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Foreign doctors prop up public hospitals -

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Broadcast: 10/08/2004

Foreign doctors prop up public hospitals

Reporter: Heather Ewart

KERRY O'BRIEN: There's no doubt when the whips start cracking in the election campaign - probably
in a matter of weeks - access to reasonable health services will be at the forefront.

The issue will undoubtedly come into sharp focus on the fringes of the major cities where new
housing developments have outstripped the supply of doctors.

Yet foreign qualified doctors who want to live in Australia and could alleviate some of the
shortage are confronted by confusing regulations and a lack of support, they say, to help them meet
local standards.

That's not the case for foreign doctors on temporary residence permits, who have been recruited by
state health departments to prop up public hospitals.

Unlike the others, they don't have to attain Australian qualifications.

Heather Ewart reports.

HEATHER EWART: Swapna Dayal is a GP trained in India.

She moved to Australia in March as a permanent resident and lives with her niece Meega and the rest
of her brother's family in Melbourne while she studies for entry to the Australian medical
profession.

Upon arrival here, she was shocked at being knocked back for employment as a doctor and is
desperate for work.

SWAPNA DAYAL, OVERSEAS TRAINED DOCTOR: Any kind of job.

By the end of job hunting I was looking out for any job and people said, "You are too qualified for
any other job," so I am left with no job.

Four months have gone and no job.

HEATHER EWART: What sort of jobs were you trying for?

SWAPNA DAYAL: I tried for a medical receptionist's job.

I even tried in the pharmacy, even as a sales girl.

And I have applied in Coles, Myers, and Safeway.

HEATHER EWART: After rejection there too, Swapna is now up at six o'clock most mornings preparing
for the Australian Medical Council exam which she was advised she must pass to become registered as
a doctor in Australia.

Her husband and two children remain in India, though the plan is for them to join her.

Do you miss your family?

SWAPNA DAYAL: Oh yes, terribly.

HEATHER EWART: When will they move here?

SWAPNA DAYAL: When I get a job.

HEATHER EWART: So when you are finished - when you've done your exam how confident are you of
getting a job as a doctor here?

SWAPNA DAYAL: I don't know.

HEATHER EWART: Swapna Dayal's case is not unusual according to recent research at Monash University
and the Federal Government has now acknowledged a failure to fully utilise the many overseas
trained doctors in our midst.

DR BOB BIRRELL, MONASH UNIVERSITY: There are thousands of permanent residents in Australia who have
degrees from overseas medical schools who are not employed as doctors.

HEATHER EWART: Is that a bit of a waste?

DR BOB BIRRELL: It is a waste in the sense that these people are eager to enter the medical
workforce and we do have a serious shortage of doctors currently in Australia.

DR MUKESH HAIKERWAL, AUSTRALIAN MEDICAL ASSOCIATION: What we are saying is give these people a
chance.

Get them across the threshold of the Australian qualifications so they can get on with their lives
and contribute to our community.

TONY ABBOTT, HEALTH MINISTER: We do have a shortage of doctors in Australia and where Australian
residents are capable, with training, of being doctors here, we should give them every
encouragement.

HEATHER EWART: The Federal Government has pledged around $1 million to the Royal Australian College
of General Practitioners to give overseas trained doctors career counselling and learning programs
to help get them registered here.

But this could amount to little more than a drop in the ocean.

DR MORTON RAWLIN, ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS: These are relatively costly
for an individual who is otherwise not in the workforce to actually afford, so we would like the
Government to consider some educational money support for these doctors.

HEATHER EWART: Because at the moment perhaps the sheer expense of it is ruling some of them out?

DR MORTON RAWLIN: Correct.

DR MUKESH HAIKERWAL: We are not asking anybody to change the rules but simply to help them across
the line.

The bar can't change - we've got to have that standard.

Everybody should be able to expect the same standard of care.

HEATHER EWART: But is it the same bar and set of standards for all overseas-trained doctors seeking
to work here or indeed, already working here?

In recent years, state governments have been actively recruiting foreign doctors to work in
overstretched public hospitals - placing them on temporary visas for fixed short terms with no
insistence they pass the Australian Medical Council exam.

Many are British and they form up to 50 per cent of the junior doctor workforce in some hospitals.

DR BOB BIRRELL: The situation we're now in where thousands of doctors serving in the front line are
coming from overseas medical schools and have not actually been assessed to ensure they meet our
standards is quite extraordinary.

HEATHER EWART: How has this situation developed?

BOB BIRRELL: That's come about because of the desperate situation of public hospitals and some
regional general practice clinics.

They simply cannot get doctors from anywhere else so they are appointing these doctors on a
provisional basis in order to fill severe gaps in the medical workforce.

HEATHER EWART: Should this whole problem have been addressed sooner?

TONY ABBOTT: Of course it should have been, but as late as 2000 the Government was still getting
official advice to the effect that there was no looming shortage of doctors in Australia.

It was only in November 2002 that we first got official advice from the Australian Medical Work
Force Advisory Council that we were facing a serious problem here.

HEATHER EWART: The Government argues it's now moving to redress the shortage and encouraging
overseas trained doctors is one way of doing this.

But for now that's of little comfort to those like Swapna Dayal, with the Australian Overseas
Trained Doctors Association claiming that permanent residents like her get second class treatment,
while foreign doctors on short temporary visas are on a much better deal.

ANDREW SCHWARTZ, AUSTRALIAN DOCTORS TRAINED OVERSEAS ASSN: We've been asking for these rules to be
changed for years and years and years without getting anywhere and we don't understand why such a
preference is given for people here on a temporary basis.

HEATHER EWART: Would you practice as a doctor anywhere?

Are you prepared to practise anywhere?

SWAPNA DAYAL: Oh yes, I was prepared to practise anywhere, even when I came here the first day.

HEATHER EWART: The Government says that it prefers doctors to go to areas of need - they are the
rules - so you would be prepared to accept that?

SWAPNA DAYAL: I did, I was prepared for that as well because I knew about it and I did apply there
as well, but I still haven't got a call from anywhere.

I applied in Ballarat, Wonthaggi...

HEATHER EWART: If she gets through her exams, she may well end up in a place she's never heard of
because under a moratorium introduced in 1997 GPs like her must work for 10 years in an area of
workforce shortage before they can hang up their own shingle.

TONY ABBOTT: Now this rule was originally brought in quite a few years ago to discourage doctors
from coming to Australia.

These days we are certainly encouraging doctors to come but we still want them to work in areas of
workforce shortage - that's why we still have the system in place.

HEATHER EWART: This usually means going to a country area, but the Australian Medical Association
warns the crisis is no longer confined to the bush, with many metropolitan areas now having needs
just as great.

DR MUKESH HAIKERWAL: What we are finding in parts of Melbourne, parts of other major cities, west
of Sydney, northern suburbs of Adelaide and certainly Brisbane is that there is a workforce
shortage.

Some parts of outer metropolitan Melbourne have got many fewer doctors per head than even the most
remote parts of rural Australia.

HEATHER EWART: While there's acknowledgement the Government is now starting to take steps in the
right direction, it's being called upon from all sides to overhaul a complex and outdated system
they say is no longer serving the best interests of our community.

KERRY O'BRIEN: That report from Heather Ewart.

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