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Monday, 21 May 2012
Page: 4916

Ms HALL (ShortlandGovernment Whip) (16:52): I would like to congratulate the member for Swan on the fine contribution that he has just made to this debate. I know the member for Hasluck will make a similarly fine contribution to the debate when he speaks to this report, Lost in the labyrinth: report on the inquiry into registration processes and support for overseas trained doctors, from the House of Representatives Standing Committee on Health and Ageing. I would like to congratulate the chair of the committee on the role that he played, and the committee staff. For the committee, this was one of those reports where, when we sat down and started looking at the issues, we were overwhelmed by the complexity of the system and by the fact that so many people involved in the system were experiencing problems, be it the person at the management end, the overseas trained doctor coming to Australia or all the associated health facilities and health workers involved in the system.

This was a system that we found was rife with intimidation. It was a fragmented system. It was a system with a lot of duplication. It was moving towards being a national system but I do not think it had quite come to terms with the fact that it is a national system and there are disparities between the states. This system is about maintaining a high standard, but at the same time we need to ensure that the doctors coming to Australia from overseas are looked after. There are communication problems. There is a partisan system. There are issues around training and cultural awareness, the need for better mentoring, hospital based experience, the appeals process and English language. All these issues came up and were identified as problems along the way. I will touch on some of them in a little bit more detail as I continue my contribution to this debate.

As we all know, Australia has one of the best health systems in the world. If you were to read the reports in the media, you would think that we had a system in crisis. All I can say is that you just need to visit a few other places in the world to really appreciate the strength of our health system, the dedication of those people who work in our health system and why it is a system that overseas trained doctors would like to work in. Unfortunately, the system does not always work the way we would like it to when it comes to welcoming overseas trained doctors—or, as I will refer to them for the duration of this speech, 'internationally trained medical graduates', or IMGs, and I am sure the House will know exactly what I mean.

Key themes that emerged throughout our inquiry were that it was a system that lacked efficiency and accountability, one where the IMGs themselves often had little confidence in the way the system operated. They had been subjected to discrimination and, I must say, some of the stories that the committee heard were heartrending. We heard about doctors who had practised in Australia for in excess of 20 years basically being told that they could no longer practise. They had no warning in a system where the rules constantly changed and was full of really poor communication. This was a system where sometimes competitive practices interfered with and had adverse outcomes in relation to where a person was.

We now have a national scheme, which I think is absolutely brilliant. It replaces state and territory schemes. As I mentioned earlier, the state and territory schemes that it is replacing have had difficulty coming to terms with the fact that it is a national scheme. There are so many duplications and the scheme needs to be more efficient than it is at the moment; it needs to provide better information to all parties involved in the system. The duplication in the system really slows it down, and doctors seeking to come to Australia are prevented from doing so or delayed. Sometimes that delay leads to them locating in another country.

First and foremost in a health system is that we have a health system. The next thing we need to look at is that we look after the patients and the workers in the system. We have to create a system that provides security to all those people who are working in the system. We have to provide support to IMGs who come to Australia from overseas. They need support to integrate into the system and they also need mentoring and cultural awareness. They need to understand the way our complex medical system works. Whilst we saw examples of that taking place in some cases, it was very fragmented and it did not always achieve what it set out to. I wholeheartedly support each and every recommendation in this report. It was a unanimous report and it was one that each and every member of that committee contributed to. We were very mindful of the fact that this would be a blueprint—at least, we hope it is a blueprint—for the way IMGs come to Australia and how they are treated when they get here. It is about setting up independent appeal processes as well as making sure that the assessments that IMGs undertake are proper assessments.

I would like to devote the remainder of my contribution to the work based assessments. We saw two very good examples, one in Launceston and one in the Hunter. I have had a little bit to do with the one in the Hunter. It has been phenomenally successful. The graduates that have gone through it have all been successful. The cost of undertaking that course is minimal when you look at the outcomes that are achieved by the participants.

I recently attended a conference that was held in Newcastle, and the chair of the committee, Steve Georganas, the member for Hindmarsh, attended that conference. It further reinforced that the work based assessment model was the best way to integrate IMGs into our system. It provided a system where IMGs were given the support that they needed right from the day they signed up into the program. There was clinical support. They had a mentor that provided them with support for their family and cultural support. They worked alongside qualified physicians and surgeons. They really learned how the system worked and if they had a problem in some area they were able to work on that. The Hunter-New England program at the time we did the report had 49 successful IMGs progress through it. There is a waiting list to get into this program, just as there is a waiting list to get into other programs.

This was a very important inquiry. It was an inquiry that I see as a way forward for IMGs coming to Australia. As a nation we have to be very mindful of the fact that if we did not have IMGs our medical system would not work. So we have to make sure of the safety within our community but we also have to value and provide the support that IMGs need to function in our health system.