Monday, 18 October 2010
Private Members’ Business
Overseas Trained Doctors
The reason I have brought this issue to the attention of the House is that it has been causing great distress for a number of doctors in my electorate of Maranoa and I know across many parts of Australia, particularly in Queensland. My LNP colleague the member for Leichhardt, Warren Entsch, who is seconder of this motion will talk further about the particular case in Cairns in his electorate. But, for now, I will talk generally about the need to ensure that we provide our international medical graduates with the support they need to serve our rural communities. There is much concern that the current process to assess the competency of overseas trained doctors is discriminatory and that the process to approve registration for these doctors lacks transparency. Five years ago, the Australian Competition and Consumer Commission published a report into its review of Australia’s specialist medical colleges. The purpose of this review was to investigate whether Australia’s colleges were upholding the principles of transparency, accountability and stakeholder participation, and whether there was evidence of restrictive trade practices. The report of the ACCC mentions that the authority had received complaints about medical colleges and the perceived lack of transparency in their assessment processes. The report made recommendations to improve transparency and the provision of more information on how competency assessment decisions are made. Many of Australia’s colleges have moved to improve their practices. It has now been five years since that report was published and I think it is timely to conduct a parliamentary inquiry into the assessment practices of Australia’s medical colleges so that we can see what has been improved and what needs further improvement, particularly in relation to transparency.
Another complaint that has been brought to my attention is the inappropriate use of the pre-employment structured clinical interview, the PESCI, in assessing the competency of overseas trained doctors. Recent decisions made by COAG mean that the goalposts have changed and doctors who want to practice in Australia are asked to undertake the PESCI. However, there are complaints that the PESCI was never intended to be a pass or fail test of competency per se but, instead, was simply meant to be used to identify weaknesses and lack of knowledge in some areas and to identify areas needing improvement. However, there have been reports that some doctors are finding that they are passing their college clinical exams but failing the PESCI, which is administered by the Medical Board of Australia and a relatively new organisation, the Australian Health Practitioner Regulation Agency—AHPRA, which came into effect in July of this year.
For many doctors the goalposts have suddenly and dramatically changed. A recent example was the Queensland doctor from Lowood in the Lockyer Valley who was deregistered after failing his PESCI. He had been practising for six years and from the email I received over the weekend from one of his patients he is well-liked and well-respected. The decision is going to court so let us hope some common sense prevails. I also read in the Courier Mail last month of the New Zealand born nurse who has been refused her nursing registration because she must prove that she can speak English competently, despite being born in New Zealand and undertaking her diploma in nursing at a Gold Coast college. In this case, it seems that the bureaucracy has just gone mad and unfortunately it is impacting the supply of much-needed doctors and nurses, particularly in rural and regional communities.
I acknowledge that there is a lot of fear in some areas, particularly in Queensland, that has arisen from the tragic situation in relation to the Dr Jayant Patel bungle. We must find the balance between ensuring our registration processes and competency assessments are rigorous and ensuring our medical fraternity can provide the necessary support for competent overseas trained doctors to stay in Australia, and in particular work in our rural and regional areas. It should not be a case of one rotten apple ruining the whole barrel of apples. Another issue with the current problem of assessing overseas trained doctors is that the current visa process is not flexible enough to allow doctors to stay in the country while they appeal decisions that they believe are wrong. One such example includes an ophthalmologist on the Gold Coast who was originally given just 28 days after his registration was revoked to leave the country. Thankfully, he was granted a reprieve and his visa has been temporarily extended. But his future treating his patients on the Gold Coast is still very much in limbo.
I acknowledge that there has been a significant increase in the number of medical students currently being trained so that in the future we can meet the demand of Australia’s health needs, but it will be another decade at least before the supply will match demand. Until then, international medical graduates are vital in filling gaps. Even when we are turning out more doctors from our own universities, how many of these new graduates will want to move out of the cities and live and work in rural and remote Australia? Many constituents in my electorate of Maranoa rely on overseas trained doctors to provide medical treatment. Many of them are fully embraced by the community and they have become important members of the community. Like many Australian trained doctors in regional and rural areas, they work long hours and go above and beyond to help their patients. They are certainly treasured and we need more of them.
Sadly, however, in some communities in my electorate they cannot even get a doctor. Recently the Aramac community learned the sad news that their hospital would be downgraded to a primary healthcare centre after the community was unable, through Queensland Health, to secure a permanent doctor. When the people of Aramac learned the news, they were getting ready to celebrate the hospital’s centenary. The health minister for Queensland expects that the people of Aramac will now travel to Barcaldine, which is some 70 kilometres away, for their health needs. Yet, just three days after the minister announced the downgrading of the hospital to a primary healthcare unit—without consultation with the community, might I add—the road from Aramac to Barcaldine was cut off by flooding, which is the third time it has happened this year.
Unfortunately, issues like this are endemic in rural Australia. We do need more doctors in rural and regional communities. We need more support for our rural and regional hospitals. That is why I am calling for this inquiry. There needs to be a fairer go for doctors trained overseas so that we can get them to come out into rural and regional areas of Australia and practise where we know we have a massive and critical shortage. I know many Australian doctors. I understand why they train at university and obtain their degree. They are not encouraged to go out into rural areas of Australia. I understand that. I do not know why they do not like our rural communities but I understand that for so many reasons it is becoming difficult to attract Australian trained doctors to our rural communities.
I invite the Minister for Health and Ageing to give us the opportunity to conduct a parliamentary inquiry, as this motion calls for. The health needs of our communities right across Australia are an important issue. I have mentioned the Gold Coast, I have mentioned the Lockyer Valley and I have mentioned Cairns. I have also mentioned the lack of a hospital in the very remote community of Aramac in my electorate. Can I just say to the Prime Minister that if she is really serious about regional issues, as she said she was when she was sworn in and spoke about the need to focus this government on regional issues: here is an issue of regional and rural health. I call on the minister to give us this inquiry. I also say to the health minister that if she came to Aramac she would be made most welcome. I will make sure that I am there to welcome her. I think we can do a lot with this hospital. I think that if we are able to get a multipurpose health service that would fit Aramac it will be a model that we can use in other parts of Australia. Currently the multipurpose health service criteria mean you have to have a full-time doctor. Let us try to find a way to get a model to fit this community, because one size does not fit all.
I look forward to the minister’s response and I look forward to other contributions. This is an important issue. It is about the health of rural and regional Australia. It is about overseas trained doctors, who are a vital part of our health needs in Australia. I look forward to the support of this parliament.