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Thursday, 26 November 2009
Page: 13116


Mr BIDGOOD (10:31 AM) —I rise to speak in favour of the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009. Before I launch into my prepared speech, I would like to address some of the issues that the member for Paterson has raised. I would like to ask him, through you, Mr Speaker, this: what did the Howard government do for the last 11 years? We do not just suddenly have this situation after two years. We have a situation where for 11 years the previous government failed to invest in extra doctor and GP training, extra nurses and extra provisions for the healthcare service. That is why the Rudd Labor government has had to come on board and do a complete review of the whole national health service across this nation. We have come up with 123 recommendations which are now before the government for consideration. So to the member for Paterson I say let us not have any more of this blame game, which you have continued with for 11 years, between the federal government and the state governments. You ripped $1 billion out of the states’ healthcare systems. Let us have no more of this deceit. Let us have the truth on the table. Why didn’t you have the political will to train more GPs in rural areas? Why didn’t you double the number of GPs being trained? You did not have the political will and you did not have the courage to take on the real hard issues and the hard causes of the nation. That is why it has been left to this Rudd Labor government to truly deliver for the nation of Australia, and I know we will deliver for the people of Dawson.

I now want to go to the substance of the bill. Its substance is to streamline the operation of section 19AB of the Health Insurance Act 2009 and to remove a number of anomalies. Section 19AB of the act provides that overseas trained doctors and former overseas medical students are not able to provide professional services that attract Medicare benefits for a period of 10 years, otherwise known as the 10-year moratorium. The bill amends the class of persons subject to the restrictions of section 19AB and amends the start date of the moratorium period. This bill is about providing for New Zealanders who study in Australia to be treated in no different way from Australians studying in Australian universities.

This bill benefits the many Australian citizens who elect to study at New Zealand medical schools. These are medical schools which are accredited by the Australian Medical Council, the AMC, to the same standards as Australian medical schools. However, as these Australians did not gain their primary medical degree in Australia, they are also subject to section 19AB of the act—being trained overseas.

In the medium to long term it is likely that changes in the bill will see an increase in the number of doctors working in non-metropolitan areas. A larger number of properly trained doctors is a win for our system and something which the previous government should have addressed in its 11 years in power but obviously failed to do.

As stated before, the main provision in the bill relates to the removal of current restrictions applicable to doctors who are New Zealand permanent residents and citizens who have obtained their primary medical education at an accredited medical school in Australia or New Zealand. The change effectively removes these doctors from the classification of ‘overseas trained doctor’ and the ‘former overseas medical student’, now to be termed ‘foreign graduate of an accredited medical school’ in section 19AB of the act.

Another important provision in the bill is the removal of the requirement for overseas trained doctors and foreign graduates of an accredited medical school to have both Australian permanent residency or citizenship and medical registration in order for the 10-year moratorium to commence. Specifically, the bill will amend the Health Insurance Act 1973, known as ‘the act’, to make four major changes: (1) removal of persons who are permanent residents or citizens of New Zealand and who obtained their primary medical education at an accredited Australian or New Zealand medical school from the classification of ‘overseas trained doctor’; (2) amendment of the classification ‘former overseas medical student’ to ‘foreign graduate of an accredited medical school’; (3) removal of the requirement for overseas trained doctors and foreign graduates of an accredited medical school to have both permanent residency and medical registration in order for the 10-year moratorium period to commence; and (4) introduction of a maximum period of 90 days in which medical practitioners can appeal against a decision to refuse to grant an exemption or a decision to impose conditions on an exemption pursuant to subsections 19AB(3) and (4) of the act.

The amendment takes into account the awareness of the Department of Health and Ageing that overseas trained doctors enter Australia via New Zealand, with the majority of these doctors obtaining New Zealand passports as a result of New Zealand’s different entry and citizenship laws. It is not intended that this proposed amendment be extended to medical practitioners whose primary medical education was obtained outside New Zealand or Australia. A significant number of temporary resident doctors, including New Zealand trained doctors, work in a district of workforce shortage for two to five years before gaining permanent residency or Australian citizenship. When the 10-year moratorium is applied to their tenure, these doctors may be obliged to work in a district of workforce shortage for up to 15 years.

This amendment proposes that the 10-year moratorium will commence from the time the medical practitioner is first registered as a medical practitioner in Australia and will cease after 10 years, provided the medical practitioner has gained Australian permanent residency or citizenship during that period. It is anticipated that a number of overseas trained doctors and foreign graduates of an accredited medical school will be taken to have completed the 10-year moratorium at the commencement of the amendment. Documentation will not be required to transfer the status of persons following commencement of the bill—that is, the department will not require the lodgement of any documentation; for example, visas or citizenship documentation in support of the change in status at the commencement date of the bill. Should the medical practitioner not have obtained Australian permanent residency or citizenship by the conclusion of 10 years from first gaining registration, the restrictions will remain in force until the medical practitioner gains permanent residency or citizenship.

I speak with some authority on this, having been the owner and financial director of two medical centres in Mackay, looking after the healthcare records of 40,000 people and managing 10 GPs and 30 staff. I know the difficulty there is in obtaining medical care for urban rural areas such as Mackay, and also areas such as Proserpine, the Whitsundays, Bowen, Ayr and South Townsville. I know these dilemmas of registration. I know that attracting Australian-trained doctors is difficult, even to somewhere as beautiful as the seat of Dawson, with over 74 tropical islands—possibly the best in the world; yet we still have trouble attracting Australian-trained doctors.

As I mentioned earlier to the member for Paterson, the reason for this difficulty is the failure of the last 11 years of the previous Howard government to have the political will to invest in more GP training. And I do take on board that there need to be incentives to move to rural and regional Australia. I know from my own personal experience that if we were to say to all the people who are not trained in Australia as doctors to leave, I can tell you now that Mackay Base Hospital would close down and a lot of the surgeries across Mackay and the seat of Dawson would also close. That is quite a damning indictment of the previous government because, as most people know, it takes at least 10 years to train a medical student and then take them on to GP training as well.

I am glad to say that JCU in Townsville is training up doctors, and I will give credit where credit is due—that was done by the previous government. But the criticism that we had at the time, as a medical centre owner and also politically, was that it was not enough. It was a good start—we recognise that—but it could have been so much more. If the capacity had been built when those original decisions were made the supply would be a lot stronger right now and we would not be having the problems that we are having in trying to meet the healthcare needs of our good citizens in rural and regional Australia.

I can say from my own personal experience that that was a good move, but the best move is what the Rudd Labor government is doing. We are taking on a full and comprehensive analysis of the whole healthcare system across Australia. The final report on the national healthcare system of Australia has been presented to the government with 123 recommendations. Those recommendations have been taken far and wide by the members of this House, by the Prime Minister and by the Minister for Health and Ageing. Over 70 consultations directly with peak bodies in the health profession have taken place. I organised one at the Mater Hospital in Mackay. Through the Mackay Division of General Practice I invited GPs and peak leaders of the health profession from hospitals and all of the specialities to come along and give their views. Many have also given their views by emails as well and those emails have all been submitted to the Minister for Health and Ageing and the Prime Minister.

This is exhaustive consultation and it should have happened in the last 11 years. The previous Howard government has left us with a healthcare system that was not efficient, that was riddled with problems and that was underfunded to the tune of $1 billion—it was ripped away from the states by the previous federal government. We are addressing workforce issues; we are investing in more elective health surgery—we have done that; and we are investing profusely across the nation in training up more GPs and nurses. This is the way to go. This is what should have been done previously.

My experience with overseas-trained doctors is that they are really diligent when they come to this country—as my former wife did—and work hard to make a difference in the communities in which they serve. Obviously there is due process and due accreditation, which are the right and correct things to go through.

I can truly say thankyou to all the overseas trained doctors who come and serve due to the lack of our own Australian trained doctors. Again, I put that squarely on the former government of the last 11 years. It was squarely their responsibility to foresee the population increases. They knew that the population was going to grow and yet they failed to meet the capacity demands that were coming. Any government with vision can see these things coming. Any government with an eye on the long term and not the short term can see these issues coming down the track. We, the Rudd Labor government, are a government of vision. As I have said before in this place, and I will say it time and time again, the Bible is true when it says that a nation without a vision is perishing, a leader without a vision is perishing and, where there is no vision, the nation does perish. We need to have vision in health, in education, in housing and in industry. We need to look after the citizens of Australia. We need to give them the best health care, the best education, the best housing and the best opportunities in life as our nation grows.

We also need to have the best education to understand the complexities of climate change—which, as we know, is very topical at this moment in time, particularly with the opposition party completely and utterly divided. The old adage is true that division is death. If you cannot govern yourselves, you cannot govern the nation. You failed to govern the health system proficiently to provide for the future. This bill goes towards that. This bill helps make the capacity designs that we need in our health service by allowing New Zealand and overseas trained doctors to come on board and to be recognised equally alongside Australian trained doctors. I wholeheartedly back what this government is doing in its complete analysis and review of the whole healthcare system in meeting the true healthcare needs of this nation. I commend this bill to the House.