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Thursday, 26 November 2009
Page: 13123


Mr TREVOR (11:01 AM) —The government’s Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009 is integral to maintaining a viable health system in our country. The health system of our country, and indeed any country, relies heavily on government support and the continual updating of legislation to match the requirements of the time. We live in a time when many laws of previous governments either have grown outdated or have failed to fulfil their intended purpose, resulting in complications for the people or issues they sought to assist or regulate. The act we are proposing to amend is a prime example of laws that hinder people unnecessarily because they never fulfilled their intended purpose.

We live in a country where our health system is largely supported by overseas trained doctors. Without their work and commitment to Australian health, our medical system would collapse. The bill today will make life easier for many of these doctors working here in Australia. By changing the ways our laws dictate the ability of overseas trained doctors to access the full benefits of Medicare, we can open up our health system to more government supported medical professionals and remove many of the complications associated with achieving this support.

The Australian population is growing at a faster rate than the medical workforce. Over the decade 1996-97 to 2006-07 the population grew by 13 per cent but the full-time workload equivalent of GPs only rose by 10.9 per cent, enhancing the shortfall in an area that was already struggling to keep up with demand. The changes in this amendment bill are absolutely necessary if we are to ensure that the capacity of our medical system does not continue to be outgrown by the ever-increasing population of our country. The amendments proposed by this bill have the potential to increase the number of government supported medical professionals working in Australia by increasing their capacity to be eligible for Medicare benefits, a change that will effectively benefit all Australians.

The major problem with the current legislation is the implications it has for New Zealanders. As many New Zealanders elect to study in Australian universities and are treated equally to Australians in terms of their eligibility to study, a large number of them enrol in a medical course before they discover that they are not considered a permanent Australian resident under the act. The problem with this, of course, is that eligibility is measured from the time of commencement of their primary medical degree and once they have commenced the degree any changes to their status, such as citizenship or permanent residency, will have absolutely no impact on their eligibility.

Another major problem with the legislation as it currently stands is the effect that it has on the Australian students who elect to study at New Zealand medical schools. As these medical schools are accredited by the Australian medical council to the same standard as Australian medical schools, many Australian students elect to study in New Zealand without understanding the dire impacts that this will have on their future ability to attract Medicare benefits. Due to the fact that the schools are overseas and not Australian, these students become subject to section 19AB of the act and, effectively, the 10-year moratorium if they choose to register as professional medical practitioners in Australia after they have completed their studies in New Zealand.

The amendments proposed in this bill aim at bringing the legislation in line with the Australian Medical Council’s recognition of New Zealand medical schools and will change the laws so that permanent residents of New Zealand are treated similarly to citizens and permanent residents of Australia under section 19AB of the act. One issue that could arise from this is the exploitation of this change by the large number of overseas trained doctors that use New Zealand as a back door into Australia because of the different entry and citizenship laws there. As this is not the intended purpose of this amendment bill, the term ‘former overseas medical student’ to be renamed ‘foreign graduate of an accredited medical school’ will continue to include any persons who were not an Australian or New Zealand permanent resident or citizen at the time they were enrolled in an accredited Australian or New Zealand medical school. This is just one of the many far-reaching, positive impacts that the amendments in this bill will have on both Australian and New Zealand medical students.

It is indeed quite clear that the significant amendments in this bill will have major positive impacts on New Zealanders who wish to work as professional medical practitioners in Australia. It will remove persons who are permanent residents or citizens of New Zealand and who obtain their primary medical education at an accredited Australian or New Zealand medical school from the classification of ‘overseas trained doctor’. Under the act, overseas trained doctors are considered to be any professional medical practitioners who obtain their primary medical degree from a medical school outside Australia. This amendment is proposing that New Zealand citizens or permanent residents who obtain their medical degree from either an Australian or New Zealand medical school are completely exempt from the 10-year moratorium. This effectively allows them to practise as registered medical practitioners with Medicare benefits from the date they register, which will not only increase their accessibility, but also increase the viability of New Zealand doctors working in Australia.

The second amendment will also assist New Zealand citizens to avoid the 10-year moratorium by renaming the term ‘former overseas medical student’ to ‘foreign graduate of an accredited medical school’. This simple yet irrefutable crucial amendment clarifies the meaning of the term and completely revolutionises its impact on New Zealand citizens who have obtained their medical degree from an Australian medical school. Under the current legislation, New Zealand citizens can stay permanently in Australia on a special category visa. Because they are not permanent residents or citizens, they are restricted by the 10-year moratorium after they obtain their medical qualifications and register as a professional medical practitioner. It is undeniable that these students, who study at medical schools that are accredited by the Australian Medical Council, should not be hindered by the legislation based on a technicality of citizenship and residency when they are already treated equally to Australians for the purpose of attaining their qualifications to be professional medical practitioners. This clearly highlights the complications of the current laws and makes it openly obvious that these amendments must come to pass.

Another of the significant amendments introduced by this bill will rectify an anomaly in section 19AB of the act to change requirements for the commencement of the 10-year moratorium for medical benefits. Currently, the 10-year moratorium will not commence until the person is both registered as a medical practitioner in Australia and a permanent resident or citizen of Australia. As many overseas trained health professionals enter Australia through the temporary skilled visa categories for periods of up to four years, the current legislation prevents the 10-year moratorium commencing until they become permanent residents or Australian citizens, meaning that it could take in excess of 10 years for these professionals to be eligible for Medicare benefits for these services.

The intent of the original act was for the 10-year moratorium to commence when the medical practitioner was first registered in Australia, but because of technicalities in the legislation this was not the case. The amendments eliminate this significantly detrimental delay by commencing the 10-year moratorium from the date they first register as a medical practitioner in Australia. With the amendments, the moratorium will cease once the 10 years have transpired, provided that they have become a permanent resident or Australian citizen during that period. If the 10 years have transpired but they have not attained permanent residence or Australian citizenship in that time then they will be ineligible until such time as they achieve it. This will effectively reduce the length of time that overseas trained doctors must work without Medicare benefits, increasing their capacity to service people of the public and making it more viable for them to do so.

It is also important for me to note here that the 10-year moratorium will continue to be used, along with reforms that are to be implemented under the Rural Health Workforce Strategy, to recruit and retain GPs in rural and remote Australia. These measures make sure that the system is fairer and recognises service to districts of workforce shortage. And, as part of our $134 million rural package in the 2009 budget, the 10-year moratorium will also be scaled so that the more remote the places doctors go, the shorter the moratorium. This year’s federal budget also delivers more than $200 million to help tackle the shortage of doctors and health workers in regional and remote areas of Australia. For the people of my home electorate of Flynn, this is great news, as all of these actions will culminate in an increased quality of services to regional and rural communities and therefore result in an improvement to rural health. I am proud, as the member for Flynn, to say that we as the people’s government are working to improve the quality of health of the people of rural and regional communities.

The final amendment in the bill that I will talk about today pertains to section 19AC of the act. It proposes that a time limit of 90 days be allowed for an applicant to seek a review of a decision to refuse an application for a section 19AB exemption or a decision to impose one or more conditions on a section 19AB exemption. This is a vital amendment that allows applicants nearly triple the time allowed in the current act, enhancing their ability to pursue what they perceive to be a viable reason for the exemption.

The amendments in this bill will ensure that the original act fulfils its intended purpose and does not cause any further unnecessary detriment to overseas trained workers. Our health system is heavily supported by overseas trained doctors and without them, as I have previously said, it would collapse. As a government we have been granted the opportunity through this bill to streamline the processes for overseas trained doctors to provide professional medical services that attract Medicare benefits, which will increase the amount of medical services available to the public and therefore increase the quality of the health of all Australians. I am a firm supporter of the amendments and believe that the changes that they will make are imperative to ensure that our health system has a bright and healthy future. It is for these reasons that I commend the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009 to this House.


The DEPUTY SPEAKER (Hon. BC Scott)—The question is that this bill be now read a second time. I call the member for Herbert.