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Rudd promises more doctors -

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Rudd promises more doctors

Broadcast: 15/03/2010

Reporter: Chris Uhlmann

The Rudd Government has promised to spend more than $600 million over the next four years to employ
more General Practitioners. But will the latest government health promise deliver doctors where
they're needed?


KERRY O'BRIEN, PRESENTER: Another piece in the Rudd Government's health jigsaw has fallen into
place with a promise to spend $632 million over the next four years to address the chronic
undersupply of doctors.

The money will nearly double GP training places to 1,200 a year by 2014 and boost the number of

It's been welcomed by health experts who say it will go a long way towards meeting the growing
demand for doctors.

But as the Government continues to press the states to sign up to its hospital funding plan, the
Opposition has again criticised Labor as a government long on announcements and short on follow

Political editor Chris Uhlmann.

CHRIS UHLMANN, REPORTER: By some measures, maybe you are better off red.

Maybe Australia should take a leaf out of the Cuban healthcare systems book.

KEVIN RUDD, PRIME MINISTER: A few problems of political freedom, but we'll leave that to one side.

CHRIS UHLMANN: Kevin Rudd's revolution lies in the future with the Commonwealth offering to assume
60 per cent of the running costs of all the nation's hospitals. The states would pick up the rest
and the hospitals would be grouped into regional management networks.

The states are yet to sign up to the plan, but the Prime Minister has announced another step in
health reform: more money to train doctors.

KEVIN RUDD: This represents new money for the system. This is a new investment for the future.
We'll be expanding these places as of next year.

CHRIS UHLMANN: Over the next four years the Government will spend an extra $632 million on GP and
specialist training. By 2014 that will buy an extra 400 training places a year for GPs, another 540
places for specialists and another 575 work experience places for young GPs.

NICOLA ROXON, HEALTH MINISTER: We know that we cannot fix the imbalances in our system if we don't
have a strong primary care system. And GPs are absolutely critical to that.

CHRIS UHLMANN: The Government says the spending will be offset by savings and health experts have
welcomed the cash.

LYNNE PEZZULLO, ACCESS ECONOMICS: For a long time there's been concerns about future supply
constraints in the general practice market and these will go some way to relieving that.

SIMON WILLCOCK, UNI OF SYDNEY: And to hear that we're now going to reach that target of 1,200
places - exactly the number that we've been asking for by 2014 - is very gratifying and certainly
will help to address some of the shortages that we've got at the moment.

CHRIS UHLMANN: Labor blames Tony Abbott for the decline in doctor numbers.

NICOLA ROXON: Of course the Leader of the Opposition was the Health Minister for many years. He
didn't tackle these problems; in fact he kept a cap on GP training places.

SIMON WILLCOCK: One of things that contributed to the shortage was that we had a cap on the number
of medical school places in Australia for around a decade, and that meant that we had only a
relatively small number of medical students graduating each year.

CHRIS UHLMANN: But there are other factors at work.

LYNNE PEZZULLO: The workforce shortages have arisen largely because of demographic ageing. As you'd
be aware, demographic ageing means that people are demanding more health services over time per
capita, and over time that means that the numbers of doctors have to increase much faster than the
population. Now this is a particular issue between 2010 and 2020. So the Government's reforms will
go some way towards redressing that.

CHRIS UHLMANN: The Opposition Leader believes the Government is long on announcements and short on
follow through.

TONY ABBOTT, OPPOSITION LEADER: To get the training places, you've got to have arrangements in
place with the state governments, with the universities, with the public hospitals and with the
medical profession, because none of this training can be delivered without an appropriate clinical
setting and already the public hospitals are under great strain.

CHRIS UHLMANN: The Health Minister says the changes will deliver doctors where they're needed.

NICOLA ROXON: More GP training places for all those communities across the country who cannot
provide access to a GP.

CHRIS UHLMANN: But simply having more doctors doesn't mean they'll go to where the need is

LYNNE PEZZULLO: Clearly there are still key issues about attracting doctors to the bush. There is
maldistribution. We have much fewer providers per capita in rural and remote parts of Australia
than what we do in metropolitan Australia. There are a number of programs that are trying to
redress those issues. I would think probably still more needs to be done in terms of getting
workforce to where it needs to be.

SIMON WILLCOCK: What we have to do and we currently do is incentivise rural and remote placements
and training placements to make sure that we have significant numbers of those entering general
practice training, both experiencing and developing skills in rural and remote practice.

CHRIS UHLMANN: While many including this government might rail against hospital waiting lists and
caps on the number of doctors, it's worth remembering that both provide a sluicegate for rationing
what are free or heavily discounted services. Without that kind of barrier, it's possible that the
cost of the health system might rise even more rapidly.

LYNNE PEZZULLO: When you have more doctors in the workplace, yes, that relieves a supply
constraint. It does means that there's going to be a greater investment in health. However what we
know is that in order to retain the current levels, the quality of service, just such an investment
is required. And what we see when we look at cost effectiveness analysis is that that's what
Australians want.

CHRIS UHLMANN: Health economist Lynne Pezzulo thinks the Government is heading in the right
direction with its reforms, but she's concerned that the move to activity-based funding might not
be enough to reign in health costs.

LYNNE PEZZULLO: I'm not sure that that particular efficiency measure is sufficient to redress the
long term financing issues that we can see in the next 20 to 30 years emerging. Basically these are
driving fiscal deficits and it's important to redress those in the future so that they're not
worsening, which is what we see when we look at the intergenerational report.

KERRY O'BRIEN: That was Chris Uhlmann reporting.