Protecting Rural and Regional Health Services Adjournement Speech

24 February 2020

Tonight, before the Senate, in this adjournment speech, I express some significant and deep concerns for the provision of health services to people in regional communities across Australia. There are communities that have been affected by the Morrison government's recent changes to the classification of rural, remote and metropolitan areas, and the effects are certainly coming home to roost in my home state of WA. These changes mean that many communities in regional areas will now be classified as metropolitan. This impacts on the ability of GPs to bulk-bill and on incentives to recruit general practitioners to regional communities. It should be of concern, to our nation and to senators here, to know that these changes have meant that the rate of bulk-billing in these communities has declined by some 34 per cent. These changes put at risk the practice of bulk-billing, which a great many GPs do for children and pensioners. Many of the areas affected are low-income areas. GP clinics have said that these changes will force them to stop the practice of bulk-billing or in some cases—most horrifyingly—to close completely. And in some of these communities there are no alternative general practice clinics.

Tonight, in raising these concerns about the government's changes to bulk-billing and GP incentives, I highlight the concerns for the Mandurah and Pinjarra communities in the Peel region of Western Australia. Anyone who knows the Peel region knows that the Peel is not Perth. The communities of Peel are fiercely regional, and they very much have a regional character in terms of their access to services. They're not communities that have the same access to services as Perth's metropolitan area does. For example, Pinjarra is an hour's drive away from the closest tertiary hospital—it will take you two hours to get there by public transport—and it is some 20 minutes drive from the nearest emergency department. I'm horrified to see that these changes have meant that a GP practice in the town is at risk of closing.

Everyone living in regional communities will know the importance of their local GP. They're almost part of your family. They know you. They know your relatives, your friends. They know almost everything about you. You share some of the most frightening moments of your life with them and you share some of the best moments of your life with them. They are integral members of the community. When you're faced with the loss of a person like that, a community resource, you are understandably going to be significantly upset. One of those community members, Vena, whose local GP is in Pinjarra, has said that the stress of losing her local GP could only further impact on the deterioration of her health. She has shared that this GP practice is vital to her and to the local community.

It's not just the community that benefits from these arrangements. Doctors who are training to be GPs also benefit from practising in regional areas. Sonia Miller, who is the WA General Practice Education and Training chief program officer, has said to the ABC in relation to these changes:

Working as a GP in training in Nedlands is very different to working as a GP in training in Peel.

Training in regional communities like the Peel region south of Perth gives these doctors a really good training environment. They're exposed to people from all walks of life—something that Nedlands certainly does not emulate. The problem is that these changes to bulk-billing incentives mean that these regions are at risk of losing these registrars. I understand that this is based on new data about better targeting health services in our regional and remote communities; however, what we need to understand in this place is that Medicare data shows that bulk-billing in regional, rural and remote areas is falling, so moves like this are absolutely counterproductive. I want to know if the government has considered the needs of these communities when making these changes, because it's abundantly clear to me that they have not. These communities have not been consulted before these changes have been made.

The issue is that this is not the first time under this government that the Peel region has been given the rough end of the stick when it comes to being considered a metropolitan area. The region has not been eligible for grants under the Building Better Regions Fund, meaning these communities are missing out on potential funding for much-needed infrastructure. Places like Pinjarra are, in fact, small country towns. They have lower incomes per household. But where has the local member, Mr Andrew Hastie, been when it comes to these issues? Each time the Peel region has been excluded or penalised by this government, one of their own, Mr Andrew Hastie, as the member for Canning, has said he would work with the community to fix this. He has not fixed any of these problems. His voice has not been heard on these bulk-billing problems. He has not fixed the regional recognition for the Peel region when it comes to infrastructure funding. Peel is sick of being treated like Perth's poor cousin by this Morrison government. I call on the government to stand up for Medicare and regional health services, which they are failing to do. It is only the Labor Party that has the capacity and the commitment to stand up for Medicare and regional health services.