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Tuesday, 15 March 2005
Page: 116

Senator SANDY MACDONALD (8:20 PM) —I rise tonight to speak about a proposal to establish a collaborative rural medical school traversing three important regional universities in New South Wales. The University of New England at Armidale, Southern Cross University and Charles Sturt University are proposing that a rural school of medicine be established, which would traverse the three campuses, which are all involved in training allied health professionals at this time. The main motivation behind establishing a rural medical school is to enable rural students to study medicine in a rural setting. As a consequence of studying medicine in a rural setting, those students are more likely to remain in regional areas to practise. The statisticians tell us that, unbelievably, a student from a regional area has nine times the chance of returning as a professional to a regional area once they graduate.

Achieving this outcome is imperative, as rural and regional New South Wales and Australia are continuing to experience a shortage of doctors. In my own community of Tamworth, new residents to the town are being turned away from doctors surgeries because their books are full. We must do more to ensure that GP numbers increase in rural and regional areas. Any family coming to a large regional centre expects good primary health care. Tamworth gets by—it has terrific facilities and doctors—but, clearly in such a large regional centre, we can and must do better.

The three regional New South Wales universities of Southern Cross, Charles Sturt and New England have the formed a working party which is currently in negotiation with the Australian government to secure funding for a feasibility study to look into the establishment of such a combined rural medical school. The students of the rural medical school would not only receive their medical education at a rural university but also undertake clinical experience at rural health centres and general practices in rural and regional areas.

One of the driving forces behind this proposal, Professor Victor Minichiello, Dean of the Faculty of Education, Health and Professional Studies at the UNE, has said the initiative would be undertaken in a consultative manner with the input of the rural communities, stakeholder organisations and existing medical schools and health services—and note that I said the UNE is already in the business of training allied health professionals at this time. So this initiative would be catering to what the community needs and wants rather than the theorists telling the community what it should have.

A multipurpose campus approach for a rural medical school has already been adopted internationally in the United States, Canada and Thailand. In fact, the Naresuan University in Thailand—of which a delegation recently visited the New England area—has developed its own successful rural medical school to train doctors and other medical specialists for regional areas in Thailand. Thailand, which is a very much decentralised country with about 65 million people, has seen the need for a specialised rural medical school to meet the needs of regional residents in Thailand.

Thai academics and health officials are committed to a working relationship with the University of New England to provide assistance in getting a similar project under way in Australia. Academics from both Thailand and Australia have visited to compare problems and discuss the answers. A collaborative rural medical school would work in conjunction with the range of initiatives already employed by the federal government to alleviate the shortage of rural doctors, who are working overtime to meet the needs of rural and regional residents.

A number of initiatives have been commenced by the government. The Rural Health Strategy was announced in 2000 and it provided $562 million to improve access to health services for people living in rural and regional Australia. At the time, this was the largest rural health program ever announced by a government. The strategy included increasing funding for the number of postgraduate training places in rural Australia for general practice. Also, to build on that, funding was provided to place practice nurses in country doctors’ clinics, registrars were paid incentives to train in rural areas, and doctors who continued to practise in the bush and set up outreach services were compensated. The government has also brought rural medicine into the 21st century, with assistance for health services to establish online links with other medical professionals and educational facilities. This broadens the ability of medicos to reach remote communities and allows easier access to education resources.

The Australian government has been able to develop a number of scholarship programs and rurally specific study programs for medical students and other allied health professionals. There are three types of rural medical scholarships offered by the Australian government. The Rural Australian Medical Undergraduate Scholarship Scheme provides medical students from rural and regional Australia with $10,000 each year to complete a standard medical degree. While not bonded, these scholarships are reinforced through a rural mentoring program and membership of the Rural Health Club. There are 100 rural bonded scholarships provided each year, and they are awarded to medical students who undertake to complete a six-year stint at a rural practice at the completion of their degree. These scholarships are worth more than $20,000 a year. The well-known John Flynn Scholarship Scheme provides for 150 new scholarships each year, where students commit to a two-week placement in a rural or remote community each year for four years. There are also various other nursing and aged care nursing scholarships, along with rural pharmacy scholarships, aimed to entice health students to practise in rural and regional Australia.

The establishment of a rural medical school based between the three regional universities—UNE, Charles Sturt University and Southern Cross University—will also work in well with some of the already established rural health policies of the Australian government. One of the most important of these initiatives is the university departments of rural health. The Australian government has provided $117 million over four years for the university departments of rural health, which work in conjunction with various universities and hospitals to ensure that medical students obtain practical experience in a regional setting. For instance, the Tamworth Base Hospital is the location for the northern New South Wales UDRH and allows medical students from the University of Newcastle to experience country life and work. This outstanding facility is to be formally opened by Tony Abbott some time in early April. While the University of New England has some involvement in the UDRH, its alliance with the facility could be greatly redefined and increased if a rural medical school were established.

In my home town of Tamworth there is an initiative to establish a pilot program. The local division of general practice is setting up a centre to allow doctors to move to Tamworth and start practising without the hassle of setting up their own clinic. The Australian government has recognised the need for such a centre and has granted the division Regional Partnerships funding to assist in getting the centre up and running. It is through all these initiatives that the Australian government is helping to decrease the shortage of doctors in rural and regional Australia.

A rural medical school is the next logical step in this process. I think it should have been done long ago. We have initiatives to encourage doctors to relocate to and settle in regional areas. This would be further enhanced if doctors were trained in regional areas, hopefully from whence they might come. As I said, if a student comes from rural or regional Australia and is trained and schooled in the country, there is the unbelievable fact that they are nine times more likely to continue living and working in regional areas. We must encourage any proposal that promotes bringing services back to regional areas. This proposal has been backed by The Nationals in New South Wales, and I stand here tonight to put on the parliamentary record my support for such a proposal.

In conclusion, a post-conference communique from the National Rural Health Conference, which was held last weekend in Alice Springs, states that we must not only try and encourage an increase in the work force supply but also look at the way our medical practitioners are working to serve rural and regional communities. Being trained in those areas makes that an even easier task. I believe that medical students who are from the country, study in the country and stay in the country will be better able to serve country communities.