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Monday, 21 May 2012
Page: 4928


Mr CHRISTENSEN (Dawson) (17:47): I want to focus in particular on recommendations 25 and 26 of the Lost in the labyrinth report. These refer respectively to district of workforce shortage and area of need. Recommendation 25 is seeking for the department to publish on its website a comprehensive guide outlining how district of workforce shortage status is determined and how it operates to address the issue of workforce shortages in the medical practitioner industry. It goes on to detail how that should be done. Recommendation 26 recommends that the department consult with the states and territories and their respective health departments to agree on a consistent approach to determining area of need status based on agreed criteria.

Putting that to the side for one moment, I turn to my electorate, in which houses the beautiful Whitsundays. It is an area that people want to come to all the time to holiday, and we want to encourage that more and more. There are four private GP surgeries operating in Proserpine and the Whitsundays, Proserpine being a small town right beside the latter. All of these surgeries are at capacity in terms of their patient numbers. I personally know of GPs operating in their surgeries for 10- to 12-hour days, and they are doing that six or seven days a week. They are burning themselves out. At the same time I have local residents in the Whitsundays telling me about the difficulty of getting in to see a doctor.

It is my strong belief that medical services in that area are in crisis, and that is directly related to a shortage of GPs. I know of at least three centres that have in recent times advertised for Australian GPs to come and work in those clinics—all to no avail. In one instance there was repeated advertising from one clinic for a period of over 18 months. During that time—and again I am mentioning the beautiful Whitsundays—they had one respondent, who was sent some information about the place and then withdrew his application. That just shows you the real dilemma that we have attracting home-grown doctors to regional areas.

The other option available to us is to have foreign doctors coming into our regions in need. As long as they are able to get a Medicare provider number allocated to them, everything should be fine, but this is the problem. We have no capacity to get those people in there because there are no more Medicare provider numbers available. I want to quote a couple of local doctors here. One is Dr Michael McFall from the Cannonvale Medical Centre, whom I am in contact with a fair bit about this issue. I could not believe when the other day he phoned me up and said to me that he had seen 50 patients already that day. This is the kind of pressure that our GPs are under. He wrote a letter to me here last year which we tried to do something about. Unfortunately, because of the system, we were not able to. He writes, 'I am a sole general practitioner with a client base in excess of acceptable levels.' The Mackay division of general practice recommendation for a client load is 1,000 patients per practitioner. His client load is 3,300. His medical centre, he says, is struggling to service this workload. He writes: 'I've been trying unsuccessfully to attract a suitable applicant within Australia for the last 18 months. Therefore, I have been forced to seek interested doctors outside of Australia. However, our region is restricted in allocated placements for overseas trained doctors. Although this medical centre is allowed one overseas trained doctor, this process is taking over nine months to fill this position from the initial contact to actually having the doctor on site. Due to this medical centre's high demand and growth, we could justify and easily accommodate an extra doctor. The problem is the processes do not allow it.'

I go on to 121 Medical Centre, also in Cannonvale, and Dr Yehia El-Baky, who is a great local GP. He highlights the issue more. He writes to me: 'Despite the region's obvious attractions, of which its beauty is just one, it is extremely difficult to attract doctors who have trained in Australia to the Whitsundays region. A new locally trained doctor might volunteer to permanently relocate to the Whitsundays only once or twice a year, and for that reason 121 Medical Centre, like many other medical practices in a rural or remote setting, relies on its ability to recruit overseas trained doctors to provide a stable medical practice capable of opening each day.'

I want to quote at length a local newspaper article on what Dr El-Baky said there. The article is from the Whitsunday Coast Guardian, and it says:

There are certain services you just can’t live without. One of them is health.

A Whitsunday doctor - who sees up to 60 patients each day - says the answer to the severe shortage of GPs in regional areas lies in the hands of the federal government. Principal GP at the 121 Medical Centre in Cannonvale, Dr Yehia El-Baky, says it's no longer "humanly possible" to continue working at the rate he and his colleague have been for the past number of years.

"I am not asking for a new doctor, just a replacement after one of my doctors left," says Dr El-Baky who admits he is considering closing his popular practise two days a week because of mounting pressure.

His practice is actually seven days a week, which I know is something that the government tries to promote to have after-hours medical clinic access. The article goes on:

Dr El-Baky says the answer to the doctor shortage right across the nation lies with the federal government's refusal to relax certain laws that allow overseas practitioners to work in Australia.

I do not want to be partisan and I am not going to be, because I understand that those same principles were in place in the former government as well; I have a problem with the regulations we have in place. The article goes on:

"We can't get Australian doctors … even with the $40,000 incentive to live in regional areas, for some reason they just don't want to come here. But overseas, there are fully qualified doctors—

who are actually here in Australia—

working in service stations, shop fronts, waiting for the okay to come to Australia and practise," he said.

"The government tells us we have about 23,000 people in this region who will need to see a GP, but this is not the actual population. We have 600,000 visitors to the region each year and about 10 per cent of those will need to see a doctor during their visit," he said.

I have been trying to work with Dr El-Bakyto find solutions. In the current system it is very, very difficult. We have actually got a petition that we gathered with all of the local clinics. We amassed almost 1,000 signatures to that petition in a very short time, and that is going through the process of coming before the House, which it will in due course.

I could go on and quote statements of support in trying to solve this issue for the Whitsundays from chemists, from the local ambulance service, from the local hospital—all of whom realise that there is a huge problem here. My issue comes down to this: the current structure for district of workforce shortage and area of need goes around where there is the most need, and I understand that, but we are always going to have smaller areas where there is the most need, and when you have areas where there is need but it is a little bit less they are always going to miss out. So in an area like the Whitsundays, where there may be some doctors meeting some sort of quota, there are going to be doctors there that are going to be burning themselves out because the quota is still going to be over and above what we need it to be, which as I detailed before is one to 1,000. We have doctors there working at ratios of one to 3,300 patients.

The only way currently to get through this is the granting of exemptions under the district of workforce shortage measures, and that is like trying to win lotto. So recommendations 25 and 26 out of this report are critical. They probably are a bit broad, to be honest, but I think that when the government looks at them and responds to them I would urge the government to consider relaxing some of those regulations so that we can get doctors into regional centres like the Whitsundays to take the pressure off existing GPs because, if we do not take that pressure off, they are well and truly going to burn themselves out.