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Community Affairs References Committee
11/05/2012
Health services and medical professionals in rural areas

ANDREATTA, Mr Lou, Assistant Secretary, Department of Health and Ageing

BOOTH, Mr Mark, First Assistant Secretary, Department of Health and Ageing

CUTTING, Mr Paul, Acting Director, Department of Health and Ageing

FLANAGAN, Ms Kerry, Deputy Secretary, Department of Health and Ageing

SHAKESPEARE, Ms Penny, Acting First Assistant Secretary, Department of Health and Ageing

CHAIR: Welcome. I know you know information on parliamentary privilege and the protection of witnesses and evidence, but I have to check that you know. I remind witnesses that the Senate has resolved that an officer of a department of the Commonwealth or of a state shall not be asked to give opinions on matters of policy and shall be given reasonable opportunity to refer questions asked of the officer to superior officers or to a minister. This resolution prohibits only questions asking for opinions on matters of policy and does not preclude questions asking for explanations of policies or factual questions about when and how policies were adopted. We have your submission. It is No. 74. Do you wish to make an opening statement?

Ms Flanagan : No, we do not wish to make an opening statement, since we have got, I think, a very comprehensive submission from the department.

CHAIR: I am going to go straight to Senator Nash, because she has to leave us.

Senator NASH: Thanks. In the evidence that has been presented before us are a range of things that are coming up under the terms of reference, but one of the things that is particularly causing some angst—and I am sure you will not be surprised about this—is the use of the ASGC-RA map to determine the arrangements when it comes to the incentive payments for the doctors. The ABS say in their submission that it is a purely geographic measure of remoteness which excludes any consideration of socioeconomic status, rurality and population size factors. It has been put to us that those things—socioeconomic status, rurality and population size factors—are the very things that should be taken into account when determining the provision of incentive payments. Can you perhaps give us a bit of background to start with on why the ASGC-RA map is being used for the incentive payments?

Ms Shakespeare : There might be a technical point that we need to clarify about the population size before we get into the reasons we have used RA.

Mr Cutting : While it is true to say that the ASGC-RA does not look at population very locally, it is still based on distances to population centres.

Senator NASH: But they are two very different things, aren't they?

Mr Cutting : They are very different things. From that position to say that it completely ignores population is probably—

Senator NASH: I should say: ignores geography from population size.

Ms Shakespeare : Previously health workforce programs were related to a system called RRMA, which was quite out of date because it had been developed in 1994, I think, and had not been updated with more recent population data. So there were issues with the use of that system which the government decided to address. It had a review in 2008, looking at new systems that could be used—other geographical systems to base workforce and GP incentive payments on. Following that process, it decided to use the RA system because it was kept up to date. It was developed by the ABS, and they update it with census data. That decision was made in 2009-10, and the workforce programs based on RA started operation on 1 July 2010.

Senator NASH: Is the department aware of the concerns in the sector about the size of populations and the ability to deliver a service for towns —I am talking particular ly about the i nner regional areas—that is illogical and inappropriate when it comes to the incentive payment? Put quite simply, if you take a region in New South Wales and you look at the town of Wagga, which has 63,000 people and is a very distinct , good service - provision area, and a town like Gundagai, which is about 2 , 000 people and has not much in the main street, you will find that if a doctor moves to either of those two places they are given exactly the same incentive payment. Is that something you are aware of? Has that been raised with you?

Ms Shakespeare: Yes. It has been raised over the period of time that the system has been operating, since 1 July 2010, and there has been a review. The government asked the University of Adelaide—

Senator NASH: What has been the response to the concern that it is illogical, because the incentive is not there because of those two very different types of locations getting the same incentive payment to doctors?

Ms Shakespeare : There are a number of factors that doctors will take into account when deciding where to practice.

Senator NASH: I did not ask you about that. I asked you what was your response when the unfairness and illogical nature of the incentive payments for doctors in those two very different types of towns was raised with you?

Ms Shakespeare : One of the responses was to commission the University of Adelaide GISCA, which is an expert on the social application of geographic systems, to undertake a review of some of the issues that were being thrown up by the use of RA. That included places like Charters Towers and Cherbourg. They looked at a variety of locations that were either on the border of RA classifications or, because of their distance to populations of particular sizes, might be surrounded by areas that were considered of greater RA classification.

The government commissioned that report and that was provided in 2011. So it is not that there has not been any response. The government needs to consider the recommendations of that report. The other thing that the government needs to consider is that this system has not been in operation for very long and workforce programs—

Senator NASH: But it is not going to change. The criteria is not going to change.

Ms Shakespeare : have an impact over a long period of time. If we are chopping and changing very quickly it does not allow you to see the impact of the programs.

Senator NASH: Seriously?

CHAIR: Hang on—

Senator NASH: Sorry.

Ms Shakespeare : As you will see at page 11 of our submission, the early data on the use of RA as a basis for health workforce program incentives has been quite positive. So we need to ensure that if are making—

Senator NASH: Can I just clarify that you are talking about getting doctors to move to the regions.

Ms Shakespeare : Yes.

Senator NASH: But that is not the issue. It may well have been positive and it may well have got doctors out to the regions. The point is, where are they going to?

I have to go. I am very sorry, because I would much rather say. Does the department think that there is not a problem with the way that it is at the moment?

Ms Shakespeare : No, I do not think that the department thinks that there is no problem. It is just that we need to make sure, if we are going to make changes to the geographical classification system underpinning our programs, that we have fully thought through what the implications of those changes are. If we change boundaries and include particular places in higher classifications does that then have a flow-on effect to more remote towns than the ones that have been raised in the evidence today?

Senator NASH: But it would seem illogical, would it not, that you are asking a doctor to move from Sydney and the options for that doctor are Wagga Wagga, with a population of 63,000, specialist services, a hospital and a plethora of medical services, and Gundagai with—as I think a doctor said this morning—a Chinese restaurant, an RSL and a war memorial and not much else, and a complete under-servicing of doctors, yet the incentive payment is exactly the same? Isn't that entirely illogical?

Ms Shakespeare : I think that—

Senator NASH: I will view your response on record but I have to go.

CHAIR: I am very interested in it. I want to follow up several of the questions that Senator Nash asked.

Ms Flanagan : One of the things we would say is that it needs to be looked at in the totality of different incentives that are provided to try and get more doctors into rural Australia. That is the objective. I think we document in our submission a range of different programs that we have. This particular element is certainly one part of that. There are programs around locums and there are both push programs and pull programs to try to get doctors into rural areas.

So I think we have to look at the totality. In fact, coming out of the budget announced on Tuesday it has been agreed that we will look at all of our programs. The Commonwealth, from the Department of Health and Ageing, spends upwards of one billion dollars a year on workforce programs. Many of those are targeted exactly at trying to get better distribution of the workforce across Australia. We are going to do an internal review during 2012-13 to see what that looks like.

At the moment, this committee is focusing in particular on distribution issues, but there is a recent report that has come out from Health Workforce Australia which suggests that, for example, we are going to have a shortage of nurses out to 2025. So we are taking the opportunity to have a look at our programs to see, if we need to do further distribution, whether we can make them more relevant to do that but also whether we have got the balance right in trying to attract the workforce where we need it in a numbers sense as well as in a geographical sense.

Senator MOORE: Has the University of Adelaide review been made public?

Ms Shakespeare : Yes.

Senator MOORE: Is there any ongoing working group engaged with the range of professions and consumers who have raised this issue with us? Has there been some kind of working group developed to keep an ongoing look at the work that is going on about this classification area?

Ms Shakespeare : As far as I am aware, there is no working group, but this would be one of the issues that we consult with stakeholders about during the review of workforce programs that the government has decided to undertake.

Senator MOORE: So, between 2011 and now, there has been no particular engagement with consumer groups, universities, the AMA, physicians—all those people—around this review, but it is going to be part of the wider work that is going to start soon?

Ms Flanagan : Mr Andreatta might like to say something, but—I have lost my train of thought, so he had better say something!

Mr Andreatta : We have had ongoing discussions with the ABS, GISCA, the RDAA and the AMA since the introduction of the RA classification. We have kept them up to date on any new developments on the monitoring that we have been conducting. They have provided us with locations where their members have said that there were problems. We investigated those, and that was part of the GISCA review as well. We have regular meetings to talk about the RA and how it is progressing. We talk to the ABS regularly about the introduction of the new versions of the data that underpins the classification.

Senator MOORE: By the end of this year, we believe.

Mr Andreatta : Yes. Mr Cutting is probably better placed to explain exactly how that discussion with the ABS goes in terms of trying to improve what we have got.

Mr Cutting : There have been discussions ranging back to GISCA, discussing the way they actually look at it and where the breakpoints are. While the ASGC-RA still stays fundamentally a distance classification, it is pictured that the new ASGS will be calculating this at a much smaller level—CCD, I think.

Senator MOORE: But no lower than CCD? We spoke 'statistics speak' this morning and we are right across it! No, we aren't!

CHAIR: You had him going then!

Mr Andreatta : Street level, I think he said.

Mr Cutting : Especially street level. We are calling them 'mesh blocks'. I think that terminology has been lost, but you are looking at sort of 100 people in an ideal sort of central city area, but I will have to go back and take a look at that classification to pin it down.

Senator MOORE: I had known that the review was public; I just wanted to get it on record, because it is not in the submission. In terms of the process, it still seems that there is great discontent, and the people who have bothered to give submissions and come to give evidence to this committee still rate it as one of the key issues in terms of their discontent with how the system is operating. In fact, the AMA's evidence says it has actually taken it back to being worse than the RRMA experience.

CHAIR: A number of people have said that.

Senator MOORE: We remember great discussions at most estimates about RRMA classifications and where people fit. The statements that people have made are that it is worse than RRMA. Just in terms of where we go forward, it is important to know that there is a disconnect between what is being portrayed as something that is working well and what people are saying to us. There is a disconnect there, so that is important to know. The other thing is the evidence that the incentive schemes are working. Is it based on statistics of how many practitioners have actually moved to the areas? Is that the only outcome? Ms Shakespeare, I think you said that there was evidence that the incentive process was working. So is the only outcome the number of people who have moved?

Ms Shakespeare : What those numbers are based on, which is set out in our submission, are Medicare billing statistics. So there have been increases since the package of programs started on 1 July 2010. It is very difficult for us to isolate the impact of one particular aspect of that compared with the other programs that we have for the workforce, but it shows that overall in the RA2 to 5 areas there has been an increase of over four per cent in full-time work equivalent GPs based on Medicare billings. That is sustained across each of the RA areas; it is not just in RA2 or 3, where there are large centres like Townsville.

Senator MOORE: And small centres like Gundagai.

CHAIR: Can I go back one step to the process of review for the Adelaide report. You said that the government is yet to respond to it. That is what I understood you to say. Is that correct?

Ms Shakespeare : There is a response. The government is considering the findings of the report.

CHAIR: Yes, sorry. Is that now going to be wrapped up as part of the internal review process that you were talking about, Ms Flanagan?

Ms Flanagan : We are going to look at all aspects, including this particular program. We are also contacted very regularly with concerns about this program. It is a relatively new program. Again, as I think Ms Shakespeare said, when you think about a GP making a decision to move to a rural area, they do not necessarily just up sticks from metropolitan Sydney or wherever and decide to move. So one of the things that we are concerned to do is to give it a little more time to see whether it is actually producing the results that we expect. Early indications are that we are seeing an overall increase in the services provided in rural Australia, but it is very early on in the program to really get a good understanding of whether it is going to achieve results.

Senator MOORE: The distribution is fine. I have this information in front of me and it is positive, though they are most positive in the RA5 area. I think the RA2 area is where we have had the most pressure. Is there any internal assessment of these differences? If this is rating all RA2 areas across the country, is there anything that can give us information about how many people have moved to Toowoomba, as opposed to how many people have moved to Roma?

Mr Andreatta : As part of the review we have looked at individual towns, and they are the ones that were identified by the Rural Doctors Association.

Senator MOORE: But you only had 23 and that is a really small sample.

Mr Andreatta : We looked at those. We looked at why doctors were moving and there were reasons not related to financial incentives. There were other reasons. Some were retiring and some were moving to other towns because of spouse employment issues. So I guess there are a range of reasons why the distribution—

Senator MOORE: So perhaps they would have moved anyway and it had nothing to do with the programs.

Mr Andreatta : It could well be.

Ms Flanagan : Possibly. It is really hard to tell.

Mr Andreatta : We just do not know.

CHAIR: The point is—I will use the examples we have been using today—Gundagai and Wagga Wagga have the same rating of RA2, so the doctors would get paid the same. What people have been saying to us is: 'Why would I go to Gundagai if I could go to Wagga, where I can go to the pictures?' or whatever—all the things you were talking about that relate to quality of life. This is not going to show up, is it?

Mr Andreatta : No.

CHAIR: That is the point they are making: 'My family is going to want to go to Wagga because there is better schooling in Wagga and I get a better quality of life there because I get more access to services.' So what process do you have to highlight where people are going within the classification? It is the same question Senator Moore asked; I suppose I am just reinforcing it.

Ms Flanagan : You would almost need to do that by survey work, to ask why they made the decision they made. In some of the survey work we have done—we have not specifically asked about whether someone would move to Wagga or to Gundagai—a lot of the decision is based around non-financial incentives.

CHAIR: Sorry to interrupt, but the point they are making is that if you gave a bit more incentive, if you further defined RA2, for example, or you used some other factors as well, the extra financial incentive could be enough for them to say, 'Okay, it's worth me being here because I'm getting a bit more recompense for the extra work that I do'. And it is extra work. Their argument is that it is extra work. That extra incentive then makes it worthwhile for them to move, forsaking those other benefits in another town. That is their argument.

Senator MOORE: When a practitioner at Batemans Bay has been advertising for seven months for a doctor and he cannot get any response—I say 'he' because it is all on record—one of the issues that dwells on his mind is that any practitioner in Hobart can be advertising at the same time. There are a whole lot of reasons why you go to a different place, but he is saying that if he is in Batemans Bay he is in the same competitive model as Townsville and Cairns, and Hobart on the other extreme, and that makes it particularly hard to say to someone, 'There will be support for you to come and move to our area.' I know you have given evidence that you are aware of it and that it is a process, but it is a running issue with the areas and has been mentioned everywhere but the Northern Territory. They are remote and classified as RA5, and that is where you have had the biggest growth.

CHAIR: We have only got a bit over 15 minutes. I have a plane to catch—I am very keen to go home. Is the process of your internal review going to look at this within classifications? I have not heard people say you have not been getting doctors into the bush, but the question is where they are going within the classifications. Through your internal review, are you looking at a process for identifying that? I understand what you are saying that it would presumably have to be qualitative rather than quantitative.

Ms Flanagan : We have the draft terms of reference framed at the moment. This is something we can look at, but I have to say that all the evidence I have seen is that financial incentives would have to be much increased to actually tip somebody in terms of their behaviour. There are lots of other things. For example, it might be very attractive to live in Gundagai because housing is cheaper than in Wagga—I do not know whether that is true or not. Senator, you look sceptical.

Senator MOORE: I am just thinking that there are not that many houses.

Ms Flanagan : I used to drive through Gundagai quite a lot, to Batlow, in fact.

Senator MOORE: Even the most concerned submissions accept that the incentive payments are but one of the elements that make people change their lifestyle. There are a whole lot of other things they are suggesting that we can do to make it more attractive to practitioners and their families to move, but because this has been the most recent change it is the area of comparison.

Ms Flanagan : Certainly the review will be trying to look at the whole suite of products that we have to try to incentivise behaviour, and this will be one of them.

CHAIR: The National Rural Health Alliance have given us a 20-point plan, which we will give you. It was one that they tabled; it was not part of their original submission. It is saying exactly what you said—it has a wider scope and is not just saying we should change the classification. Not one person has said, 'Fixing what we see as a problem is the answer'; they are all taking an integrated approach.

Senator MOORE: We have had a number of comments about the use of overseas doctors and a number of claims that it is short term and the end result is not going to be better medical practice in their region. There are also some concerns about the degree of competence—people being very careful not to be in any way derogatory but genuine concerns about the levels of skill for people who have that as their only way into the system as opposed to an option. I think that would be a fair way of putting it.

There is also great concern expressed by people on the 10-year moratorium process. Can you give us some indication of when the 10-year moratorium came in, how it works and just some indication about policy in that direction?

Ms Shakespeare : I think we might have to get back to you on when it started.

Senator MOORE: It is not particularly mentioned in your submission. If you would like to send up some more information, because it has been particularly identified by some groups as a negative.

Ms Shakespeare : I think it has been going on for a while.

Ms Flanagan : Yes, I think it is 1990s.

Ms Shakespeare : We will take that on notice and get back to you.

CHAIR: I did specifically want to go to the training aspect and Aboriginal health workers. When we were in the NT I must say I was very pleasantly surprised with the report from Congress and the excellent work they have done. They were very proud of the fact that they had a really good retention rate and did not have any vacancies other than audiologists—they were a little embarrassed about not having audiologists.

Senator MOORE: They were pretty embarrassed to have to even admit to us that, because they have always been so perfect before.

CHAIR: There are still ongoing health issues—no-one is pretending that it is all fixed—but one of the key things that came up everywhere, even when we were doing the Stronger Futures inquiry it came up, was Aboriginal health workers and not getting enough people into the system, struggling to keep up with the requirement for updating their qualifications, an ageing workforce. So I am very interested in looking at how you are dealing with that. It is not the first time we have heard it, by the way.

Ms Shakespeare : There is a few things to mention there. Firstly, from 1 July this year there will be a new category of health professional through the National Registration and Accreditation Scheme, which is the Aboriginal and Torres Strait Island health practitioners.

CHAIR: And this is playing into the concern.

Ms Shakespeare : That, as you are probably aware, will require certificate IV, which is training provided by a body accredited by the new ATSIHP board. That, I think, has been received quite positively as it is going to provide a career pathway potentially for people who are Aboriginal health workers who are looking to provide more clinical services. There are programs in place, certainly, to help people with training to get to certificate IV. Health Workforce Australia has quite a significant program to up-skill Aboriginal health workers so that they can become qualified under the new practitioner NRAS regime. We also have the Puggy Hunter Memorial Scholarship Scheme, which provides support to Aboriginal and Torres Strait Islander people who want to do training in any clinical field, and that would include certificate IV for Aboriginal health workers clinical training. I imagine that there would be a range of programs also running through FaHCSIA and DEWR to assist people with readiness for training. So think that there is probably a lot of Commonwealth programs in place there, but there may be a piece of work to do to get people into the training.

CHAIR: That is the point. I do not doubt anything that you have just said. Given the level of concern that was expressed to us—and I have got to say that it has been previously—it seems to be there is something missing there in terms of people accessing. One of the things that an older Aboriginal health worker said to me was, 'I'm flat out in my community, I am flat out looking after my family: I actually can't get out of community to go and actually do training.' The concern was who would look after the family. There were financial issues as well. There are whole range of reasons why people are not accessing it. What was put to us—and I do not think I am expressing this to strongly—is that there is going to be a real problem if something is not done real soon.

Senator MOORE: Yes.

Ms Flanagan : Can I just mention two other things there? Within the suite of products that we have, our locum arrangements for, say, nurses who want to leave their rural community to do some extra training; we enable that to happen. I do not know whether we have many applications from Indigenous people to do that. Again, this can be part of the review. The second thing is that when health ministers are discussing this—the Northern Territory, WA and Queensland are talking about having a more integrated, regional Top End training workforce support infrastructure, which I think might go to some of the issues that you have heard about. We can get you some more information on this.

CHAIR: Any additional information you could provide would be appreciated. It is an area that needs some urgent attention. Each time now I seem to be going to a community where concern seems to have escalated.

Senator MOORE: Over a number of inquiries.

CHAIR: Yes. Did you have Medicare Locals?

Senator MOORE: Yes. There have been a number of comments about Medicare Locals. Most people are at the stage of saying: 'They're new. We'll see how they settle.' There have been a couple of specific issues. One is that there is no mention of specialists in Medicare Locals and we were told that in the development and role of Medicare Locals there was a view that specialists were not involved. Another thing was ongoing discussion about the after-hours process, particularly from medical witnesses. There was concern about the control of after-hours funding and the role of Medicare Locals as a funds holder and body that allocates funding. That was raised.

Also, from one area, the definition of 'after hours' was raised. We were told that in this particular region after hours was defined as between five and eight in the evening. That does not seem to me to be after hours; that is an extended service, but it certainly is not providing care in a significant region.

The make-up of Medicare Locals was raised. Every professional group feels as though they should have a role in Medicare Locals and that, if they are not in it, it is not going to be able to operate. We have had the Ranger review suggest that it should be totally GPs because only GPs know about what happens. Everyone—allied health and community people—has been putting forward their own view that if it is going to be truly representative of the community, and able to respond effectively to its needs, they have to be represented. They were the key issues that came up.

Mr Booth : There are a few points to that. I will try to—

Senator MOORE: Mr Booth, start with this and then possibly put a little bit together on notice. That would be good. Please give us some time, but because of time shortages there could be some more things you want to send us.

Mr Booth : I am happy to do that. Just briefly, then, on the make-up of Medicare Locals: Medicare Locals, as you know, have been established to provide a population health perspective of a particular region and a particular geographic area. The Medicare Locals have been tasked to do a number of things, one of which is to look at the health needs and requirements of the population within their area and, also, to look at the professional services that are available. That includes general practice, allied health, community health, specialists working in the community—

Senator MOORE: So specialists are mentioned.

Mr Booth : Absolutely, yes. Specialists are very much part of what Medicare Locals need to work with. In fact, we have been doing a lot of consultations and discussions with the Royal College of Physicians who look after the specialists.

Senator MOORE: Perhaps there could be a little more work there, Mr Booth.

Mr Booth : In terms of—

Senator MOORE: Discussion with the Royal College of Physicians. When you have a look at Hansard

CHAIR: Maybe if you have a look at Hansard and take it on notice to respond to that.

Mr Booth : I was talking at their annual conference yesterday.

Senator MOORE: In Brisbane, I believe.

Mr Booth : In Brisbane, absolutely, and I was discussing this very issue about the role of specialists in Medicare Locals.

CHAIR: Your response would be appreciated.

Mr Booth : Yes. What Medicare Locals are particularly looking at is patient flow, and how we look at the barriers between primary care and secondary care and ensure that there are pathways that link primary and secondary care together. Specialists clearly have a key role in doing that. The make-up of Medicare Locals was very specifically designed that there should be skills based boards are not goods that were dominated by any one single profession. When Medicare Locals were established, it was indicated that they should have boards of nine or 10 people and on the boards you should have people who have a good knowledge of the local health community, you would have community representation, you should have legal, financial—the kind of skills that you would find on any board. Clearly there is not room for every single health profession on that board; it just is not possible. However, the Medicare Locals do have a series of advisory boards and advisory groups underneath them, including cross-membership of those advisory groups with local hospital networks to make sure that you do get that wider range of allied health, hospital based, all those ranges into there. That is working well. Medicare Locals have been established and are moving like that. We can give you more information on that.

What is happening with after hours is that the funding for after hours is increasing and there is significantly more money going into after hours. Historically what has happened with after hours is that some areas have been very well provided for and other areas have been very poorly provided for. That is because of the way these services have developed. Instead of doing a practice incentive payment direct to the practice, the money is going to the Medicare Local so the Medicare Local can look across the whole of their community and the whole of the area. If there are after hours services that are working well, they will carry on being funded, but with the increased funding Medicare Locals will be able to look at those areas that are not being served very well in after hours and try and put solutions in place there. So it is about getting better after hours services across the country.

Senator MOORE: The Medicare Locals are aware of the concerns.

Mr Booth : Absolutely. They have put specific plans in place as to how they are going to increase after hours.

Senator MOORE: And how to communicate with the people who are aggrieved by the change?

Mr Booth : A lot of Medicare Locals are doing those discussions and we are doing discussions as well. That is happening and that is going on. Another thing to mention in the after hours space is the GP after hours helpline which has been introduced and is now available across the whole of the country. Victoria signed up and had people coming on about a week ago. Queensland has also signed up. So from anywhere in the country you can now get to services. We normally define after hours as after six and going through the weekend.

Senator MOORE: So not five to eight.

Mr Booth : No.

Senator MOORE: Could you check the Hansard today of some evidence as well. The other thing that came through deeply from regional areas was the involvement of GPs at local hospitals and the way it has caused great problems and GPs are just not doing the work. The inference was that people who were there not by choice were not picking up work in the hospitals either, so it was an ever narrowing group of people on whom local hospitals were relying and it was creating great workload disincentives. I would think that the LANs would have a role in working on that issue, but some of the evidence we got today really focused on that from a range of different submitters. I thought that was an interesting thing. I think we are in a situation where anything else will have to be put on notice.

CHAIR: There is one thing I want to raise for you to take on notice. An issue that has come up repeatedly is generalist specialists. It has come up everywhere and the need for this and the dual pathway that New Zealand runs. You have dual specialists?

Ms Shakespeare : Under the specialist training program we are now assessing applications for the 2013 intake. That is one of the priorities, the criteria for assessing applications.

CHAIR: Thank you very much. I am sorry to rush you. There is only one plane to Perth a day and I want to be on it.

Senator MOORE: Can I also put on record that everyone was very pleased about the Workforce Australia review of workforce. People were speaking very positively about that, and also the report that came out recently that the minister released about 2025. They all felt that was a very positive process of actually doing that work. I think the good thing should be mentioned as well.

CHAIR: And thank you for staying to six o'clock on a Friday night. Thank you to Hansard, broadcasting and the secretariat.

Committee adjourned at 17:59