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Interview with Monte Irvine from Breakfast with Monte on 2NZ, Inverell

Read the transcript of Minister Gillespie's interview with Monte Irvine from Breakfast with Monte on 2NZ, Inverell.

The Hon Dr David Gillespie MP
Former Minister for Regional Health

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MONTE IRVINE: I've been joined on the phone now by Dr David Gillespie. Dr Gillespie is the Minister for Regional Health for the Federal Government. Good morning, Dr Gillespie. How are you this morning?

MINISTER GILLESPIE: I'm great, Monte. Pleased to be with you, and hello Inverell. Great to be on the line with you.

MONTE IRVINE: It's great to have you here and thank you so much for taking the time to have a chat to us this morning. Now, the reason why we're talking is the Senate has an, has an inquiry at the moment into regional health - it's, it's sitting again this morning. And there was an article in The Inverell Times talking about getting submissions for the inquiry. What are you hoping will come from the inquiry, Dr Gillespie?

MINISTER GILLESPIE: Well, I'll follow it very closely. The issues around shortage of general practitioners and other medical professionals around regional Australia is well-known, well-researched, and we've got a lot of policies in place to redress the inequity.

It's not just a problem in places like Inverell, it's widespread. but we've made many advances in the time that I've been in Parliament.

Because, you know, before I was a politician, I was a doctor practicing for 33 years. And when I was in Port Macquarie, I came up to Inverell a couple of times for medical talks with the local GPs, and I've been back there with Wacka Williams and Greg Kachel and with Barnaby (Joyce) - it's a great part of the world.

But look, regional Australia deserves the same workforce that you get in the, in the metro areas. And that's the problem. There's a maldistribution of our medical workforce from doctors, through pharmacists, nurses, physios, midwives. And we are trying to redress this through a whole heap of initiatives I can take you through.

MONTE IRVINE: Alright. Well, as we know, it's not an overnight problem. It's certainly a problem that's been around for a while. A quick search of medical issues, or shortages in regional and rural Australia on the ABC website, news website, takes you back to articles back to 2007. It's not a new issue, it's an issue that's spanned both Labor and Coalition Governments. What has this current Government got in place to try and redress this?

MINISTER GILLESPIE: We have a whole suite of measures since 2013 that I've been involved in at various times. In 2018, we launched another $550 million Stronger Rural Health Strategy. Part of that was the expanding the Rural Health Multidisciplinary Training (RHMT) Program which gets med students, nurses, physios into rural clinical schools around the country.

In regional towns, we've expanded rural clinical schools into full end to end med schools in the Murray Darling Medical School Network.

We've got programs where junior doctors, when they're in a teaching roster, well they get out in their first couple of years working into a general practice.

Rural generalist is a type of doctor general practitioner who's working with advanced, skills like a GP-obstetrician, or a GP anaesthetist. I mean, Inverell has got several people that meet that criteria. We've been supporting training more of those.

We're in discussions with, not only the College of Rural and Remote Medicine, but also the College of General Practitioners to make sure that 1,500 cohort of general practice trainees gets the appropriate training.

But the big competitor is that it takes 12 to 16 years for a person to get through all the medical training - both their uni degree and then what's called their vocational training in a college-led second degree before they can hang their shingle up.

And a lot of things happen in metro Australia. And we've flipped the paradigm and making it that more of that 10 to 12 years of training, including your medical degree, then your Royal College degree is done in regional and rural.

And look, it took me 12 years before I hung my shingle as a gastroenterologist in Port Macquarie. So, I know if a med student went in in 2013, into university when I joined Parliament - and I've done three terms in Parliament - he or she wouldn't be finished yet. So, it's a long gestation.

When we make these changes the benefits take a few years to work through the system. But I've got many other plans in place, and policies we're working up, to make a material difference so that more people are attracted back into general practice and to general practice in regional and rural Australia.

MONTE IRVINE: What are, what are some of the barriers for these general practitioners to come to regional and rural Australia?

MINISTER GILLESPIE: Well, there's no barrier in getting a Medicare number - that's the first thing.

People have this idea that they're limited. No, they're unlimited. But some of the practitioners in rural Australia have been trained in overseas universities and systems, so they have obligations to practice in regional areas for 10 years, and they have a special Medicare qualification - and that might have factored into some of your discussions and news items.

But we're trying to improve that with a number of workforce, cash incentives and programs to keep people in regional Australia deliberate. Because they're competing against salaried jobs in big hospitals where you've got much less financial risk and responsibility and you can just turn up and be a doctor and collect a wage in a salary job in a hospital, as opposed to being a general practitioner where you run your own practice, you employ people.

You're a small business as well as being a doctor. And we're trying to make it better so that more people go into that general practice stream rather than hanging out in the hospital for the rest of their life.

MONTE IRVINE: Liz Hayes, the reporter for 60 Minutes, is due to give evidence this morning, or today, to the inquiry. What are you expecting to come from that?

MINISTER GILLESPIE: Oh look, there'll be many, many other people giving evidence. I'd be very interested to see what Liz has in her own personal experience.

Obviously, I'll be following the results and the depositions closely to see if I gain any insights.

But as the head of the Rural Doctors Association, Dr John Hall, said, we know what the problems are there. They're well, well documented. We've got lots of policies in place already which are delivering an extra 750 doctors and 700 nurses into regional Australia - we know that from the registration figures since we started our stronger rural health strategy.

It is delivering, but there's a big backlog of places that need a fresh cohort of general practitioners, not only just Inverell.

And as other people have said, part of the solution for country Australia is the hospital system, which the states run. And in Sydney you can be a general practitioner and never walk inside a hospital, but in a town like Inverell, you're working in your practice and you're working in the hospital.

So we've got to change, and I'm looking for partners in the New South Wales health system to get a better deal so that people feel that it's a rewarding career to work in a hospital as well as a general practice. And that's the sort of doctor we need in country Australia, and in country NSW in particular.

MONTE IRVINE: That's, that's a great point that you make there, Dr Gillespie. While you have the federal health system and the state health system, the two systems and the two, I suppose, ministers and departments need to work together. Are you finding that cooperation from the NSW Health?

MINISTER GILLESPIE: Look, I've got good lines of communication. but I've only been in the job for a couple of months and we are in the middle of COVID, so we've had our hands full. But I'm beavering away to get some really good policies out during this parliament so that we can shift the dial and address those things that I've just referred to - make it more attractive for general practitioners - back general practice as opposed to a salary job in a big hospital, either in a big city or in a, you know, major regional centre.

The maldistribution is the big issue. We're trying to redistribute all these wonderful doctors we're training into- more of them going into, you know, country towns, regional centres, and remote Australia.

MONTE IRVINE: Dr Gillespie, you mentioned COVID 19. Part of the terms of reference for this inquiry is the impact of COVID 19 on doctors or shortages in rural and regional Australia. As the Minister for Regional Health, what reports have you gotten back about the impact, say, in Dubbo and Bathurst and Orange, those areas with, with the pandemic and the outbreaks that are there?

MINISTER GILLESPIE: The biggest COVID effect has been the shutting of borders, which has prevented a lot of locum doctors from moving around where they normally do, that's probably the most immediate, and the same for nurses.

We have obviously got people who are willing to work, but if, you know, your state border says you can't cross over to Glen Innes or come down to Inverell and do a locum, well, you know who suffers.

It's not people in Queensland, it's people in New South Wales. The whole point of federation was that we got rid of these ridiculous state borders. And the sooner that we can get the vaccination rate up and get the state premiers to relax their rigid, sometimes irrational rules about the movement of people, the better.

MONTE IRVINE: Dr Gillespie, you mentioned there about the vaccination rates. Is it- with your, your hat on as a medical expert, is it a little bit frustrating for you to see members of your own party or government coming out with misinformation about vaccines and alternative treatments such as Ivermectin?

MINISTER GILLESPIE: Oh look, everyone's got a right to speak if you're in Parliament, and I might not agree with them, but they've got a right to speak. It's a misinterpretation of the explosion of information. Some of its high quality, some of is low quality. And even a person with a scientific medical background like myself, I have to question some of the things that you see on the internet.

Because it's on the internet doesn't mean its fact or it's taken in the right context. But Parliamentarians have a right to speak.

You mentioned Ivermectin. It has been used in humans and animals. But my one recommendation is, don't go buying stuff over the internet or going down to the farm supplies place to dose yourself up on Ivermectin.

Go see your doctor, get some clinical advice.

And the most important thing you can do to help yourself and help your friends and your family and get the business that you're working going again, is to make sure you're vaccinated.

Because that reduces the severity of the illness; reduces the chance of you spreading it; reduces the chance of your ending up in hospital; and, reduces the chance of you dying from it.

So that is my take-home message.

MONTE IRVINE: Fantastic. Look, Dr Gillespie, thank you so much for your time this morning. The current Inquiry into Regional and Rural Health is underway by the Senate. They are still taking submissions, if you're waiting to make submissions, up until the 30th of this month. And Dr Gillespie, I assume you are encouraging people to do exactly that.

MINISTER GILLESPIE: Yeah. Well look, the New South Wales Government has had an enquiry along the same lines - we've had inquiries onto it.

I've been working on it since I got into Parliament. And as Dr John Hall, the President of Rural Doctors’ Association said, we are making headway.

But I also pointed out that the gestation of policy changes to when you get a fully franked, you know, vocationally registered doctor, it is about eight to 10 years and up to 12. So, this workforce manoeuvring, we are trying to change the dial on, and we have already, but we can always do more.

MONTE IRVINE: Okay. Dr Gillespie, thank you so much for your time. You have a great weekend.

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