RURAL MEDICAL WORKFORCE
March 23, 2011
Mr CHESTER (Gippsland) (7.17 pm) — I rise tonight to urge the Minister for Health and Ageing and the Prime Minister to listen to the concerns of the Rural Doctors Association of Australia, which continues to highlight the very real crisis in the rural medical workforce. This week I, along with other members in this place, met with representatives from the Rural Doctors Association and discussed a range of policy initiatives that are required to provide regional communities with a fairer and more equitable health service. I believe the discussions that we had today at the breakfast hosted by the RDAA were very useful and allowed for a good exchange of ideas between the medical professionals who are at the coalface in terms of the delivery of health services in our rural and regional communities and members of this place who took the opportunity to talk with the doctors—many of whom have many decades of experience. In fact, one of the big problems is that we have an ageing medical workforce in regional communities and there is a need for a succession plan to encourage younger health professionals to set up practice in our regional communities. It is a challenge not only faced by this government but also faced by previous governments. It is a very significant issue right across regional Australia.
The Nationals believe that regional health deserves a higher profile in the overall health policy of government. When health policies are being made, we believe there should there be a dedicated regional health minister in the cabinet to stand up and fight for country communities. We also believe there needs to be an overhaul of the regional incentive programs to attract and retain health professionals in rural and regional communities. The current system of using the Australian Standard Geographical Classification Area simply does not work for many of our regional towns. The system has created some quite unusual anomalies where small regional towns like Sale and Yarram in my electorate are placed in the same category as some of the outer suburban areas for the purpose of calculating any financial compensation or incentives for doctors. I believe there needs to be a better targeted system of payments which rewards doctors and other health professionals who move to some of the more difficult to service areas and then choose to stay there.
If we are serious about attracting and then retaining doctors in these communities, particularly Australian trained doctors, in rural practice, we need to provide better incentives among a range of other measures which add to their whole experience of living and working in a regional community. We also need to make sure that we are providing opportunities for students from regional communities to actually achieve the marks to go on to study medicine. It has been proven over many, many studies that students who have some origins in a regional community are more likely to come back and practise in those communities in the future. It is a very important issue, and I am sure other regional members on both sides of the House are well and truly aware of the fact that we do have a crisis in the rural medical workforce.
These views are consistent with the Rural Doctors Association of Australia and its plans to improve access to health services in regional Australia. I refer to the RDAA budget submission to the Treasurer, where the organisation highlights the concerns it has with current policies and emphasises the need for decisive action to overcome the current crisis. In his letter to the Treasurer, the president of the RDAA, Dr Paul Mara, referred to areas where ‘the current policy framework is failing to meet the needs of rural and remote communities’, and he says:
This need is reflected in the health status of people in these communities, the considerable underspend in Medicare in comparison to metropolitan areas, ongoing difficulty in attracting doctors and other health workers to these communities.
In his submission, Dr Mara says:
If we are to improve the much poorer health outcomes in rural and remote communities, we must build a sustainable rural medical workforce and viable practices that can support better access to primary health care/ general practice and local secondary (hospital) services. The key elements of sustainability are:
(i) Professional issues including training, skills and qualifications of doctors and local professional supports to enable doctors and their families to have adequate leave for study and recreation;
That is a key issue in making sure that the experience for a doctor in a regional and rural location is a positive one—that they are not forced to work ridiculous hours and always be on call but that they actually have a quality of life in our regional communities. The other key elements of sustainability for our regional workforce were:
(ii) Structural issues including practice infrastructure and business structures that support private investment in health to complement public investment; and
(iii) Ensuring that the higher level skills, commitment and responsibility of rural practice is adequately reflected in the economics of practice—
so that they can get a good return from their business.
I agree with Dr Mara. Regional Australia makes an enormous contribution to the wealth and prosperity of our nation, and regional people deserve a better deal with it comes to health services. Investment in rural health is not just an investment in doctors or even the health of individuals; it really is an investment in the health of our entire economy.\
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