*Check against delivery*
I want to thank the organisers of the Rural Medicine Australia Conference and all the staff who have worked tirelessly to bring this forum together.
I would also like to acknowledge:
- National Rural Health Commissioner Professor Ruth Stewart
- ACRRM President Dr Dan Halliday
- Newly appointed RDAA President Dr RT Lewandowski
- RDAA Immediate Past President Dr Megan Belot
- AIDA President Dr Simone Raye
- RACGP President Dr Nicole Higgins
- Chair RACGP Rural Council Professor Michael Clements
FIRST NATIONS HEALTH
I’d like to begin by acknowledging the traditional owners of the land on which we meet and pay my respect to elders past, present and emerging. I extend this respect to any First Nations people who are joining us here today.
I also acknowledge the result of the Voice referendum last Saturday and the mental load that many Aboriginal and Torres Strait Islander people have carried in the debate.
It was not the result the Government had hoped for, but it was a clear result, delivered by the Australian people, and we accept it.
Our determination to improve the health outcomes of First Nations Australians is unchanged.
There are many health challenges that unarguably impact Indigenous Australians differently, particularly those living in rural and remote communities.
The health disparity between First Nations Australians and non-Indigenous Australians is a gap which we remain determined – working alongside you, and alongside First Nations communities – to close.
Solutions for patients. That is what our government is focused on.
We know that to find the best solutions in health care, we need to start with access and affordability to primary care.
This Australian Government is committed to closing the city-country divide that has deprived regional, rural and remote Australians of quality health care for far too long.
A key initiative is our investment of $3.5 billion to the bulk billing incentive to address the sharp decline in bulk billing rates over recent years.
This move – long overdue – will make healthcare more affordable for 11.6 million children under 16, pensioners and other Commonwealth concession card holders.
Consistent with the existing rural bulk billing incentives, the new incentives will be scaled and increase for patients who live in regional, rural and remote communities.
Critical to this working is a collaboration between practitioners and government.
Our job is to give you tools that you need to provide affordable, accessible and importantly quality care.
This investment in bulk billing is exactly that.
It will do many things.
Here in Tasmania, GPs have told me that it will support them to return to bulk billing or start mixed billing.
A GP practising on the South Coast of NSW told me for the first time in a long time she felt optimism about general practice.
But ultimately what it will do is make health care more accessible and affordable for vulnerable Australians.
Easing cost of living pressures is a fundamental part of the Government’s overall strategy – and health costs are a big player in that space.
Tripling the bulk billing incentive is the largest investment in bulk billing in the 40-year history of Medicare.
In 12 days, on November first, the tripling of the bulk billing incentive comes into effect, as does the indexation of the Medicare Rebate.
Here in Hobart or just down the road in Launceston, this means that the total payment a doctor receives for a standard bulk billed consult will increase by around 50% - to $72.80.
In the most remote parts of Australia that increases by more than half, to $81.05.
Doctors and patients have been calling for this change. We’ve listened and we’ve acted. We’ve given general practice the tools that they need to do the important work that they do.
EDUCATING RURAL DOCTORS
But of course, doctors can only bulk bill rural and regional patients if there are doctors living and working in rural and regional Australia.
It is no secret that we face workforce challenges in this country. But more than that, we face a distribution problem.
Not enough doctors, and importantly not enough GPs, are working in our regions.
Time and time again government of all levels have tried their hardest to attract city trained doctors to the bush.
The unfortunate fact is that medical professionals educated in Carlton, Victoria are not moving to Carlton, Tasmania.
The health care divide between our capital cities and our country towns remains stubbornly wide.
Today a woman who lives in the most remote parts of Australia can expect to die 16 years earlier than her city counterpart - that is before we even begin to talk about quality of life.
That is unacceptable, it has to change.
Where a person lives, by their choice or their circumstance, should not determine their quality of health care, or the quality of your health.
Since the formation of Medibank by the Whitlam government in the mid-1970s, equitable access to healthcare has been a key part of our national identity.
It is part of our belief that no matter who you are, where you come from (or where you are going) you deserve the best care possible.
But it isn’t working.
Over the past few months, I have travelled to Townsville, Cairns, Wagga Wagga, Orange, Burnie and Bathurst.
In each of those places I have met with outstanding young medical students from the regions working hard to give back to their communities.
They have all told me the same thing, that they want to study, live and work in rural and regional Australia. It is the kind of work that health care professionals are desperate to do.
The diversity in opportunity, in which the only thing you do know for certain is that you can expect the unexpected.
It is tough work, but it is also the most rewarding because you can see first-hand the real impact that your service is having not just on your patients but your community as well.
Our job is to give rural students that opportunity.
It is why we are boosting the number of Commonwealth Supported Places in our Rural Clinical Schools by 100 starting next year, and importantly making universities match that commitment.
We are also providing much needed funding for infrastructure for those schools so that they can provide the very same education that is available in Melbourne, Sydney, Brisbane or Perth.
And as announced in January we are working with the Tasmanian Governments to make it easier for Tasmanians to see a doctor by delivering an innovative four-year single employer program to support stronger rural healthcare in the state.
Under the program, GP Registrars, including Rural Generalist trainees, will have the option of being employed by the Tasmanian Health Service as salaried employees, allowing them to do their final placement in GP practices across the state instead of changing new employers with each placement of 6 or 12 months.
By providing GP Registrars with guaranteed income and entitlements such as annual leave, parental leave, sick leave and other remuneration and benefits received by doctors working in hospital settings, the single employer model (SEM) will make working in rural and general practice more attractive and improve recruitment and retention of GPs in rural communities.
This will give medical graduates the best opportunity to build their careers while supporting our medical workforce in rural areas, making it easier for Tasmanians to see a doctor.
This is a model that has worked in its previous trials, we know it offers the security that many young doctors are after, and it provides a sustainable pathway to increase the number of rural GPs and highly skilled Rural Generalists across Tasmania.
Up to 20 GP Registrars will work across the state in regional, rural and outer metropolitan areas of need.
We’re getting on with the job of reducing the city-country health divide. It’s not going to be easy – it won’t happen overnight – but working together we can make a real difference.
You are all a part of making that a reality.