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Tuesday, 26 May 2009
Page: 4391


Mr NEUMANN (6:29 PM) —I rise to speak in support of the Health Workforce Australia Bill 2009. If Australia were to be federated today, I am sure that we would construct our federation in a different manner to that which we constructed it in at the end of the 19th century. The situation is that the Commonwealth government’s powers have been expanded through a number of different mechanisms over the years. We have seen referenda put to the Australian public, most of which have been voted down. We have seen High Court of Australia decisions interpreting section 51 of the Australian Constitution, which enumerates the Commonwealth government’s powers, and we have seen a more expansive approach—two steps forward, one step back—with respect to the Commonwealth government’s powers as a result of the High Court’s decisions in relation to constitutional matters.

I think the Australian public expects us as a government, and expects governments of all persuasions, to take a more national approach to health. But the way in which the Australian federation has changed the most, I think, has been in the cooperative federalist approach undertaken by COAG agreements. That is when state, local and federal governments get together to agree on outcomes, which results in legislative and funding arrangements which change. We have seen magnificent reforms as a result of this sort of approach—for example, in the area of corporations law, defamation law and family law and also in the area of health.

I really support this bill, because I think it is extremely important for my local community. I represent the seat of Blair, which is based in Ipswich and the rural areas outside the Fassifern Valley and the Lockyer Valley. In my area some years ago the Ipswich and West Moreton Division of General Practice, under the then CEO, Kevin Pittman, undertook a study in relation to the health needs of the local community. It found that health needs were great. Obesity was a challenge, diabetes was a challenge and heart disease was also a challenge. It also found that our workforce of doctors and nurses was ageing. About a third of the GPs in my local area will retire in the next five to 10 years. It found that there was one GP for every 1,609 people living in the Ipswich and West Moreton area. That is a particular challenge.

We have addressed this issue of the shortages of doctors and nurses at a national level. This issue was created, I might add, by the deliberate and intentional policies of the Howard coalition government. We have addressed this with 457 visas. One of the biggest users of 457 visas, if not the biggest user, has been the New South Wales health commission. It has used the visas to get more doctors and nurses to work in New South Wales. In Queensland we also have many fine doctors coming from overseas, but we simply have not trained enough doctors and nurses and other allied health professionals. Certainly, not enough paramedics and researchers have been engaged.

These people do not just form the backbone of our system; they actually form the blood, the tissue and the muscle that allow us to do what we need to do. So we need to support the health workforce not just in education but in financial support to induce people to work in these areas and to work in rural and regional Australia as well. We also need to support them to achieve the necessary outcomes in job satisfaction, familial satisfaction and also vocational development. We need to have the research and the information available to us which will enable us to work out where we need to place our doctors and nurses. It sounds like indicative planning, but it is important for us to do it, because the forces of the market have not always worked successfully, as we have seen.

We need to really look at planning and research and development, and we need a cooperative approach. That is why I am very pleased that we have talked about $1.6 billion for the health workforce reform package. That was achieved by COAG in November 2008. I commend the Minister for Health and Ageing and all the various state ministers for what they have done. Coordinating planning, funding undergraduate clinical training places, supporting our health workforce and supporting research, planning and policy development are just crucial. It is amazing that the Howard government failed in this regard. The Institute of Health and Welfare in October 2008 came up with a study which the previous Minister for Health and Ageing, the member for Warringah, had to admit was correct—the Howard coalition government had failed to invest in health and hospital infrastructure and funding and the much-vilified states had taken up the slack. The states, which at that stage mainly had Labor governments, had increased their funding at the same time as the Howard government had underinvested in this area.

This area is vital. People on low incomes or from low socioeconomic backgrounds simply need to have access to a good public hospital and a GP clinic where they can be treated. That is the front line of our health system. They need that, and the shortages are particularly acute in rural and regional communities around the country, particularly in the state of Queensland, where the pattern of settlement is very different from that in any other state. Workforce shortages and inflexibilities have aggravated that and mean that people in rural and regional Australia have not got access to the kinds of health care they deserve or expect—in a First World country. So this sort of funding and this sort of authority, where we can take a national approach governed by a board comprised of a nominee from each jurisdiction so no-one misses out and everyone has a place at the table, is simply a sensible way to go about a national approach to health funding, research and development. A national partnership agreement is a sensible way to ensure that we invest properly and appropriately and take into consideration not just the demography but the regional development of the country.

Many speakers have gone through in detail the background, the functionality, the coordination and the membership of Health Workforce Australia. I want to concentrate on a more local aspect and make a more Queensland based response. In my electorate we have about 15,000 people who are over 65 years of age. In terms of the pension payments, we received in the first economic stimulus package a lot of money—about 44,000 people actually received either the $1,400 single rate or the $2,100 couple rate. In the budget we saw 23,505 people receive the increase in the pension. There are people with a veteran background. I have many veterans in my community because we have the RAAF base at Amberley. They like to come and settle here. We have nearly 8,000 people on disability support type pensions in my electorate. For these types of people, their GP and their public hospital are vital.

The Rudd government have made a major investment in our public health system—$64 billion over five years, an increase of $20 billion and nearly 50 per cent over the previous Australian Healthcare Agreement. That is an enormous increase in health expenditure, and it is a Labor government that is doing it. Labor governments, when it comes to things like education and health, are the ones that really matter to the Australian public. We are the ones who invest for the benefit of this country. We are delivering vital reforms at a time of great economic crisis—investment in public hospitals, health infrastructure, our workforce, maternity and midwifery services and health services in rural and regional Australia. We are upgrading our hospitals. We are training more doctors—a 35 per cent increase in GP training places. It is to the absolute shame of those opposite that they actually froze the number of training places. We need more highly skilled GPs and nurse practitioners to tackle the workforce shortages left as a legacy of the previous government. That is the tragedy—they simply failed to invest.

Investing also in medical and health research is simply vital. This government will invest $430.3 million to upgrade and build health and medical research and training facilities across this country. There is $596 million to expand cancer research facilities drawn from the Health and Hospitals Fund, including $14 million for a smart therapies institute in Brisbane—a collaboration between the University of Queensland, Mater Medical Research Institute, Princess Alexandra Hospital, the Queensland University of Technology and the Queensland government. That is simply vital for my constituents, many of whom travel to Brisbane for cancer treatment. That is simply the case.

We are investing $1.5 billion to upgrade key hospital infrastructure across the country. For my constituents, many of whom have really challenging problems in terms of oral health, the $104 million for the oral health centre in Brisbane, which will treat 17,000 patients a year, is simply crucial. Investing in our health and hospital system is important for its lifeblood. It is our responsibility. It was the responsibility of the previous government and it is a tragedy that they did not take it up.

The situation is that we will care for our people. We will provide options for women as well. One of the things that I am so happy about is what we have done in terms of maternity care, the access to Medicare and the PBS for midwives. The budget includes a $120.5 million package for measures to include choice for women and access to maternity services for pregnant women and new mothers in Australia. I have met with the local group involved in advocacy in this area, and I commend them for their work. Cas McCullough, the National President of the Maternity Coalition, lives locally in my area. I have spoken with her, and she is a great contributor to the Natural Parenting magazine. The midwifery association of Queensland has been strong in its advocacy for these types of reforms. I think this is a commendable reform, and I think it gives women birthing experiences and options which they did not have before. Surgical interventions are not always in the best interests of women, and it is not always what they want. Often they want qualified midwives with sensitivity, understanding and tenderness, someone with whom they have developed a relationship over a long period of time, to assist them in this wonderful experience for them. Women deserve to be empowered, and this reform of the Rudd Labor government is a terrific reform.

The local expression of that in my electorate, of course, is the University of Queensland Ipswich campus, where you can choose to study nursing or midwifery. Ipswich campus has become well known as a campus of excellence where people come to learn how to become not just nurses and midwives but doctors also. We have taken in our first cohort this year, the first graduates from the Bachelor of Health Science. What we are going to see are doctors trained through the University of Queensland Ipswich campus. I think that is important. I have spoken to Pro-Vice-Chancellor Professor Alan Rix about this, congratulated him and commended him on the work that they have done in this regard for Ipswich. I want people to actually study in Ipswich, live there and practise there.

For nearly a decade I served on the Health Community Council, as an employee of the Queensland government. One of the challenges we had was getting doctors to come to Ipswich General Hospital and practise locally. We did that in rural areas as well. We gave them a right of practice in places like Boonah, Laidley and Esk in the electorate of the member for Dickson. We did that. But it was difficult getting them into those rural communities. So getting them locally trained means they are more likely to live there. They study there, they live there, they make friends and they get involved in the life of the community, and that is tremendously important for my constituency.

Ipswich campus also has become known as a centre of excellence with respect to research and innovation. There are a number of important things that have developed there as a result of the initiative of the Queensland state Labor government but also as a result of the Australian Cancer Council funding, and with the support of the Ipswich Hospital Foundation. What has been established in Ipswich, at the University of Queensland, is a Healthy Communities Research Centre. That has been involved in important social research undertaken with respect to the Ipswich study. It is undertaken by the University of Queensland Boilerhouse Community Engagement Centre.

Allied with this, we saw the Queensland government undertake a great initiative last year. That was the establishment of the Centre of Excellence for Behaviour Support. What will happen there will be a great deal of study, innovation and research undertaken in the local area to establish what is needed for people with disability. How can we help them? What can we do to improve the health and cardiorespiratory medicine needs of the local area? What about whiplash nursing? What about people who have come from backgrounds where they were institutionalised, in, say, the Challinor Centre in Ipswich, and are now living in the community? What are their challenges? What are their needs? What are their health needs? These two research centres in my local constituency will make a big difference. That is the sort of planning and research we are talking about under this legislation. The Rudd government is committed to it.

If you do not think it is accepted well by the universities, just have a look at what Professor Peter Coaldrake, the new Chair of Universities Australia, said just today, commenting about the implication of the federal budget provisions for higher education. He is the Vice-Chancellor of the Queensland University of Technology. He said:

Vice-chancellors—

that is, the vice-chancellors of the various universities in Australia—

examined two recent studies by Access Economics and KPMG that identified education as a lead industry providing immediate economic stimulus, long-term gains in skills and productivity and contributing significantly to GDP.

Professor Coaldrake commended the government for the substantial capital infrastructure funding available as part of the budget for studies and research facilities. These are the kinds of research facilities that I am talking about in my electorate, on the University of Queensland Ipswich campus, which you can imagine Health Workforce Australia will be really interested in. They will be really interested in the kind of information that comes out as a result of the research that develops there. So it is not important just in terms of the budgetary stimulation for jobs, economic development, productivity and skilling. We are really talking about caring for our community when it comes to disability and health needs as well.

This bill seems as though it is about the creation of a statutory authority and the Commonwealth Authorities and Companies Act 1997, but I can imagine that Health Workforce Australia will be particularly interested in what the University of Queensland Ipswich campus is doing, because the studies that come from that institution will go a long way towards establishing the real needs of people not just in Ipswich, not just in Queensland, but in Australia and internationally. A coordinated approach to this type of thing is simply vital for our community. It is vital to establish what our needs are locally, state-wide and nationally. This is one of those bills that I am warmly supporting, and I commend it to the chamber.