Peta Murphy (Dunkley, Australian Labor Party) Share this | Hansard source

I start by joining others in this place in thanking all of the medical staff and people who have supported medical staff through the pandemic, from nurses doing COVID testing to the administrators helping the nurses as we go through the mass testing sites to have everyone registered for their testing; to the pathology service who have processed the tests; to the doctors, the nurses and the administrators in our hospital systems who have been under such pressure dealing with COVID; to the GP clinics and the people that work in those clinics, be they the GPs, the practice managers or the people at the front desk. You have been the front line of our fight against COVID and will continue to be as we open up. All of those people deserve the support of their government—not just words of thanks, which I'm sure are welcome, but the funding that's needed to make sure our public hospital systems can continue to operate not just for the sake of people who have COVID but for everyone else who needs to access a public hospital, which is often overwhelmed at the best of times and certainly has the extra burden of COVID. For the Medicare system, for the GPs who are now seeing people for their health check-ups, for their ongoing treatment, for getting the vaccine, sometimes then for treatment of COVID—their workload has increased. Sadly, we haven't seen enough funding guaranteed going forward to help these people.

The Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021 brings forward some changes that are welcomed, but it doesn't address some of the specific issues that Australians have in outer metro seats like my seat and my community of Dunkley and in regional and rural areas in accessing health care and, in particular, in seeing a GP.

Tightening access to regional bulk-billing incentives that the government has brought in is a policy from a Morrison government that's made regional GP shortages worse, and we feel those shortages in outer metro seats like mine; it's not just in the regions. There's also the impact of the government's six-year freeze in Medicare rebates and the decision back in 2014 to abolish Healthcare Workforce Australia, the consequences of which we are still feeling today.

This is the time that the government should be investing in Medicare and delivering more services to people, not fewer. October is Breast Cancer Awareness Month, and the Breast Cancer Network of Australia and other organisations dedicated to helping women and the smaller number of men who have breast cancer have been ringing the bell loudly and clearly for at least 18 months now about drop-off rates of women getting checked—having mammograms—and the consequences of later detection of cancers for survival rates and for the sort of treatment that you have to go through.

There is so much to be done in the healthcare system on top of COVID, and we can't afford a government that is not just asleep at the wheel but failing to look after people in their time of need. If we can't properly train up enough people to be GPs in Australia, if we can't devise a system that incentivises GPs to get to outer metro seats like mine, we're going to continue to be reliant on GPs coming to Australia from other countries. We've seen that something like this pandemic really impacts the ability for GPs to come from other countries. We welcome medical practitioners from around the world, and they bring so much to the profession and also to our community. We of course should continue to actively recruit people—the best and the brightest—from all different parts of the world to come and work in Australia, but we have to skill up Australians. We have to give Australians the opportunity to be the best medical practitioners that they can be.

We have to have a system that doesn't make it almost impossible for GP clinics in outer-metropolitan seats to recruit GPs. That's why Labor established a Senate Community Affairs Reference Committee inquiry into outer-metro, rural and regional GP and healthcare services. That inquiry is also going to consider the performance of programs such as the Bonded Medical Program. There is a crisis in outer-metro seats. There is no doubt about it; there is a crisis in being able to recruit and retain appropriately trained GPs. It is unfortunate that we have to have a Senate inquiry to push for reforms in this area. It should be something that is done as a matter of course by a good government, but it hasn't been done.

The inquiry happening in the Senate, I understand, has heard from numerous stakeholders. If you look at the committee's website, it says that some 40-odd submissions have been received so far. I thought that was a bit strange, because I made a submission on behalf of my community in Dunkley and it's not on the website. So my office contacted the committee today. Apparently there are so many submissions to this inquiry that they're overwhelmed trying to get them all up onto the website. So those 43 or so submissions that are on the website don't reflect the huge number of stakeholders, MPs, local councils, medical colleges, individuals and GP clinics who have made submissions. The point of this inquiry is not simply to hold an inquiry; it's to get practical, positive solutions to make sure Australians have access to quality health care regardless of where they live. I've made a submission on behalf of Dunkley, and I encourage everyone who lives this issue or is concerned about this issue to get engaged in the inquiry.

This issue was first brought to my attention shortly after I was elected in August 2019. Dr Chung and Lucina Wilk from the Total Care Medical Group in Frankston came to me. Dr Chung, 72 years young, wants to retire. He wanted to retire in August 2019 but he couldn't—and still can't—recruit enough replacement doctors to be able to do so. I've raised this issue with the minister and I've raised this issue in the parliament, but the barriers to employing doctors at Dr Chung's clinic remains and he continues to work. In November 2019 I met with Rachael Hatzopoulos, from the St Mary Medical Centre in Carrum Downs, because of the serious barriers to employing new doctors that that clinic and other clinics associated with it have been experiencing. Ms Hatzopoulos said to me at the time that it is a common problem across bulk-billing, outer-suburban clinics. It was then and it is now. Ms Hatzopoulos has put in a submission to the committee, which I helped her to submit.

Recently, I had a roundtable discussion with local clinics and Labor's shadow minister for health. Here is a summary of what was clear from that roundtable. As an MM1 location, the Dunkley electorate is not listed as a distribution priority area. From 2022, all doctors require a 3GA program placement; however, there are no programs available in the local area. The only program is the AGPT, which has been closed for several years in metropolitan locations. Health workforce certificates are not granted in MM1 locations, resulting in local clinics being unable to recruit an international medical graduate. Clinics with GP shortages have used locum doctors to fill the gaps, but these placements are only available after they've passed their FRACGP exam and for a maximum of six months. So patients and clinics are consequently subject to frequent GP changes, which is not good for people who need ongoing care. Multiple GP clinics with active patient lists of over 6,500 have reported having only one full-time doctor, with some part-time assistants to manage their patient load. Additional pressure is being put on hospital emergency departments. Patients who can't be seen by a doctor in a timely manner are being referred to hospital for primary care matters.

It's just not good enough. It's not good enough for my community of Dunkley and it's not good enough for people across Australia. We are constantly putting out a positive message to people to look after their health: engage actively in preventative health, go and see their doctor if they have concerns about anything, get tested and carry out courses of treatment in the way that they are prescribed to them. It's really, really hard for people in outer suburbs who rely on bulk-billing GP clinics if they cannot engage a GP to help them to do all of those things. It shouldn't matter what your socioeconomic status is. It shouldn't matter where in Australia you live. You should have access to superb, top-quality care and you should be able to get that care at a bulk-billing GP clinic. When the clinics in my electorate can't recruit doctors and can't get them to stay at their clinics, that undermines the care that is given to often the most vulnerable people, and it's not good enough. I call on the government to actively participate in the Senate inquiry, to look for positive solutions and to implement those solutions. It's actually urgent and it really needs to be done.

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