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Thursday, 26 November 2009
Page: 13165


Ms OWENS (2:25 PM) —It is good to see so many members on the government side of the House taking the opportunity to speak on the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009, which recognises two areas that are very important to us all. The first is, of course, ensuring that we have a medical workforce that is able to meet the needs of all our communities. The second is acknowledging the very strong and extraordinary relationship that exists between Australia and New Zealand. We do bag the Kiwis at just about every opportunity, and I am desperately trying not to do so in this speech, so if it slips in, Madam Deputy Speaker, perhaps you can call me to order.

Our two countries are well and truly tied together by our proximity, our way of life, our business relationships and our family ties. In fact, as I stand on my feet now, my older sister, who has been living in New Zealand with her family for 30 years, is flying to Brisbane to get together for Christmas. I do hope we get out of here in time for me to see her. I think we might; I hope we do.

We do have a special status between our peoples and between our businesses, and we also have a special status that is recognised in law. Under the 1973 trans-Tasman travel arrangements, citizens of Australia and New Zealand can move freely between the two countries. We can live, visit and work in each other’s country without the need for a specific authority. But, under the changes to the Migration Act in September 1994, Australia required all noncitizens lawfully in Australia to hold a visa. This led to the introduction of a special visa to accommodate that Australia-New Zealand relationship. A new visa called an Australian special category visa was created. This means that, when a New Zealand citizen presents their passport to immigration at the airport, they are considered to have applied for a visa and, subject to health or character considerations, automatically receives that special category visa, which is then recorded.

While in Australia, New Zealand citizens can live here and work here as if they are permanent residents or citizens, even though they are not. People from both countries travel to the other country to study. As long as a New Zealand citizen or permanent resident who is staying in Australia is studying accountancy or engineering, that is fine. But, when they choose to study medicine, the Migration Act bumps up against the Health Insurance Act 1973 and creates consequences for graduates of New Zealand citizenship which are at odds with the special relationship between our two countries. New Zealand medical students studying in Australia have, in effect, permanent resident status without the need to attain permanent residency, but under the Health Insurance Act they are treated very much as if they are temporary residents because they are captured under the definition of ‘former overseas medical students’ in section 19AB of the act. That definition includes a person whose primary medical qualification was attained from a medical school located in Australia but who was not a permanent resident or an Australian citizen when he or she first enrolled at a medical school in Australia.

This amendment proposes to remove New Zealand citizens and permanent residents from the category of former overseas medical students, and there is a very good reason to do that—it is more than just a technical matter. Currently, former overseas medical students are subject to what is known as the 10-year moratorium. Doctors who are former overseas students who were trained in Australia are ineligible to claim Medicare benefits for 10 years unless they meet some specific criteria, usually involving practising in rural areas where there are shortages of health specialists.

It was known by the mid-nineties that Australia was not producing sufficient medical practitioners to meet the health needs of its population. In 1997 the 10-year moratorium was introduced. Overseas trained doctors and former overseas medical students can be granted an exemption from that restriction under section 19AB if they work in a district of workforce shortage. Section 19AB is one of the key mechanisms which the government uses to influence where doctors work and ensure that we have an appropriate workforce in rural and remote areas of Australia. The 10-year moratorium has proved to be a particularly effective mechanism. It is well known that some 41 per cent of doctors in those shortage areas have trained overseas.

We continue to be largely reliant upon overseas doctors in rural and remote areas, and in that respect we are not that much different from many other OECD countries: Canada, the UK and the United States, all of which have relatively large percentages of foreign trained doctors working in areas of shortages. These changes, of course, will exempt New Zealand doctors who trained in Australia or in accredited universities in New Zealand from that moratorium. It will allow them to work freely in Australia on the same basis as Australian doctors, in keeping with the special relationship we have between the peoples of our two countries.

I am particularly proud of the medical training that takes place in my electorate of Parramatta. The University of Western Sydney is the key trainer of nurses in the state of New South Wales. It has an exceptionally good-quality nursing training facility at both the undergraduate and the postgraduate level. We also have a recently opened medical school in Western Sydney which fulfils an extremely important role in training people for our region and beyond. It is good to know that some two-thirds of the people studying in that facility come from the local area of Western Sydney, because unless we have those training facilities in our own region it is very difficult to attract the number of medical practitioners that we need.

We are also making some changes to the 10-year moratorium process. In this year’s budget there was some $134 million for a rural package to encourage more doctors into rural areas. We have also adjusted the 10-year moratorium so that it is scaled so that the more remote you are the shorter the moratorium. From 1 July next year, some 3,600 overseas trained doctors who have restrictions on where they can practise will be able to discharge their obligations sooner, depending on where they choose to work—again, an important adjustment that ensures we have appropriate medical services in all of our communities.

We have also introduced an extensive workforce reform program that will deliver the biggest ever investment in workforce through a COAG partnership that delivers training for the huge increase in Australian trained graduates, which will increase from 12,700 positions this year to some 14,700 in 2013. That is being delivered through a $1.6 billion COAG partnership. As part of that, there will be support for undergraduate clinical training for 13,800 medical students, many of whom will be in the region of Western Sydney, and some 38,500 nursing students and allied health students in 2010. We are also providing a significant boost to help train some 18,000 nurse supervisors through a $28 million allocation of funds and an additional 7,000 medical supervisors. These are important additions to the support for medical services training, and I was very proud to see them put forward in this year’s budget.

This is an important bill, Madam Deputy Speaker, as you can see by the number of people who have spoken on it, particularly on this side of the House. It will deliver some significant benefits to the relatively small number of New Zealanders who study in Australia or choose to practise in Australia having studied in Australia. It is a relatively small number but they are an incredibly important group for this country, given our special relationship. I commend the bill to House.