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Friday, 12 June 2020
Page: 4066


Mr COULTON (ParkesMinister for Regional Health, Regional Communications and Local Government) (10:06): I move:

That this bill be now read a second time.

I am proud to introduce the Health Insurance Amendment (Continuing the Office of the National Rural Health Commissioner) Bill 2020, which amends the Health Insurance Act 1973 for the purpose of continuing the Office of the National Rural Health Commissioner (the office) and strengthening its functions.

Improving rural, regional and remote health, including through access to health professionals and primary care services is an integral priority for the government.

Our health system is one of the most successful health systems in the world. Like all systems though, it is not without its challenges.

In Australia our challenge is not about having an undersupply of doctors, but about getting an equitable distribution of doctors to where they are needed most—outside of our capital cities and into our regional, rural and remote communities.

The government is committed to tackling the challenge of getting doctors, nurses and allied health professionals to take up rural health careers.

Since 2013 the government has demonstrated its commitment by delivering a range of initiatives and program reforms which benefit the rural health workforce and the rural training pipeline.

We've increased funding to the Royal Flying Doctor Service, including supporting mental health and dental clinics. We've provided more opportunities to train rurally by funding the Murray-Darling Medical Schools Network and the Rural Junior Doctor Training Innovation Fund. And we've introduced GP telehealth for remote and very remote communities.

We've made changes to support more student, junior doctors and trainees to undertake training in rural communities, because we know that if you train in a rural area, you are more likely to stay in a rural area.

We've invested in the Stronger Rural Health Strategy, a $550 million package of reforms including incentives, targeted funding and bonding arrangements to meet the challenge of redistributing the workforce.

And in 2016, we made a commitment to establish a National Rural Health Commissioner office to support improvements to rural health policies and programs.

The inaugural commissioner, Emeritus Professor Paul Worley, has considered a substantial body of research and contributed analysis and recommendations, which has underpinned the government's decision to continue the office as a critical resource for government in developing future policies and programs.

Since its establishment in 2017, the office has delivered valuable outcomes, including brokering the landmark 'Collingrove Agreement' to develop a framework for the rural generalist subspecialty and providing advice leading to the $62.2 million investment in the National Rural Generalist Pathway.

More recently, the office has been investigating how we can improve access to allied health professionals in rural communities. The office has contributed a comprehensive review of the evidence for strategies to improve rural allied health access and quality, with work underway to translate the evidence into recommendations for reform.

I'd like to take this opportunity to acknowledge and thank Professor Worley for his leadership establishing the office, his energy and passion in performing his role, and his profound commitment to improving health outcomes for rural communities.

And that is why I am proud to introduce this bill to continue the Office of the National Rural Health Commissioner beyond 1 July 2020, when the office is currently due to cease.

Rural health is built on the commitment, the expertise and the courage of its workforce.

That is even more evident in today's climate.

There's no doubt that drought, the recent bushfires and COVID-19 has had a significant impact on our nation.

In response to it, we have seen that we have some of the most resilient and passionate people working in this sector.

The continuation of the role of commissioner, supported by a cross-disciplinary team, will provide the rural health workforce and communities with a dedicated office focused on the health needs of rural communities.

The office will support the development and implementation of government's health strategies and policies to ensure the needs of rural Australians are considered.

It will contribute to significant reforms already underway in the Health portfolio including primary healthcare reforms, the National Medical Workforce Strategy and consideration of the review of the Rural Health Multidisciplinary Training Program.

And it will be a key source of independent and impartial advice on opportunities to improve health service access and sustainability for rural communities.

The office will have a key role in strengthening the rural training pathway, considering innovations to achieve a sustainable and accessible workforce, and will have patient needs at the heart of its work.

In particular, the office will continue to provide advice and support on implementing the National Rural Generalist Pathway, a medical training pathway focused on providing general practitioners with advanced skills to better support the communities in which they live and work.

I want to ensure the office has a focus on delivering practical outcomes.

One of the early priorities for the new office will be to support the government's ongoing rural response to COVID-19 and to advise on the impact on the health workforce in regional, rural and remote communities.

The office will drive innovation, with a clear focus on supporting on-the-ground improvements. This will include an initial focus on working with communities experiencing chronic workforce shortages to co-design implementable primary-care models that respond in a targeted way to each community's circumstances. This will assist government to identify opportunities for practical trials, to be evaluated by the office.

In continuing the office, I have sought to ensure that the commissioner and his or her team will have a broader remit to support government in delivering better health outcomes for rural Australians including through supporting implementation of programs and in undertaking specific projects as tasked by the minster.

Additional functions relating to regional, rural and remote health are able to be conferred on the commissioner by legislative instrument. This will enable the commissioner to be tasked with taking a more active role in implementing rural health initiatives, delivering on-the-ground change to support communities.

As a member of a small rural community, I know how important our rural doctors, nurses, allied health professionals, and Aboriginal and Torres Strait Islander health workers are to country Australians.

In fact, in a rural town, there is a good chance that your GP also works in the hospitals administering anaesthetics or delivering babies.

That means that your nurses and allied health professionals are a critical part of getting day-to-day medical attention.

With this in mind and to deliver on the intent of taking a broader perspective on rural health, the office will incorporate non-statutory deputy commissioners, who will play a critical role supporting the commissioner and will enable the office to have expertise across a range of vital rural health disciplines.

Importantly, this breadth of expertise will mean the office brings a deep understanding of how different health professions work together to deliver the best possible services in our rural and remote communities.

Of course, a key role of the office will be to build and maintain strong relationships across the sector, so that government benefits from the insights, ingenuity and different perspectives on improving services for communities.

The office will be expected to take a patient centred and regionally focused approach, considering the needs of the communities, families and individuals that make up country Australia.

It's important that the office delivers for rural Australians.

To that end, the office will be reviewed after five years of operation to assess its effectiveness and achievements. This will be an important checkpoint to identify opportunities for improvement or confirm the appropriateness of the office's arrangements in areas such as its functions, operations and governance.

The outcome of this review will be tabled in parliament.

This government recognises the value of our rural communities and the special place they hold within the fabric of this country.

People living in these communities make an enormous contribution to our national economy, and to the culture and character of Australia.

Access to a quality standard of health care is what they deserve and are entitled to expect.

Rural and remote communities face chronic doctor shortages and higher burden of disease. In addition they have the ongoing impact of drought, the recent bushfires, and now COVID-19.

The government's action today means the Office of the National Rural Health Commissioner can continue a focus on the health needs of rural Australians, particularly in this time of pandemic.

This legislation will be a vital contribution to rural health policy in Australia.

This government looks forward to working closely with the office to ensure we can improve access to health services for all the men and women who call regional, rural and remote Australia home.

Debate adjourned.