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Tuesday, 13 May 2008
Page: 1679


Senator Allison asked the Minister representing the Minister for Health and Ageing, upon notice, on 21 February 2008:

(1)   On what dates did the Central Gippsland Health Service in Sale, Victoria apply for and receive an area of need specialist classification for a paediatrician.

(2)   Is the Minister aware that two suitably qualified, locally-based paediatricians applied for a paediatrician’s position in late October and early November 2006 and that the Central Gippsland Health Service subsequently applied for area of need status?

(3)   Is the Minister aware that the Central Gippsland Health Service subsequently appointed an overseas-trained doctor (OTD), who had failed the Royal Australasian College of Physicians examination, to fill that position?

(4)   Was the appointment consistent with area of need guidelines and processes?

(5)   Would the granting of a 457 visa under these circumstances be allowable?

(6)   What evidence do local health services have to provide to establish that they have been unable to attract a suitably qualified local applicant in order to qualify for area of need status?

(7)   What processes does the Government have in place to monitor the area of need classification process?


Senator Ludwig (Minister for Human Services) —The Minister for Health and Ageing has provided the following answer to the honourable senator’s question:

(1)   The Department of Health and Ageing (the Department) received a Preliminary Assessment of District of Workforce Shortage (PADWS) application from Central Gippsland Health Service in Sale, Victoria on 24 April 2007. A PADWS was issued for one paediatrician on 7 May 2007.

(2)   The Department was informed via the PADWS application that a locally-based paediatrician had applied for a full time paediatrician position. In the same application the Department was informed that the Victorian Department of Human Services endorsed the position as an Area of Need in December 2006.

(3)   State and Territory Medical Registration Boards have a statutory responsibility to determine if a doctor is competent to practice medicine. The Department’s delegate approves a section 19AB exemption for an Overseas Trained Doctor (OTD) based on the merits of the application, which includes a certified copy of a doctor’s current medical registration. On 18 September 2007, the Department’s delegate approved a section 19AB exemption for an OTD to provide Paediatric services at the Central Gippsland Health Services. The Department was not aware the OTD had failed the Royal Australasian College of Physicians examination.

(4)   Yes.

(5)   When processing a section 19AB exemption application, granting a 457 visa under these circumstances would be allowable provided there are no conditions placed on their medical registration. Note that all visa applications are approved by the Department of Immigration and Citizenship.

(6)   Rural and remote Australia is considered to be a district of workforce shortage for specialists. Where a PADWS application is received for a location in a particular specialty seeking to work in rural and remote Australia it is approved, however the advice does not guarantee formal approval for a future section 19AB exemption at a particular location. All applications for exemptions under section 19AB will be decided on their individual merits at the time of lodgement.

(7)   Overseas trained doctors are subject to Medicare provider number restrictions that generally require the doctor to work in a district of workforce shortage (DWS) in order to access the Medicare Benefits Scheme. A DWS is a geographic area in which the general population need for health care is not met. Population needs for health care are deemed to be unmet if a district has less access to medical services than the national average. A doctor to population ratio is frequently used to help determine if a specialty type is in shortage in a particular area. This ratio is based on recent Medicare billing statistics. These statistics use a full-time equivalent measure, which takes into account Medicare billing in the area, irrespective of whether or not local doctors are working in a part-time or a full-time capacity. The Medicare billing statistics and the doctor to population ratios are updated on a quarterly basis. There are over 52 recognised specialities. In determining a district of workforce shortage, only the Medicare billing statistics for that particular specialty are taken into consideration.