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Home > Ministers > The Hon Nicola Roxon MP - Minister for Health and Ageing > Media Hub > Transcript of Interview with Ian Henschke – ABC 891 Adelaide - GP Training Places, Specialist Training Places, Health Reform, Mental Health

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PDF printable version of Transcript of Interview with Ian Henschke – ABC 891 Adelaide - GP Training Places, Specialist Training Places, Health Reform, Mental Health (PDF 52 KB)

20 May 2011

E&OE ONLY

Topics: GP Training Places, Specialist Training Places, Health Reform, Mental Health

Ian Henschke: We're joined by the Federal Health Minister, Nicola Roxon, to talk to us about health matters. I tried to get to a doctor the other day and was told I had to wait a couple of days to see my local GP. There are, I think, probably a number of people had to wait longer than that, so this is one thing that, on a personal level, I think people sort of worry about. They say are there enough GPs out there.

We spoke to the new president of the AMA in South Australia the other week when he took up his role and he said that's something that needs to be addressed. But on the positive side, a lot of people thought the federal budget did a lot for mental health, so there are brick bats and bouquets.

Good morning Nicola Roxon.

Nicola Roxon: Good morning.

Ian Henschke: Yes, this issue of access to GPs, this is something that most people, I think say they would like to see better access to GPs. Are you able to do anything about that?

Nicola Roxon: Look, we are. And we're actually already investing much more. We have 68 new additional GPs training in South Australia right now, as we speak, because we made a decision, when we were first elected, to remove the cap on the number of new graduates who could go into general practice.

So we're actually now - used to be a limit of 600 GPs being trained each year coming out of university. It's now 900 and it will go up to 1200 each year. All the advice we have is when we're actually producing that number of GPs each year, that we will be able to meet demand.

So it does take a long time to properly train a GP, but we're already partway through that process and you are starting to see some of the results, although I think the difficulty for many people, in many suburbs, it's still quite severe.

Ian Henschke: Well the AMA's a bit worried about the number of people being trained, who are from overseas. They're saying that's enough home grown GPs being trained. Are you addressing that issue?

Nicola Roxon: Yes, well those extra numbers increasing from 600 training places in a year, to 1200, that's all for Australian GPs. We do still rely on a lot of doctors from overseas, because for many, many years we haven't been able to be self-sufficient. We'd like to be able to turn that around and we are investing hundreds of millions of dollars to do that.

And, as I say, I think people are starting to see that change. We've been prioritising that those new training places go to the suburbs that are in short supply and inter-rural and regional areas.

Ian Henschke: Well in rural and regional areas, around 50 per cent of the GPs in the country are international graduates, so there's a real issue there.

Nicola Roxon: Absolutely, and that's why these extra training places that have started to increase two years ago and are gradually increasing each year, we're actually seeing that change. I mean I've been visiting places where they're training an Australian graduate for the first time in many, many years. And similarly we're doing that for other specialties like obstetricians and psychiatrists.

We, for the first time, are a Government that has said we actually need to have national health workforce planning. We need to know what number of doctors, or nurses, or mental health specialists we need. No government before us has tried to do that and every state and territory's had a different system. So we feel that our health reforms are really starting to put this particular need in focus. We're investing, as we go, to increase the numbers. But I know it's still very difficult for people. I know often getting into your GP, in a timely way, can be very difficult.

It's why we've also got some strategies like investing in GP Super Clinics, and also expanding existing general practices, giving them some money to be able to build on extra rooms that - for nurses, or perhaps for a trainee doctor. And that's all starting to flow through to the community as well.

Ian Henschke: Of course, we're hearing that we're going to have this boost in population of - all across Australia we're bringing in more and more people. Are you able to keep up with this, because we're ageing as well? I mean South Australia's got the oldest average population in Australia, so shouldn't we perhaps get a few more GPs here and in the light that we're supposed to be having a couple of million people in Adelaide by the middle of the century, how are you planning for that?

Nicola Roxon: Well, absolutely. We have to actually properly plan for work - for the projections, not just for now. We've been playing a game of catch-up, because - and I think, you know, Mr Abbott and the Liberal Party now admit this was a mistake putting a cap on - the people that could into GP training has had consequences long past the time that they made the decision to do that. We're turning that around by doubling those numbers of places. But we do need to plan properly for the future. No-one's ever tried to say what are the right number of doctors, what are the right number of nurses? So then planning with universities, with medical colleges, with the community has been very difficult and we are tackling that head on.

Ian Henschke: Yesterday, we had a situation here where the Ambulance Employees Association said that ambulance officers are being taken off the roads and having to work in the corridors of emergency departments, particularly the Flinders Medical Centre, because there's not enough staff in our emergency departments. Now you can wait a couple of days to see a GP, I suppose if it's nothing life threatening, but in an emergency department, this clearly isn't a good situation. What are you doing to ensure our emergency departments are properly staffed?

Nicola Roxon: Well what we're doing at the federal level, because we are responsible for the number of training places and the specialists that can be supported, is again investing, as part of our billions of dollars of new money going into workforce training, more for emergency doctors and nurses as well. The particular issue, at any particular hospital, obviously is still a decision for the state government.

Ian Henschke: Well this is the thing that people are confused about, and the public, because there was talk that the federal government was going to sort health out in Australia. That's gone by the by now hasn't it? It will be - so when something goes wrong, you'll say that's a state issue.

Nicola Roxon: No, it is an area where there's shared responsibility and our big reforms that have been finally agreed by all states and territories in February this year make much clearer who's doing what, how we put funding on a stable footing long-term. But it is right that the states will remain the managers of hospital services, although we're giving, in these reforms, much more responsibility to local doctors and nurses and get proper, sort of, input from our clinical teams in local areas as well.

But the reality is, in our federal system it is an area where there are shared responsibilities and we've tried, through these reforms, to make sure that the Commonwealth pulls its weight, but we also demand that the states pull their weight.

Ian Henschke: I'm talking to Nicola Roxon, the Federal Health Minister, on the Morning program this morning. If you've got a question, 1300 222 891, 1300 222 891.

John from Adelaide, you've got a question?

Caller John: Yes, good morning. Look, a member of our family is seeing a psychologist at the moment, and what actually happens is you need to see a GP to get what's called a mental healthcare plan, which gives you six Medicare-funded visits to the psychologist, and you can apparently go back and get another healthcare plan to get another six, so you get 12 for the year.

Now during the budget, there was talk about that being scrapped, and it got a bit unclear what was actually happening.

Ian Henschke: Well, it's straight to the minister.

Nicola Roxon: Thank you. We have made some changes, but you'll be pleased to know that there is still the process of seeing your GP, that will coordinate the care. We have adjusted the amount that a GP is being paid, because the evidence showed us that most of the consultations were not taking as long as had initially been thought they would take, and we're still paying for 10 consultations each year…

Ian Henschke: So it's 10, not 12?

Nicola Roxon: It's 10, not 12, but…

Ian Henschke: So that's been reduced?

Nicola Roxon: So that's changed, from the budget, but we also…

Ian Henschke: And according to the AMA, they're saying that you've taken $406 million out, from the GP rebates over five years, in the area of GP mental health care?

Nicola Roxon: Yes, that's right, but let me explain why, and I think the reason that we've seen only the AMA complain but not the divisions of general practice, or the colleges, or the psychologists, because as well as making that change, we are investing much, much more in some additional targeted programs, one to get to areas where Medicare hasn't been able to fund enough consultations in the past, so areas where there might not be as many doctors or psychologists or psychiatrists, we've put in several hundred million extra dollars, but also for the first time, invested for those people who have severe and persistent chronic mental health problems…

Ian Henschke: Well just on that point, just…

Nicola Roxon: …that make it a detailed package, which is not restricted by 12 consultations, or any such thing. So it is a bit - you need to look at the whole thing, because the changes are also picking up gaps that otherwise are in the existing system.

Ian Henschke: Right, well just on that one about people with persistent and long term problems, Ita Buttrose, who's the chair of the Alzheimer's body there in Australia, she spoke out saying that the Federal budget had really overlooked one of the biggest areas of mental health, Alzheimer's, what's the response to that, to that call by her?

Nicola Roxon: Well look, I'm absolutely looking forward to working with her in her new role as the head of Alzheimer's Australia, and Minister Butler, the Minister for Mental Health and Ageing, and one of your home-grown, Adelaide MPs, was actually at the conference with Ita, and has been talking with the community very closely, about…

Ian Henschke: So will you make that an area of priority in the next budget, or are you going to direct some of this mental health funding, the $5 billion, into that area?

Nicola Roxon: I t's already an area of priority for us, and some people with particular illnesses, including Alzheimer's, will be able to benefit from this package.

But more importantly, when we are dealing with the aged care reforms that will be part of next year's budget, the Productivity Commission report is underway, this is clearly an area that fundamentally overlaps with that, and Mark has been working closely with many stakeholders to make sure those issues are part of the reforms that will be focused on for next year's budget.

Ian Henschke: I'm talking to Nicola Roxon, the Federal Minister for Health, it's just on a quarter past nine, if you'd like to call us, it's 1300 222 891.
Chris has called in, and he's concerned that mental health nursing no longer exists, it's not recognised at all by the new National Registration Board, and this means there are, or there can be, unqualified people working as nurses in mental health. Is this something that will be addressed at a Federal level?

Nicola Roxon: Look, our budget hasn't made any changes at all to the support that's provided for mental health nurses, in terms of removing any entitlements or benefits, so I'm not sure if your caller is talking about changes that came about from national registration, I'd have to take that one on notice, but it's certainly not something that the government has made any sort of Act change to try to remove their benefits, or entitlements, or recognition.

Ian Henschke: A call regarding access to GPs, let's go to Phil Palmer, Phil has called in, good morning, Phil.

Caller Phil: Good morning.

Ian Henschke: Yes, your concern?

Caller Phil: My point is, following on from the issue you raised earlier on about the problems in ED at Flinders, one of the contributory factors to that is that so many people who could go to a GP, actually present at ED departments, because - in the case of down south, there's just not enough GPs, so in the absence of easy access to a general practitioner, people rock into the ED, and then block other more urgent cases from coming through, because they're filling up the waiting room.

Ian Henschke: Phil Palmer's the secretary of the Ambulance Employees' Association, minister, to give him some hope?

Nicola Roxon: Well we agree with Phil on that, we're on the record as saying we've got to do more to make sure that people can get the care closer to home, and don't need to go to emergency departments, there are obviously many times when people do need our ambulances and emergency departments, but we're dealing with this comprehensively, it's training more staff, it's giving hospitals stable funding for the future, it's implementing from 1 July our GP hotline, so more minor issues can be dealt with on the phone, talking to a nurse or a GP, you know, we have to approach this from a lot of different directions, to make sure that people can get the health advice they need, as early as possible in any illness.

Ian Henschke: Let's go to Ron, from Brooklyn Park. Ron?

Caller Ron: Good morning, Ian, minister. I had cause about a month ago to be taken to Flinders by ambulance. Now they did what they call the admission, I think it's called lockdown, and I could not get into Flinders until half-past-one in the afternoon. Now the drivers had to pick me up, and take me on a scenic tour, before they could get to the hospital so I could get in at half-past-one. How ridiculous is that?

Ian Henschke: Nicola Roxon?

Nicola Roxon: Well obviously I can't answer questions for a particular patient's experience with an ambulance, I know that we have very hard-working teams, both in our hospitals and in ambulance services, but I'm simply not in a position to explain what's happened in a particular instance.

Ian Henschke: Well, it's clearly an issue that's been going for some time down at the Flinders Medical Centre, so if there are going to be some issues there, you're saying they're state-related?

Nicola Roxon: Well look, any direct example for a particular person I don't think your listeners would expect that as Federal Health Minister I'm going to know the situation for every patient that goes into each of our several hundred hospitals every day, in fact there's, you know, 750 public hospitals across the country, I think that people want to know that at a local level, they can get the care that they need.

But part of fixing this problem is making sure we've got the right workforce, we've got the right funding available, we've got support for people to get more information through their GP, or on the telephone for that matter, and we think all of these different things, working together, will improve our health system.

It's never quick, it does take a long time to change things, when you've got to train people who can take up to 10 years to do their education, but if we don't make the decisions now, the situation will get worse. Instead, we're actually seeing it start to get a bit better.

Ian Henschke: Thank you very much for your time this morning, Nicola Roxon, the Federal Minister for Health.

Nicola Roxon: It's a pleasure.

Ian Henschke: We appreciate your time, thanks again.

Nicola Roxon: A pleasure.

Ends