Andrew Gee

I move:

That so much of the standing and sessional orders be suspended as would prevent the private Members' business order of the day relating to the Doctors for the Bush Bill 2024 being called on immediately and being given priority over all other business for final determination of this House.

This bill needs to be debated urgently. There is a crisis unfolding in rural and regional Australia. It's a health crisis. It's a disaster unfolding before our eyes, and its consequences are absolutely devastating. This is an urgent matter. My Doctors for the Bush Bill actually does something about this.

All over central-western NSW and around country Australia, doctors are leaving the bush and they are not being replaced. Around the Calare electorate, the rural doctor shortage crisis is being felt in communities big and small. Gulgong had four doctors but now doesn't have any doctors at all, and this is putting pressure on larger towns like Mudgee. It has two medical practices and they are both no longer accepting any new patients. Practices in communities like Canowindra and Molong have also lost doctors and they are also closing their books to new patients or adopting a locals-only policy for appointments. In Wellington, it now takes two months to see a GP. The impact this crisis is having on the health of country people is very concerning and very shocking. It was only recently that I spoke to one local doctor, who said that they recently met one patient who had advanced cancer and had not been able to get in to see a doctor and had therefore missed out on vital treatment.

The rural doctor shortage crisis has been made much worse because country areas no longer have priority for overseas trained doctors. Before July 2022, if an overseas trained doctor or international medical graduate, as they are known, wanted to practise in Australia and bill Medicare they had to work in a country area for 10 years, unless that was reduced because they worked in more remote areas. These country areas were and still are known as distribution priority areas. For many rural areas, this policy was a lifeline, providing badly needed access to GPs and basic medical services. But all that changed in 2022 when the Labor government upended the Distribution Priority Area system and, for the first time, allowed outer metropolitan areas to become distribution priority areas.

For the Australian public tuning in now, all parts of Australia are classified according to what is called the Modified Monash Model. There are seven categories, ranging from MM 1, which is a major city, to MM 7, which is very remote. Previously areas MM 3 to MM 7 were distribution priority areas. To give people context, large regional centres like Bathurst and Orange are classified as MM 3; Lithgow and Mudgee are MM 4; Molong, Gulgong and Canowindra are MM 5. The government has now declared MM 2 areas as distribution priority areas, therefore destroying the priority for overseas trained doctors that country areas once had. This means that areas such as Fairfield, Hornsby and Warringah and the outer suburbs of Sydney and Melbourne now have the same priority as country areas for overseas trained doctors.

When you look at the map, it's quite clear that the whole state of New South Wales is basically one big Distribution Priority Area except for the inner suburbs of Sydney. People in the country cannot understand how this could possibly be, but the Doctors for the Bush Bill, which I introduced today, remedies this blatant unfairness by restoring the priority that country areas should have by legislating that Modified Monash Model areas MM 1 and MM 2 can't be classified as distribution priority areas. It will mean that country areas and country Australia once again has priority for international medical graduates. This restores the Distribution Priority Area system to that which existed before the last election. I would therefore expect that every single coalition MP would be lining up to support this bill. It will be very telling if they don't, and I would be very surprised and disappointed if their support isn't forthcoming.

In terms of the urgency of this matter, you only need to speak to the residents of the Calare electorate to hear what they have to say about the urgency of this issue. Carlo Nazeti writes:

A lack of consistent GP services has left many residents in distress. For example, some have shared their experiences on social media of running out of critical medications, such as thyroid medication, because local doctors are either unavailable or not accepting new patients. This level of neglect is putting lives at risk, and it is unacceptable in a country like Australia.

Mr Nazeti also writes:

It is critical that the government steps in to address this crisis before more lives are put at risk.

I have received correspondence from Ian Marsh, who is the president of the Gulgong RSL sub-branch. He is worried this shortage will mean, and he puts it bluntly, that people will die:

… from not being diagnosed or treated for conditions if they cannot get a GP appointment or a misdiagnosed through telemedicine or a subject to haphazard management of chronic conditions through lack of continuity of care.

He says:

I am sure you would not accept this in your home city or town and nor would you like to see your loved ones being treated in this system.

Helen Chisholm has written to me. She has said that she spoke to a local doctor in the Mudgee area and:

… he advised me that the GP shortage is now putting extra strain on the Mudgee Hospital as many people can no longer see their GP in a timely manner, if at all.

And it does not stop there. Sue Stanmore has written to me. She said:

I'm writing to you in regard of the sub standard health system we have here in the Mudgee District.

She goes on to state the surgeries in the Mudgee area have 'closed their books' and:

… Gulgong has no Dr's at all. With the growing community what are we expected to do, it's a joke in this day & age.

This highlights the urgency of this matter and of addressing the rural doctor shortage crisis. There is a Change.org petition we have started, which already has 13,000 signatures or thereabouts, which basically calls on the government to end the rural doctor storage crisis. So this bill that I have put into the House today is very important, because it actually takes action to do something about it.

As I said to this House earlier today, it's predicted that, in Australia, we will be short 10,600 GPs by 2031. At the same time, demand for GP services is expected to increase by 58 per cent over the next decade.

There is a fundamental unfairness and inequality in access to health services in this country. Out in the Central West of New South Wales, we call the Great Dividing Range the 'sandstone curtain', but it is a great divide in so many other ways as well. We need to actually take action, because the cold hard truth is that the further away you live from the city the shorter your life expectancy will be. That's the truth of the matter. With close to one-third of the Australian population living in the regions, how can this possibly be? The answer is simple: country people have less access to doctors, such as GPs, who are often the first point of contact when someone feels sick or has a health problem. This crisis is adding more strain onto an already overstretched hospital and emergency department system. We need to take action on it straightaway.

I commend this motion to the House, and I commend the Doctors for the Bush Bill 2024, to achieve better health outcomes for country patients. This situation is urgent. It's at crisis point, and it's critical that the House deals with this issue without delay.

Maria Vamvakinou

Is there a seconder for the motion?

Bob Katter

Yes, I second the motion. It's not entirely germane to what we are proposing here, but there were three Katter boys—my father and his two brothers. Their parents had gone out to their region in a stagecoach in the 1870s. Two of the boys died as a result of the tyranny of distance. My uncle was injured in a football match—and this is where the story does not really pertain to doctors in the bush. By the time the Qantas aeroplane—and my grandfather was a major shareholder in those days—came back from Longreach to Cloncurry and then took him from Cloncurry to Brisbane, it was too late. Sadly, he died. If the aeroplane had been at Cloncurry, he'd have been alright. So he died as a result of the tyranny of distance. My father had cancer. He should have gone down for the operation, but the airline strike came. He wouldn't jump the queue and he was in no condition to drive down. By the time he got down there, 3½ months later, it was too late; the cancer had got away. So he also died as a result of the tyranny of distance.

There are people dying every day in Australia because there is no local doctor. The actual statistics that were done some years ago indicated that, where you've got a thousand people in a town without a doctor, there will be a death once a year. So there's an actual figure that we can put upon this.

The honourable member quite rightly pointed out, when he moved to call on this legislation, that—and I could not believe this—when the very special help was given to country areas to help them to attract doctors, that included Cairns! It's one of the most salubrious places in the world to live. And it's isolated? Heavens! If Cairns is isolated, God help the rest of Australia! The honourable member is pointing out that most of Sydney is in the same category as far western New South Wales. How can that be? The government, whatever government it was, with good intentions, moved the legislation, and some serious lobbying by vested interests got them to change the legislation. So the minister quite rightly brings his attention to bear upon this fact.

For six or seven years of my life, I carried the names of six doctors around with me because, every time we lost a doctor in Julia Creek, I would ring up England or, I don't know, America. There was a place in the Middle East where a doctor was available. He's a good bloke. I had six doctors overseas that I could call to come in because I was determined that Julia Creek would not be without a doctor. Julia Creek had over a thousand people in those days and now it's got very much under a thousand people. One of the reasons people leave is that there are no doctors there. Yes, they send a doctor out for four or five days a week from Mount Isa or Townsville or somewhere, but that's not having a doctor there.

In our day, though we didn't have many doctors coming through the Brisbane university, which was the only university in Queensland, those doctors were, for two years, bound to go where the government sent them if they wanted to become qualified to practise in Queensland. We should return to that. I wouldn't say for two years but I'd say for a year and a quarter. The government puts a million dollars into you. If you graduate as a doctor, the government has put a million dollars into making you a doctor, and it will give you the right to earn a squillion dollars a year. If you've got the right to practise as a doctor, you'll be a very rich person. If the government gives you that right and gives you a gift of a million dollars to get that right, then I think you owe something to the people of regional Australia.

I say regional Australia because it's not just the Julia Creeks that we're talking about here. We're talking about the Mareebas. Mareeba's only 30 kilometres from Cairns, yet their situation is grim. (Time expired)

Long debate text truncated.

Summary

Date and time: 1:19 PM on 2024-11-25
Allegra Spender's vote: Abstained
Total number of "aye" votes: 12
Total number of "no" votes: 64
Total number of abstentions: 75

Adapted from information made available by theyvoteforyou.org.au