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Monday, 28 November 2022
Page: 3656

Mrs PHILLIPS (Gilmore) (18:08): I'm incredibly excited today to speak in support of the Higher Education Support Amendment (2022 Measures No. 1) Bill 2022. I am pleased that this bill is helping to support students with fairer grandfathering provisions for job-ready graduates. As a former TAFE teacher, I know how important education is. We need to make sure that our rules are fair and clear. Students shouldn't be lumped with fees that they weren't expecting because our laws aren't clear enough or because their university made decisions to change or cancel their courses. So that is an important change.

But what I'm really excited about with this bill is the new provision to encourage the employment and retention of doctors and nurse practitioners in rural, regional and very remote areas of Australia. This fantastic bill is taking real, innovative action to address the GP shortage we are facing across regional and rural Australia but in particular in my electorate of Gilmore on the New South Wales south coast. What it means is that doctors and nurse practitioners will be incentivised to live and work in regional and rural Australia by having their university debt waived if they stay long enough. It's not just if they come for a short while but if they come for a long while. Medical degrees certainly don't come cheap, but the Albanese government is working to reduce that cost. The only catch—not that I would call it a catch—is that you have to work in regional Australia. As someone who has spent their whole life in regional Australia, I can tell you that is not a bad deal at all. The south coast is the most magnificent place on earth—why wouldn't you want to live and work there?

This is truly something to be celebrated, but to really understand why this change is so important, I think it's important to understand the scale of the problem we are facing. I want to talk a little bit about the difficulties local people have had in accessing a doctor. The shortage of doctors in regional and rural Australia has been escalating for years. Local GPs are overworked and struggling to cope in a system that isn't supporting them, with a hospital system that is broken, and with an ageing population that increasingly needs more care and support. The major hospitals in my electorate are in desperate need of upgrades. The Eurobodalla has been waiting for a new hospital for years. We have been fighting to make it a level 4 hospital against a state government that has continually played down the health needs of this community. The Shoalhaven hospital is chronically at the top 10 of a number of lists, but nothing to celebrate—it's top 10 in the state for the longest emergency department wait times and the worst hospital for rostering. Only 46 per cent of its patients have their treatment start on time, and only 47 per cent leave within four hours. The list goes on.

There has been chronic underfunding from Liberal state and federal governments for years and years. The trouble is, it's a negative feedback loop. The fewer GPs, the more pressure on hospitals, and the more pressure on hospitals means more pressure on GPs—a system that can't cope. Local people have to either travel great distances or, in many cases, go without, leading to more serious health complications. We need more GPs. Local doctors in our community have been demanding change for a long time, pointing out, quite rightly, that the incentives for getting GPs in regional areas have just not been fit for purpose.

When I was first elected to parliament in 2019, I joined with many members of the Tuross Head community to raise concerns about the closure of the Queen Street Medical Centre in Tuross Head. The wonderful Tuross Head Progress Association presented me with a five-page submission on the negative impacts this decision would have on the local community, and on the domino effect the closure would have on retail businesses, patients and the broader community. Queen Street Medical Centre has its main centre in Moruya, at the time had satellites in Broulee and Tuross Head. When the local doctor left, they struggled to recruit a new one. There weren't enough incentives or reasons to attract doctors to small places like Tuross Head—hard to imagine, given how beautiful the area is—not to mention the pressures the former government's Medicare cuts were placing on GP practices. We're working on that, too, another big but important task. So, sadly, the Tuross Head practice closed.

This is an ageing population, with more people over 65 than under, but all too often they have to travel great distances for medical care. Now they have to travel just to see their GP. The flow-on also means local people don't use the local pharmacy, stop by the local bakery or grab a coffee from the local cafe. Instead, they do all of this in a larger town, putting even more pressure on the small local Tuross Head shops. These are the flow-on impacts, all from the loss of a doctor. As an ageing population, many also don't drive. This means many people might avoid or delay seeing their doctor, which we know leads to more health complications. It's just simply not good enough.

I along with many others was relieved when in 2020 a doctor from Sydney finally came to the rescue, opening a practice once more in Tuross Head. This doctor could see the huge need in regional communities and was spurred into action after the COVID pandemic. At his own cost, he took a decision that actually didn't make business sense but acted for the good of others. I can tell you that is an attitude we know well on the south coast—a truly selfless community. We welcomed this new doctor with open arms.

Sadly, Tuross Head is not an isolated example. Last year Sanctuary Point lost its last GP because the amazing Dr Kate Manderson, who runs a few centres around Shoalhaven, could not find a doctor to replace the retiring GP there. As many of her GPs retired, she had just been unable to find and recruit new ones. I have met with Dr Kate on many occasions to hear her views on how we can address the issues facing local GPs. She has lots of great ideas, and we are connecting those through to the minister for health, who is very receptive to how we can improve regional and rural access to GPs. I always appreciate the time Dr Kate takes to share her thoughts with me on important local issues. Annette Pham, who runs another set of local practices, also had the same issue at her practice. They have struggled to recruit and keep local doctors. They could see the problems and have so many ideas to fix the issues.

Both Annette and Dr Kate advocated strongly to improve incentives for recruiting and retaining GPs in regional areas like ours. They advocated for years to have the Distribution Priority Area updated for our community, and I joined them in that fight. The former government removed the DPA status of Nowra-Bomaderry and Sussex Inlet three years ago, and the case for undoing that was clear from the start. I advocated strongly to the former minister about this, raising that concern here in the parliament, writing to the minister and begging him to change our status. We were absolutely thrilled to see that change finally happen in February this year—a huge win for our community, a hard-fought win. But it was a long fight, and that one change is not enough to make up for the loss of doctors in our community. A lot of damage was done in that time.

Dr Kate and Annette continue to be fierce advocates for how we can address this issue. Together we also managed to advocate for a reintroduction of Medicare item 288, video/telehealth psychiatry consultations, in regional and rural Australia. The former government removed this important bulk-billed service. It was a heartless decision that many local doctors and patients raised concerns with me about. People told me how they had been put into a dark place because they couldn't afford to see their psychiatrist anymore. They could no longer afford to get their prescriptions renewed. They were abandoned by a government who did not understand the healthcare needs of regional Australia. Together with local doctors and patients, our advocacy saw that reinstated by the Albanese government. I was so delighted about that, and many people contacted me to say how relieved they were.

So the voices of local doctors really do make a difference to the policies that we deliver. I was pleased to welcome Annette, her husband, Dr Hao Pham, and other advocates from their service to Parliament House last week to meet with the health minister and continue their advocacy. They want to see more doctors becoming GPs. They want to see bulk-billing increased again after years of cuts. They are fighting for vulnerable people, and our government is listening. I will be welcoming Dr Kate very soon as well so she can share her thoughts on GPs and aged care, because I know their voices are crucial to getting this right. I sincerely thank them and every local doctor, nurse and medical practitioner for their advocacy on these crucial issues.

In my time as member for Gilmore, literally hundreds of people have contacted me to say they can't find a GP. People are travelling hours in the wrong direction just to see a doctor or ending up in our already overloaded hospital system. GP access has been spiralling out of control for far too long, made worse by cuts to Medicare and a decade of mismanagement by a Liberal government who wouldn't prioritise access to health care. Fundamentally, they did not believe in Medicare, so I am absolutely delighted that today we are taking one more serious step in the right direction to recruit and keep doctors in our regional communities. Once again I like to think that it is the ideas of our community on the South Coast that have contributed towards this important reform. In my recent Jobs and Skills Summit Survey, conducted in the lead up to the summit in September, many people suggested that removing or reducing education debts for people who work and stay in regional and rural areas was the way to go. Juanita said:

Provide subsidies for relocation and providing HECS relief to those who commit to staying and working in rural communities.

Gina said:

… reduce the HECS debt of bonded medical students who come to the regions.

These were two amongst many similar suggestions. Well, Juanita and Gina, that is exactly what this bill will do. If this bill passes, from 1 January next year, eligible doctors and nurse practitioners will have their HELP debts reduced or wiped if they live and work in areas like the South Coast for the equivalent length of their degree. Doctors and nurse practitioners who meet half of the time requirements will be able to access half of the HELP debt removal. This is fantastic news.

Moving to regional and rural Australia is no easy task for someone who has never lived here before, so we need to encourage them, not just for a short time but for a long time. We need to encourage them to put down some roots, build a network of family and friends and live their lives here. Zero HECS debt is a strong incentive for a young doctor or nurse practitioner to try regional Australia, particularly in this economic climate, and I know that in a beautiful area like the South Coast there are more than a few reasons to stay. This is one step in the right direction, one part of a suite of changes we are working on to address our GP crisis across regional Australia.

I'm delighted that the recent budget is also delivering a Medicare urgent care clinic for the Batemans Bay region. Providing bulk billed medical care in this community will make a huge difference to local people. We hope to see more of these clinics rolled out over time, but I am really pleased that Batemans Bay will be one of the first. The Albanese government is going to continue to work hard to improve health services and health outcomes for regional and rural communities like ours on the New South Wales South Coast. This bill today is so incredibly important. We need to incentivise more doctors into our communities, and I say to any studying doctor or nurse practitioner, if you want a free degree, why not come and live on the sunny South Coast? We have beaches, mountains, valleys, even a rainforest, and we have the best community in Australia. We will welcome you with open arms, so give us a shot. I commend this bill to the House.