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Thursday, 26 November 2009
Page: 13150


Ms REA (1:15 PM) —I too rise in support of the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009. Whilst many in this House today may be primarily focused on or concerned with their political health, if there is one thing that is of major concern to all Australians, including those in remote and regional communities, it is their reliance on good quality, personal health care. This bill is yet another very practical, reasonable and appropriate step in the Rudd Labor government’s commitment to improving the quality of our healthcare system and to improving the provision of medical services to all Australians regardless of where they live or their current circumstances.

The bill is designed to remove a number of anomalies that currently exist in the Health Insurance Act. It focuses on amendments to address the restrictions that apply to overseas trained doctors and former overseas medical students. It specifically amends the Health Insurance Act to make changes to the so-called 10-year moratorium, which prevents an overseas trained doctor from attracting Medicare benefits until that moratorium has been served. The bill recognises the need to change in order to provide more general practitioner services throughout the suburbs and in communities across the whole nation. Overseas trained doctors and former medical students who were first recognised after 1 January 1997 have generally been restricted from providing professional services that attract Medicare benefits for a period of 10 years, and this is what has become known as the 10-year moratorium. Approval of this legislation will enable New Zealand doctors who have trained either in Australia or in New Zealand to be exempt, effectively, from the moratorium. It means that New Zealand medical students, once they are registered as doctors either here or in New Zealand, will be able to attract Medicare benefits as soon as they start practising.

There are a range of reasons why this legislation is good, but I think it is important to acknowledge that the amendment reflects the very close relationship that exists between our two countries. As the previous speaker has already said, the similarities between us and our cousins or friends across the Tasman are very clear. We might fight it out on the sporting field and, at times, we may well be bitter rivals in the field of sport. We might both fiercely protect our national and cultural differences—and, of course, this is a good thing because communities are shaped by their circumstances and their unique history and there is much between New Zealand and Australia that because of historical circumstances has highlighted the differences. We might make fun of each other’s accents quite regularly and we might often jibe each other with what are well-known nicknames—and of course the word ‘Kiwis’ comes to mind.

Ultimately it is the similarities that we share, not the differences, that have made us very long-term, historical friends and good neighbours and allies. It is our commitment to our democratic institutions, our commitment to the political system that we both work under, our commitment to providing good-quality education and professional services and the goals that we both want to seek for improving the welfare of our communities that we share. It is the commitment that both countries have to providing essential services to the citizens of both our nations, particularly a good-quality healthcare system, that means we often speak and act as one. Our differences may be the subject of good humour, but they do not outweigh the common bonds that we hold. For that reason alone I support this amendment, because I believe that it is important that we acknowledge our similarities and that we work with our New Zealand neighbours to share the skills, the resources and the intellectual capacity of the citizens of both countries to provide good-quality health care.

Another important amendment also acknowledges the professional services from some overseas trained doctors who are currently providing medical services here as temporary residents by including those years of service within the calculation of the 10 years of their moratorium and therefore reducing, in effect, the amount of time that these doctors serve as medical practitioners before they attract Medicare benefits. The 10-year moratorium is currently calculated from the time an overseas doctor receives permanent residency or citizenship here in Australia, but some overseas doctors are currently working and providing very important medical services in the areas that we call ‘districts of workforce shortage’. They are providing a very important service that sometimes would not be provided if we were simply relying upon either an Australian trained doctor or an overseas trained doctor who had served their 10 years and had their moratorium lifted.

This bill enables the 10 years of moratorium to be calculated from the time of registration if overseas doctors have been working in these areas, albeit with a temporary residency visa. This is important, because it means that some very well trained, good-quality overseas doctors—particularly those filling very important vacancies in some of our more remote and regional communities—could have to wait for up to 15 years before the moratorium ends and they are able to attract Medicare benefits. This bill is a very important step in reducing that time frame and enabling these doctors to attract those benefits—which, of course, flow on directly to the cost of health care to their patients. In acknowledgement of the difficulties that often occur in very remote communities, the scale of reduction in time can be affected by the remoteness of the community that the doctor is working in. In more remote communities, it may well be that the time frame required for the moratorium to end is shortened.

Both of these amendments are very important, and not just because they provide very important health services in areas of remote Australia where vacancies may not otherwise be filled. Even an electorate like my own—the electorate of Bonner, which covers the south-eastern suburbs of Brisbane—whilst contained within a metropolitan city, has very real shortages of trained doctors working as GPs. There are shortages in suburbs right across our country, from the largest inner-city suburbs to the very remote areas of the country. What this means is that we as a community will have access to more doctors who will be able to provide that very important localised personal health care that we all depend on. In particular, those New Zealand doctors who, as I said, have trained here or in New Zealand will be able to step in and provide very important services in all of our local communities. It addresses the chronic shortage of GPs, and it should be commended.

It is very much a part of the approach to improving both preventative healthcare services and primary healthcare services in all of our communities. We hear much and we read much about the pressure on our public hospital system. We hear and read much about the crisis in the public health system. We all know that perhaps one of the most significant ways in which we can reduce pressure on our public hospital system is to reduce pressure on casualty departments, to reduce the number of people who are presenting at a public hospital either because they cannot afford to go to a local GP or because they simply cannot find a local GP who is open. We all know that illnesses, particularly in children, do not confine themselves to nine to five business hours. My own experience is that, invariably, they will happen at any time of the day other than during business hours. It is then that you are desperately looking for a doctor to assist you. Putting more doctors into our communities to provide primary health care will definitely contribute to easing the pressure on the casualty departments of our public health system, which in turn will take pressure off elective waiting lists. There is a range of ways in which putting more doctors in the field will assist across the whole spectrum of public and private healthcare services.

It is also important to acknowledge that this bill works very much in partnership with the significant number of dollars which the Commonwealth government are currently putting into improving our healthcare system, including the $1.6 billion that is the COAG partnership working towards providing better health services. More importantly, there are significant dollars working in partnership with our state governments. We are ending the blame game. We are stopping the rivalry and we are stopping the buck passing; we are actually putting money towards a partnership which, if we work together, will give us greater value for our health dollars than if we were simply rivalling with each other or blaming each other. The $1.6 billion will go towards the training of 13,800 medical students, 38,500 nursing students and 18,000 allied health students. On top of that there are another $28 million to help train 18,000 nurse supervisors, 5,000 allied health and VET supervisors and 7,000 medical supervisors. This year’s budget also delivers more than $200 million to help tackle the shortage of doctors and health workers in rural and remote Australia.

As I said in the beginning, while we are dealing with very important matters of national interest here today, particularly in the Senate—and we hope that the health of our planet will prevail as a result of their debates—it is also important that we do not take our eyes off the ball in relation to the other very important responsibilities which we as a government and as a parliament have towards the Australian community. Indeed, there can be no greater importance than supporting our healthcare system and protecting the personal health and welfare of all our citizens, regardless of where they live and regardless of their economic circumstances. The only way we can do that is to look at ways and means to get better quality health care with more health professionals, particularly more doctors, out in our suburbs and in our local communities, those who can work with individual patients to prevent many of the preventable diseases which currently cause people to rely much more than should be the case upon our public hospital system. This is about a healthier society and a healthier community. I commend the bill to the House.