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Monday, 21 May 2012
Page: 4914

Mr IRONS (Swan) (16:44): This is the third time I have stood to speak on the report on the registration processes and support for overseas trained doctors and it is a pleasure to continue. The committee received many suggestions for increasing efficiency of the registration process. More efficient sharing of information regarding working visas will reduce the stress and difficulty faced by international medical graduates, improving our ability to attract talent to Australia. The committee recommended that the Medical Board of Australia and the Australian Health Practitioner Regulation Agency provide the Australian government Department of Immigration and Citizenship with direct access to information on its registration database to improve this process. As the committee continued its investigations, the need to improve administrative efficiency and reduce duplication for accreditation and registration became apparent. Unnecessary delays of up to two years were reported to the committee. The Western Australian department of health reported the experience of five- to 24-month delays for international medical graduates in starting work in Western Australia. Clearly the lengthy time frames are frustrating for international medical graduates and their families, as well as for the prospective communities in need of their service. Screening processes need to be robust; however, steps need to be taken to reduce duplication and inefficiencies. Many of these inefficiencies arise from poor communication between key organisations involved in assessment, accreditation and registration. A streamlining of the system and more transparency in the processes will help rectify this situation.

The committee believes that there is a need to establish benchmarks for time frames, with regular reporting on performance against these benchmarks. Succinct and clear data should be published on at least a quarterly basis. This will not only assist international medical graduates and prospective employers to understand the average length of time certain processes will take, but also provide key organisations involved in accreditation and registration with an understanding of how their processes impact on the overall time frames.

As part of increasing administrative efficiency, it is proposed that the Medical Board of Australia, the Australian Medical Council and specialist medical colleges publish data against established benchmarks on their websites and in their annual reports on the average length of time taken for international medical graduates to progress through key milestones of the accreditation and registration processes. AHPRA's annual report in respect of the functions carried out by the MBA must also include a number of other key performance indicators, providing further information to international medical graduates. Furthermore, providing computer based information management systems with up-to-date information regarding the requirements and progress of individual international medical graduates' assessments, accreditation and registration status will enable timely provision of advice. Retraining of administrative staff is also suggested.

A further recommendation goes to where an international medical graduate considers the processes prescribed under the national registration and accreditation system to have placed them at a significant disadvantage compared to their circumstances under the processes of the former state and territory medical boards, proposing that the Medical Board of Australia investigate the circumstances and, if necessary, rectify any registration requirements to reduce disadvantage.

We considered the issue of harassment and bullying, with the report finding that it is implicit upon all medical practitioners to act with a high degree of professionalism not only with their patients but also with their colleagues, irrespective of seniority or any perceived advantage. Individuals have the right to work in a fair, supportive and productive workplace. For these reasons, evidence of allegations of workplace bullying was of great concern. The inquiry received evidence regarding allegations of bullying and workplace harassment. Evidence was also received from individuals asserting that some supervisors have experienced instances of harassment as a result of decisions they have made.

The instances of bullying highlighted in the report are a cause for concern. The committee understands that these issues are not confined to IMGs but also extend to others within the medical profession, with surveys reporting approximately 50 per cent of junior doctors having experienced bullying in the workplace. The committee has made a number of recommendations to deal with bullying and harassment. The tabled report calls for the Australian Medical Council, the Medical Board of Australia and the Australian Health Practitioner Regulation Agency to increase awareness of administrative complaints handling and appeal processes available to international medical graduates by prominently displaying on their websites information on complaints handling policies, appeals processes and associated costs.

IMGs and their families need support which extends beyond clinical and professional orientation to also include social and cultural support to help them as they adjust to living and working in Australia. The committee has heard evidence from a range of stakeholders highlighting the importance of initial support and outlining various orientation programs, the features of which vary significantly in relation to the timing of orientation, the duration of the program and the topics covered in that orientation. Providing a structured and targeted orientation program when they are first exposed to the medical system in Australia should better equip international medical graduates to understand the intricacies of the Australian health system and the medical profession.

The Australian Medical Council reported to the committee that the importance of orientation for international medical graduates has been acknowledged by COAG; however, mandatory participation and orientation is not currently required. A program of orientation to be made available to all international medical graduates and their families to assist them with adjusting to living and working in Australia was a key recommendation by the committee. Health Workforce Australia, in consultation with key stakeholders, should offer this program. Detailed information on immigration, accreditation and registration processes, as well as accommodation options, education options for accompanying family members, health and lifestyle information, access to social welfare benefits and services and information about ongoing support programs for the international medical graduates and their families will greatly improve their transition to Australia. Information on Australia's social, cultural, political and religious diversity and an introduction to the Australian healthcare system, including accreditation and registration processes, were also identified as key recommendations.

The committee views clinical and professional orientation, including cultural awareness education and training, as an important component of the introductory support needed to help IMGs adjust to working within the Australian health system and acquire an understanding of the social mores and customs of Australian culture. In the committee's view, the consequences for IMGs, their patients and the wider community if the IMG is not supported appropriately in this way could be considerable. For this reason, the committee believes that such introductory support should include, but not be limited to, information on immigration, with a comprehensive outline of the steps required to gain full medical registration in their chosen field. Such orientation should also include introductory information on the structure and functioning of the Australian health system. Social orientation to be provided to the IMG should include the provision of basic information such as accommodation options, education options for accompanying family members, health and lifestyle information and access to social welfare.

In conclusion I would say that I believe the committee has produced a really worthwhile report. I hope that it will make a real difference to health care in communities in both rural and city areas. However, in the medium to long term we really do need to look at training more medical doctors, and a good place to start is to establish a Curtin medical school in my electorate of Swan. Thank you.