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Thursday, 26 November 2009
Page: 13146


Mr CHEESEMAN (12:54 PM) —I commend the member for Werriwa for his very wide-ranging contribution on this matter. He certainly has a very deep interest in the people of Western Sydney and is a very fine advocate for their needs.

Today I rise to speak on the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009. The relationship that has been maintained between Australia and New Zealand is a very special one. The two countries have had various arrangements in place since the 1920s and this has led to a free flow of people between Australia and New Zealand—and that, of course, includes me. We share common ideals and a bond that extends from the history of the Anzac legend to our cross-Tasman rivalry in all forms of sport. It is fair to say that barely a week goes by without a major story arising about a clash between the Silver Ferns and the Diamonds or the Wallabies and the All Blacks.

Since 1973 the trans-Tasman travel arrangement that has allowed Australian and New Zealand citizens to flow freely between one another’s countries has very much assisted both our economies. The number of New Zealanders in Australia has increased, particularly in times of economic strength, and when our economic conditions lessen or slow there is a free flow back. On 30 June 2009, an estimated half a million New Zealanders were residing in Australia. Currently, New Zealand residents are allowed to stay in Australia permanently under the conditions of a special category visa. Under the current terms of the Health Insurance Act 2009, New Zealand doctors who seek to practise in Australia are lumped with the same restrictions as those that apply to other international doctors. This, of course, does not reflect the nature of the special relationship between our two countries.

The Australian Citizenship Act 1948 provides New Zealand citizens living in Australia with many benefits. Under the provisions of the act, New Zealand citizens maintain permanent residency rights without the requirement to obtain a permanent residency visa. On the other hand, the Health Insurance Act 2009 requires the Department of Health and Ageing to refer to and use the Migration Act 1958 as the authority in determining residency status. The Migration Act 1958 considers New Zealand citizens to be temporary residents of Australia. The effect, under the current provision, is that New Zealand citizen doctors are considered to be overseas trained doctors if they were first recognised as a medical practitioner after 1 January 1997.

The framework of section 19AB of the Health Insurance Act 2009 does not currently accommodate the close nature of the relationship that Australia and New Zealand maintain. Under the current arrangements, many New Zealanders who elect to study at an Australian university are treated no differently from Australian students. Also, a New Zealand student can enrol in a medical course in Australia in much the same way as an Australian can. However, they are not considered to be an Australian permanent resident under the meaning of the act. This has the ongoing effect of bundling them under the same arrangements as doctors who have trained overseas.

Once these doctors enter the skilled workforce they are subject to the same constraints as international doctors. This means they are restricted from providing professional services which attract Medicare benefits for a period of 10 years from the date on which they become both a medical practitioner and an Australian permanent resident or citizen. A significant number of temporary resident doctors, including New Zealand trained doctors, work in districts 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.

The experience of temporary resident doctors is not in keeping with the original intent of the act, which was for a 10-year moratorium to commence from the time the medical practitioner is first registered as a medical practitioner in Australia. Whilst New Zealand and Australian citizens have benefited from changes to the Migration Act 1994, this has not been reflected in the Health Insurance Act, as it refers to the Australian Citizenship Act 1948 for its definitions. Due to the nature of these requirements, from the time a student commences their primary medical degree to the time they obtain citizenship or permanent residency they are restrained by an act that should no longer be there.

Due to this situation, a number of anomalies arise. There is no point in beating about the bush when we talk about the shortage of doctors in Australia. By aligning the anomalies that currently exist between departments, this government is delivering positive reform to health services in Australia. Whilst the previous government spent 11 years savaging the health system and trying to dismantle Medicare and privatise the health system, they failed to address the reality that we need more doctors practising medicine in Australia. This reform will have the effect of encouraging health professionals from New Zealand to go through the processes and help us bring quality services to our health sector. Currently our migration laws reflect our close relationship with our neighbours across the Tasman, yet our Health Insurance Act does not reflect that close arrangement.

I would briefly like to highlight some of the things the Rudd government has been working on within my electorate of Corangamite. I want to talk in particular about our GP superclinic, which was an election commitment that I secured in the lead-up to the 2007 federal election. That commitment was for a $7 million facility that we worked on with Deakin University and the local GP association. This GP superclinic will not only provide a huge amount of services to Geelong’s growth corridor of Belmont, Waurn Ponds, Highton and Grovedale; it will also play a very significant role in training Deakin University medical graduates coming out of the Waurn Ponds campus, which will of course help bolster the number of GPs in regional and rural Victoria. It will also play a significant role in bringing together many allied health professionals so that we have team based medical services being delivered, enabling our communities to access world’s best practice in the delivery of medication and medical services.

We have worked very closely in partnership with Barwon Health who have provided the land for the clinic to be built on. That highlights the strong and continuing work that we have been able to do with the state government in Victoria to ensure that our growth corridor in Geelong has adequate medical services. The first of the medical students coming out of Deakin University will be in 2011-12. I certainly look forward to having the super clinic up and running by then, enabling those medical students to be able to practise whilst they learn under the appropriate supervision of doctors.

In conclusion, I would like to commend the work of the minister. She is prepared to work very hard to reform our health care system. She is prepared to make the hard decisions, often against the interests of sectional minorities, and I commend her for the zeal that she takes to the debate in reforming the sector. I commend the bill to the House.