The GP Association of Geelong estimate that we in Geelong are about 40 GPs short of achieving what they believe would be the ideal ratio of one GP to every 1,200 people. That is a reflection of the state that the health workforce has found itself in after 12 years of the Howard government. This government, the Rudd government, intends to act differently in relation to health and this bill is very much an example of that. We are providing an unprecedented level of funding for health care in this country. The $1.6 billion provided by COAG in November of last year, consisting of $1.1 billion from the Commonwealth and $540 million from the states, represents the single largest investment in the health workforce in this country ever made by Australian governments.

Five hundred million dollars of the Commonwealth’s contribution will be spent on undergraduate clinical training and that will increase the clinical training subsidy to 30 per cent for all health undergraduate places. There will also be $175.6 million spent over four years in capital infrastructure to expand teaching and training places. This particularly will have a focus on regional and rural Australia where the shortage of GPs and indeed other medical practitioners is felt most acutely. What we know is that students who train in rural areas tend to practise in rural Australia.

The health education sector in Geelong has become an area of enormous activity within our town. But we remain in desperate need of trained practitioners. As I stated, the GP Association estimated that we are 40 GPs short of an optimal level. There are 18 medical practices across Geelong right now which are currently looking for GPs. We are also experiencing a shortage in other health professional fields—nursing being another case in point.

The Deakin University School of Nursing is a fantastic example of a part of the education sector which is going from strength to strength. It is now one of the largest nursing schools in Australia. It is the largest nursing school in Victoria and it is growing. Last year across the three campuses of Deakin which do nursing training—Burwood, Warrnambool and Geelong—540 nurses graduated, and of that number 200 graduated in Geelong. Most of those 200 have clinical placements in hospitals in and around Geelong and the vast majority have a placement at the Geelong Hospital, which is becoming one of the busiest hospitals in this state and, indeed, a major teaching hospital within the state.

Last year we had the opening of the Deakin Medical School. It was opened on 1 May last year by the Prime Minister, Kevin Rudd. There are right now 136 first-year students at the Deakin Medical School and 114 second-year students. The first year of graduation will be 2011. All of that is going to help significantly to deal with the issue of the health workforce in Geelong. But as student numbers grow, without any intervention we are going to find that the system will strain to place those students in clinical training places. That is why this bill is being put in place to establish Health Workforce Australia to manage the $1.6 billion investment in this area, and that will expand the scope of training opportunities. It will help find new and varied places for medical students, nursing students and allied health students to train. It will usher in a new era in health training within our country.

Importantly, the bill will open up the private sector, such as private hospitals or private practices, to training students. It is very costly for those private practices and hospitals to take on a student and that is particularly the case when we are talking about allied health students such as physiotherapists or speech therapists. It is particularly difficult for those areas because they have never had, until now, an identified funding stream for their clinical training. Most of the training does occur in private practices and it requires time and effort. There are of course many practitioners who are happy to take on students, through their sheer love of teaching on the job, but in many cases educational institutions find themselves in the position of needing to beg practitioners to take on students in these clinical training places. Health Workforce Australia and the funding that it will administer will help cover the cost of taking on students in private practice, which is a very important and necessary resource intervention in this country.

Another added benefit associated with Health Workforce Australia is that it will have a research function. For the first time it will be gathering very important data on the health workforce which can assist in informing public policy makers about how to improve the situation of the health workforce around Australia.

In terms of the practicalities, this bill establishes Health Workforce Australia, which will administer the new funding and provide an overarching organisational structure. The bill provides for $125 million over a four-year period for the work of Health Workforce Australia. The governance structure of Health Workforce Australia will involve one representative from each state and territory, an independent chair and up to three independent members. That is a very important governance structure and will provide the proper advice to the constituencies that Health Workforce Australia will provide for.

At present, there is a division in the responsibilities for health between state governments and the Commonwealth government. Indeed, for many years this country has been experiencing a blame game, particularly under the Howard government, where blame would be shifted from one tier of government to another and, in the process of doing that, problems that needed to be solved within the health system fell through the cracks. Far from describing an extra layer of bureaucracy, as the member for Dickson was intimating in his contribution, Health Workforce Australia will provide a way of breaking through that barrier between state and Commonwealth responsibilities, it will have an overarching responsibility across the state and the Commonwealth and it will assist in removing that blame game.

It will also assist in providing something of a bridge across both the education and the health sectors. In doing that, it will meet the future challenges of the health system through workforce reform. There will be put in place a mechanism which will allow health ministers around the country to direct the work of Health Workforce Australia; there will also be put in place a mechanism to allow Health Workforce Australia to report to health ministers. There is a need to get on with the business of this bill. Health Workforce Australia needs to be established from 1 July this year in order to be fully in place to administer the funding that exists for the coordination of clinical places from 1 January next year.

In summary, this is a very important bill which provides for an overarching governance structure of a very important and extensive initiative to provide funding for health training in this country. I say this from the point of view of a regional MP in this place and particularly from the point of view of Geelong: we hope that through this additional funding in relation to the training of health professionals we increase the numbers of health professionals practising in regional Australia and address the current shortfall. For those reasons, I very much commend this bill to the House.