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Thursday, 26 November 2009
Page: 13170


Mr TURNOUR (2:49 PM) —I rise today to support the Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009 and support the member for Moreton and others on this side who have made a contribution to this debate. The Rudd government are committed to improving the health system in this country. We have shown that through our ongoing investments in GP superclinics, in cutting elective surgery waiting lists and in improving cancer services. This bill is another measure and another step along the road to improving the healthcare system in this country.

The member for Moreton and others have touched on the Health and Hospitals Reform Commission report, which is an important part of an overall look at the healthcare system. It was great to have the Prime Minister in my electorate in the middle of this year to undertake a commissioned consultation at the Cairns Base Hospital following the recommendations coming down. I know local GPs, hospital staff, nurses and allied health professionals enjoyed the opportunity to make direct contributions to that report. The report is important in terms of looking at the overall health system. We need to make sure that, going forward, we address issues such as the ageing population as well as the real challenges we face with preventable disease—such as diabetes, heart disease, obesity, or other diseases that we can prevent—becoming a real burden on society to a point where they gobble up the entire federal and state budgets.

We need to ensure that we put in place a sustainable healthcare system. That is why the Rudd government has put a focus on health; it is a priority. This bill is just one of the things that we are doing along the way to create a fairer and better system not only for New Zealand trained doctors but also for overseas trained doctors. It is part of our overall commitment to address and improve the health system in this country. This bill goes to the shortage of doctors in Australia and the need to ensure that overseas trained doctors, as I have said, are treated fairly and appropriately if we are to continue to attract them to Australia. It allows Australia to recognise the close relationship between New Zealand and Australia and the valuable contribution that New Zealand doctors make to Australia.

The purpose of the bill is to streamline the operation of section 19AB of the Health Insurance Act and remove a number of anomalies. Section 19AB of the act provides that overseas trained doctors and former overseas medical students are not able to provide professional services that attract Medicare benefits for a period of 10 years—the 10-year moratorium. The bill amends the class of persons subject to the restrictions in section 19AB of the act and amends the moratorium period. The bill removes current restrictions applicable to doctors who are New Zealand permanent residents and citizens and who obtained their primary medical education at an accredited medical school in Australia or New Zealand. The change effectively removes these doctors from the classification of ‘overseas trained doctor’ and ‘former overseas medical student’ in section 19AB of the act, which is fantastic for New Zealand trained doctors.

Another important provision goes to the issue of overseas trained doctors generally. It removes the requirement for overseas trained doctors and foreign graduates of an accredited medical school to have both Australian permanent residency or citizenship and medical registration in order for the 10-year moratorium to commence. What we are basically talking about here is that, under the current system, you need to be registered and an Australian citizen or a permanent resident before the 10-year moratorium commences. We want to change that so that registration in Australia becomes the starting point. Many overseas trained doctors have been forced to work well in excess of 10 years before their services have become eligible for Medicare benefits. If you take five years to get permanent residency or Australian citizenship, it is only fair that, after a 10-year contribution to the community as a citizen or a permanent resident, this be recognised.

It is fair and I think it is going to help Australia attract good quality overseas trained doctors because they are going to get recognised within what is a 10-year period. They will not have to wait until they get their residency or their citizenship before they start the 10-year moratorium period. When the legislation was introduced it was about ensuring that, when you became registered in Australia, you had practised for 10 years as an overseas trained doctor and you needed to become a permanent resident or an Australian citizen. After 10 years the intent was that your services would be eligible for benefits under the Medicare schedule. Under the current laws that is not possible.

It is a good day for the number of overseas trained doctors who would have been here for longer than 10 years and are now residents or citizens and will now be able to access Medicare benefits. I think that is good, particularly for many doctors in rural and regional Australia.

I represent the great electorate of Leichhardt, the region including Cairns, the Cape York Peninsula, the Torres Strait and, who can forget, in the wonderful former Douglas shire, Port Douglas and Palm Cove. They are wonderful tourist icons, there is an international airport and it is a great place to live. We do love good-quality people coming to live in the far north—in Cairns, Cape York and the Torres Strait—and we do need more doctors up there. Cairns has been an area of district workforce shortage in the past and it is an area that we are looking to attract doctors to, which means ensuring that they will be treated fairly.

Under this legislation, doctors from New Zealand will be able to get registered and recognised appropriately here, and overseas trained doctors from other parts of the world will, after the moratorium period, be recognised appropriately within that 10-year period. As I said in the beginning, this is part of one of our overall steps to improve the healthcare system. It is maybe only a little step in terms of the bigger picture but it is a very important step for those overseas trained doctors and for New Zealand doctors who may be living here now or thinking about coming here to work in places like Cairns or in other parts of the country. So it is part of our overall plan to improve the health system—unlike the former government, which ripped a billion dollars out of the public hospital system and had no workforce strategy to ensure that we did not get to the situation we have in many communities across the country, where there is a crisis in the availability of doctors and nurses.

Through the National Health and Hospitals Reform Commission and our workforce planning we have started the work of developing up health strategies and workforce planning strategies for this nation. This year we are spending more than $700 million, which we will invest in better targeted workforce initiatives in rural communities. That is a 45 per cent funding increase for rural programs compared to the $483 million provided by the previous government in its last full year, 2006-07.

The government is making the necessary reforms to rural health policy in order to ensure that incentives respond to current population trends and provide the most support to communities in greatest need, because we not only need good quality overseas trained doctors; we need to make sure that we have incentives in place so that doctors want to work in rural, remote and regional areas like the ones I represent—Cairns, Cape York and the Torres Strait. I know that my electorate is benefiting from these reforms.

There was a $134.4 million package in this year’s budget to respond directly to medical workforce shortages in rural and remote communities. Part of this package is the introduction of Australian standard geographic classification remoteness areas as a measure of eligibility for a number of workplace programs. It will replace the outdated rural, remote and metropolitan areas classification, the old RRMA system. The new package will encompass a number of initiatives that aim to better target workforce incentives to communities in the greatest need. These reforms are based on scaling or gearing of incentives in return of service obligations to provide greatest benefit to the most remote communities, where there is the greatest need, and transition of program eligibility in a new geographic remoteness classification system. It is estimated that the transition to the new system will see 2,400 doctors in rural communities being able to access incentives for the first time. Almost 500 communities around Australia will become eligible for rural incentive payments.

The rural incentive package announced by the Rudd government in the 2009 budget, as I said, will directly benefit my electorate of Leichhardt. A doctor relocating to Cairns and surrounding suburbs from a capital city will be eligible for a $30,000 relocation incentive for the first time, and around $18,000 per year after working in Cairns for five years. If doctors move from Brisbane or another capital city to Cooktown, north of Cairns, for example, they will be eligible for a $60,000 relocation payment and will be paid $13,500 after their first year working in Cooktown. This yearly retention rate grows to $27,000 every year after they have been in Cooktown for five years. These are great initiatives to attract doctors to regional centres and to rural and remote areas. But this legislation is not just about making it fairer for overseas trained doctors, New Zealand trained doctors; it is also about ensuring that we have in place a system that encourages Australian doctors to work in rural and regional areas, because many overseas trained doctors effectively end up working in rural and remote areas.

This is part of an overall package to improve the health system in this country. As I said, there are plenty of things happening in my electorate. We had 10 or 12 years of not a lot happening but we have seen quite a bit happen since the Rudd government was elected, across the spectrum of health. I want to touch on a few of those initiatives and those commitments that we have achieved in my electorate of Leichhardt. We know that dental care is a particularly important challenge that we face. We are talking today about the availability of overseas trained doctors, including New Zealand trained doctors. I have already spoken about some of the strategies we have put in place to attract doctors to rural and regional areas. We have also got a shortage of dentists in this country—another area where we need to do more in terms of the workforce shortages. I am very pleased that the Rudd government has committed almost $50 million to support James Cook University in developing a dental school. I see the member for Herbert here; they have got a great medical school in Townsville, and they are building a dental school in Cairns, the other hub of James Cook University. I know that the member for Herbert will welcome the ongoing growth of the university that we have in the north and the far north. It is certainly a wonderful university. I was out there earlier in the year and had an opportunity to meet with a number of students and to open some of the training facilities. I congratulate Professor Ian Wronski and his team for the work they are doing in bringing the dental school on.

We have also committed $8 million to the Cairns Base Hospital, and the state government has provided $450 million for the redevelopment of the hospital, which is a fantastic commitment from them. We are working in partnership with them to improve health services in the far north. The $8 million we have committed to the Cairns Base Hospital is for a new MRI machine and a Medicare licence to provide recurrent funding for the operation of the machine. In 2004 I ran for office and unfortunately was not elected, but I made a commitment that we would get an MRI machine at Cairns Base Hospital. Unfortunately, the Howard government was returned in 2004 and there was no MRI machine for the Cairns Base Hospital, but I ran again in 2007 and got elected, and it is wonderful news that we have continued that commitment to see an MRI machine in the Cairns Base Hospital. The Rudd government has delivered on it already.

It shows the difference between this side of the chamber and the other side. We can talk about providing more doctors in a city like Cairns and we can talk about providing better facilities. An MRI is a classic example. Many times people came to the Cairns Base Hospital for an MRI, but there was no access to an MRI machine so they were airlifted to Townsville. Now we have an MRI machine at Cairns Base Hospital, people will get the assessment, the treatment and the care they need at Cairns and they do not have to go on to Townsville for that. That is good news, and that is the sort of improvement in health care that we have managed to achieve under the Rudd government.

We also made an $8.3 million commitment towards a radiation oncology facility in Cairns Base Hospital. This is being built in partnership with the state government and is well progressed. It is going to be known as the Liz Plummer Memorial Centre. Liz was a great campaigner for oncology services in Cairns, and tragically we lost Liz this year. I know Max and her family would still be hurting, as the community is hurting, over the loss of Liz. She was a great Australian and a great member of the Cairns community.


Mr Sullivan —I can confirm that.


Mr TURNOUR —The member for Longman, who obviously knew her, can confirm that as well. She will be sadly missed. But her efforts will be remembered through the better oncology and cancer services in Cairns. COUCH are doing a wonderful job, and it is great to be able to work in partnership with the Queensland government to deliver the Liz Plummer Memorial Centre, which will be a great addition and improvement to Cairns cancer treatment facilities.

I am also looking forward to working with the hospital foundation under the leadership of Ken Chapman, and also Bob McGill and the COUCH team, on the work that they are doing with the Queensland government, putting in a submission to the new federal government cancer centres funding that was announced in the budget earlier this year. I have spoken with the minister, Nicola Roxon, about that and I look forward to continuing to work with the local community, the private sector and the base hospital to see what we can do to continue to improve cancer services in Cairns, building on the work that COUCH has done and the work that people like Liz Plummer have done and the contribution they have made to the community of Cairns. Improved services in Cairns benefit Cape York, the tablelands and the Torres Strait. They benefit a lot of people in rural and regional Queensland. I am looking forward to continuing to work with those groups and the Queensland government to develop better services and a submission for a cancer centre for Cairns as part of the package that was announced by the health minister following the budget.

So, as I said, we have made considerable contributions to cancer services through the MRI and radiation oncology commitment. We had $500,000 for expanded chemotherapy services at Cairns Base Hospital that were opened this year. We have also put additional funding into Indigenous health. There was $307,000 this year for the Apunipima Cape York Health Council to employ an additional community GP who will provide primary health care services in Mapoon and Napranum communities on a shared basis. We have also delivered $291,000 a year to assist the council to implement a family centre primary health care model in Mossman Gorge with the Queensland government in order to establish a similar model to the one operating in Mapoon. These are examples of what we are doing in Indigenous healthcare support.

Earlier this year we announced $5 million for Mookai Rosie to build a new 24-bed facility. That is about closing the gap and improving the quality of facilities available to Indigenous mothers from the Cape, the Torres Strait and the Gulf who have to come to Cairns to have their babies. Mookai Rosie does a wonderful job. It is a wonderful Indigenous organisation that was set up by Aunty Rose many years ago to provide support for mums who came down to the Cairns Base Hospital and did not have anywhere to stay. Rose took them home, and subsequently a group worked together to establish Mookai Rosie. I am very pleased and proud that the Rudd government is investing $5 million to build a new facility for this organisation, because they have done a wonderful job. This will effectively expand their facility from, I think, 12 beds to a facility that will have 24 beds.

We have a new breast cancer nurse for Cairns as part of the McGrath Foundation. It was great to be with Glenn and the health minister when we announced that. They are doing a good job. That is another example of the work that we are doing on improving cancer services and support in Cairns.

We are spending $10 million as part of our Economic Security Strategy to improve and redevelop the health precinct at the Tropical North Queensland Institute of TAFE. We have $12.8 million in the budget this year to improve health care in the Torres Strait, including $9.2 million over four years for the expansion of the Saibai Island clinic and the provision of staff housing to facilitate delivery of an HIV-AIDS and STI support and education program, plus $2.9 million over four years to continue support for a joint Australian government and Queensland government mosquito control program. There are significant health risks and issues across the border between the Torres Strait and Papua New Guinea.

These are just some of the health initiatives that we are implementing and working on as the Rudd government. The government take health care very seriously. We are very serious about making a difference to working Australians and the types of services that they receive. We came to power ripping up Work Choices, improving education through the education revolution and making very strong commitments around improving health services. Today’s bill is a technical bill that goes to the issues around overseas trained doctors and New Zealand trained doctors, but it is part of an overall commitment that we have to improve health services in this country. I am very proud to be part of a government that makes commitments and delivers on them. It is a government that is making a difference not only in Brisbane, Sydney and Melbourne but also in places like Cairns, Cape York and the Torres Strait. It is a good government, it is a strong government and I look forward to being part of it in the future.