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Thursday, 26 November 2009
Page: 13142


Mr HAYES (12:34 PM) —Through the amendments that are contained in the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009 it is proposed to streamline the Health Insurance Act 1973 by removing a number of anomalies. As previous speakers have alluded, there has been a chronic shortage of doctors in this country. One of the things that this bill is attempting to do is to address, amongst other things, some of those anomalies that may artificially restrict the health professionals, the doctors, from being able to work within our system.

The Health Insurance Act 1973, amongst other things, currently restricts doctors who are New Zealand permanent residents and citizens who have obtained their primary medical education at an accredited medical school outside Australia. It restricts them from providing professional assistance that attracts Medicare benefits for a period of 10 years. This is commonly referred to as the 10-year moratorium. So you can see from that, Madam Deputy Speaker, as the act currently applies it artificially restricts graduates of New Zealand based medical academic institutions or New Zealand permanent residents, if they seek to practise in Australia, from being able to bill for Medicare benefits over that period.

Overseas trained doctors and former overseas medical students may be granted an exemption from these restrictions if they work in a district with a workforce shortage, particularly if it is in a rural, remote or outer metropolitan area. Indeed, we have in the south-west of Sydney sought to have various overseas trained doctors apply under those exemptions in order for them to be able to practise in the south-west of Sydney.

The first amendment in the bill removes from the classification ‘overseas trained doctor’ any New Zealand permanent resident or citizen who obtained their primary medical education at an accredited Australian or New Zealand medical school. Previously a person was considered to be an overseas trained doctor if they obtained their primary medical degree from a medical institute outside this country. Given the amount of activity that has occurred in the last decade between Australia and New Zealand, it does seem to be significantly restrictive, particularly where we have cross-recognition regimes in place in just about all professional areas, and I think only recently even in accounting, that we provide an artificial restriction restricting doctors trained in a New Zealand medical institute.

The second amendment in the bill will rename the ‘former overseas medical student’ to a ‘foreign graduate of an accredited medical school’. That will more accurately reflect the meaning of the term. This will address issues arising from New Zealand citizens who are able to stay permanently in this country on a special category visa but who are not considered to be Australian permanent residents being restricted under the 10-year moratorium after they obtain their medical qualifications from an Australian medical school.

The third amendment will rectify an anomaly in section 19AB of the act, which currently says that the 10-year moratorium will start from when a medical practitioner achieves Australian permanent residency or citizenship. The amendment proposes that the 10-year moratorium commences from the time the medical practitioner is first registered as a medical practitioner in Australia and will cease after 10 years, provided that the medical practitioner has, by that stage, gained permanent residency status in this country. Should a medical practitioner not obtain Australian permanent residency or Australian citizenship by the conclusion of that 10-year period, from when they first gain their medical qualification, the restriction will then remain in force until such time as permanent residency or citizenship is obtained.

Finally, section 19AC of the act will be amended to insert a new time limit of 90 days during which an applicant can seek to a review of a decision to refuse their application for a section 19AB exemption or a decision to impose one or more conditions on a section 10AB exemption.

This is a bill which is seeking to streamline the application of those parts of the act but it will also remove some of the artificial barriers for overseas trained doctors, particularly for our colleagues from New Zealand. I will talk later about the number of overseas trained doctors that we have currently working in our system, which as everybody knows has been strained for some time. It is a system that this government is determined to do something about.

The bill will allow more doctors to provide medical services which attract Medicare benefits to patients throughout this country. I am happy to report that I have a facility in my electorate doing almost the same thing. The University of Western Sydney School of Medicine was opened by the Acting Prime Minister, Julia Gillard, in November 2008. The School of Medicine is an 8,000-square metre facility based at the Campbelltown campus of the University of Western Sydney. It boasts an impressive lecture theatre as well as an anatomy laboratory, a computer laboratory, a clinical skills area and eight research laboratories.

The University of Western Sydney School of Medicine is helping to solve the south-west of Sydney’s critical doctor shortage. This shortage is one which I spoke about many times during the term of the previous government and one which we said was, quite frankly, an embarrassment for the people of south-west Sydney to have to endure. The School of Medicine is an institute which is working very well to try to encourage local students—students who have lived and grown up in this area—to stay on, take their medical education in the area and, hopefully, stay as GPs and specialists in the south-west of Sydney.

Approximately two-thirds of the university’s medical students are very much proud local kids from greater western Sydney. It is a very big catchment area, but until the university’s program was established the opportunities for those young people was either to go to one of the sandstone universities of Sydney or to go to Newcastle. Young people can now decide to study medicine locally. We believe this will produce a greater number of local doctors. We are very proud of the fact that two-thirds of the current medical students registered at the university are local to greater western Sydney. It is expected that most of these students will choose to live and work as doctors in the area. This has been borne out by a series of research projects which gave rise to the decision of the former government to place a campus of the university in the south-west of Sydney.

Last year, UWS received 3,000 applications from students to study a medical degree. There are certainly plenty of young people in western Sydney willing to start and commit to a career in medicine. I think that is very important. As I said earlier, for the years and years that I have been in this place I have complained that the number of doctors available, particularly general practitioners, in the south-west of Sydney was a blight on our area.

Under the leadership of the School of Medicine’s new dean, Professor Alison Jones, these medical students will learn and obtain the clinical skills and knowledge necessary to be the medical leaders of the future. Professor Jones joined UWS in October this year. She is an internationally recognised leader and educator in clinical toxicology and a very active clinician in her own right. Professor Jones has been Professor of Medicine and Clinical Toxicology at the University of Newcastle, as well as the director of the National Poisons Information Service in London and Head of Medicine at London’s Guy’s and St Thomas’ hospitals. To say that the medical students at the University of Western Sydney are in good hands would be an understatement.

When the School of Medicine was opened in 2008, the foundation dean of medicine was Professor Neville Yeomans. He said at the opening that the school would provide:

… a state-of-the-art learning environment that seeks to stimulate, challenge and inspire a new kind of doctor—one who understands the importance of doctor-patient communication, primary health, and collaborating with nursing and other allied health professionals to provide a continuum of care for every patient.

The education our students receive in this facility, together with the training they receive in our local hospitals and community settings with specialist doctors, GPs and community health partners, gives them a special perspective on chronic health problems, particularly in Greater Western Sydney, which has high rates of cardiovascular disease, mental illness, obesity and diabetes …

Professor Yeomans went on to say:

Now, for the first time, hundreds of aspiring doctors and medical specialists from across Sydney’s west have the opportunity to stay, train and work in the region they have grown up in and understand so well.

UWS doctors and researchers will be at the frontline of health care, working to significantly improve the health and wellbeing of future generations of Australians.

The University of Western Sydney School of Medicine’s approach to clinical education is one that should be mirrored throughout this country. For the 4½ years for which I have been the member for Werriwa, I have had an association with the practitioners from this institution. I have seen firsthand how they work with various local community groups—not necessarily medically based groups but groups looking after single parents and children with disabilities. These doctors have the opportunity to work with the real people, if you like, outside the lecture rooms of a university, people who reflect the nature of the area in which we live in south-western Sydney. This is something which is quite foreign, as I understand it, to contemporary medical education—actually exposing doctors not simply to the academic aspects of their profession or what they are likely to be coming into contact with in the future but actually showing them the real dynamics of what occurs within a modern society, the one they grew up and choose to live in and which they will hopefully continue to serve as medical practitioners. It is not just textbook diagnosis. It is looking for doctors who actually understand, empathise and will work with their society as it develops and meets the challenges of the future.

I would like to take this opportunity to congratulate Professor Yeomans for all that he achieved at the School of Medicine before his retirement a few months ago. His hard work and dedication over the five years during which he acted as dean of the college have not gone unnoticed by either the university or the School of Medicine. His persistence, dedication and professional approach have certainly meant that his standing in my local community is extremely high. Although Professor Yeomans has retired, I know that he will be a continuing source of advice and encouragement long into the future.

Speaking for the future of the first hundred doctors, who are due to graduate from the School of Medicine in 2011, these young people are about to experience in a very unrestricted way practising medicine in a very different environment from what would have been the case had they selected a different medical school in which to do their undergraduate studies. Bear in mind that the south-west of Sydney is going through an extraordinary growth rate. It is predicted that over the next 20 years there will be an additional 450,000 people based in the south-west of Sydney. As these students graduate in 2011, undoubtedly, through the education they have received at the University of Western Sydney, they will certainly have a very bright but nevertheless very busy future ahead of them.

To help prepare them for that future, students undertaking a Bachelor of Medicine and Bachelor of Surgery at the School of Medicine receive an education which, quite frankly, in my opinion is second to none. They are working closely with the clinical staff at the Liverpool, Campbelltown and Camden hospitals, where they are getting very much a hands-on experience of what it means to be a doctor. From week 1, students are placed in a hospital based environment, learning skills that will equip them for the future. But one of the main things they learn—and this is what Professor Yeomans had always stressed ever since I first met him some 4½ years ago—is to do no harm. This is not experimenting on patients; this is understanding the patients. The approach that has been established at this School of Medicine is unique.

One of the people helping to guide these students is the state Labor member for Macquarie Fields, Dr Andrew McDonald. I happen to know Andrew very well. As a matter of fact, I was heavily involved in recruiting him to stand for the seat of Macquarie Fields not all that long ago. Both Andrew and his wife, Jenny, are paediatricians. Jenny is still a paediatrician practising at Campbelltown Hospital, and Dr Andrew McDonald, who now is a state member of parliament, still attends hospital one day a week. He works pro bono either at the Campbelltown Hospital for people in need or, alternatively, at Tharawal medical centre, servicing our local Aboriginal population, which is the second largest in the state. This is pro bono.

I suppose politicians cop a lot of brickbats in their time, and sometimes it is more deserved than others. But here is a man who has sought to advance the aims and interests of his area in entering state parliament, and I think he makes a very good contribution to the state parliament in doing that. But, in addition to that, one day a week he practises without charge, pro bono, for people in need. That is an outstanding contribution.

Apart from other things, Andrew is an associate professor at the University of Western Sydney, and therefore, I think, having him involved in the teaching of young people coming up in the medical profession is quite invaluable. He takes his commitment to advancing the needs of the area very seriously. Apart from being a paediatrician, he has become—and I hate to use the word ‘politician’—a parliamentarian and takes that role very seriously also. But, in addition to that, he still maintains an active medical role. It is not just a matter of keeping his hand in—that is not what he does, because he is a specialist in his own right. He goes out there with a view to working pro bono for people in need. That is the sort of person we do want to develop in a modern society, a person who actually cares. I am very proud to have Andrew as a friend, and he and his wife have made an extraordinary contribution to our society. (Time expired)