Assistant Minister McBride – speech at the Tasmanian Rural Health Conference in Devonport – 13 May 2023

Read the transcript of Assistant Minister McBride at the Tasmanian Rural Health Conference in Devonport, Tasmania, on 13 May 2023.

The Hon Emma McBride MP
Assistant Minister for Mental Health and Suicide Prevention
Assistant Minister Rural and Regional Health

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General public

Acknowledgements omitted.

Thank you for inviting me to attend this conference.

As someone who worked as a pharmacist in a regional community for many years, I know the important difference that healthcare workers can make outside of major cities.

Our rural, regional and remote communities are home to millions of Australians who deserve quality health care where and when they need it.

Sadly, the facts speak for themselves. The further you live outside of a city, the worse your health outcomes are likely to be.

Outside of our capital cities it is harder to get the care you need. It is too often out of reach or over budget.

Recently, the Royal Flying Doctor Service released their Best for the Bush, Rural and Remote Health Base Line Report.  It showed women living in very remote parts of Australia were likely to die 19 years earlier than their city counterparts.

It also found that those living in very remote areas are 2.8 times more likely to be hospitalised.

This Government’s challenge and my challenge as Assistant Minister for Rural and Regional Health is to turn this around.

For the first time in the history of Medicare the average gap fee for a standard consult is more than the Medicare rebate itself.

It's never been harder or more expensive to get in to see a doctor.

Less than 20% of medical graduates are choosing a career in general practices and only 2 in 10 of those are choosing to work in a rural setting.

So, we've got a very serious problem with the pipeline of new general practitioners to replace those who are retiring.

Doctors are saying that they are worried about the viability of general practice.

It’s clear that we need stronger Medicare so general practices can thrive and every Australian gets the care they need.

That’s why we are reforming Medicare so that Australians will have better access to affordable care, cheaper medicines and a stronger health workforce.

In the Budget we announced that we are tripling the bulk billing incentive for GPs. This is the largest increase to the incentive in the history of Medicare.

We are also raising the Medicare rebate for GPs. The largest increase of the Medicare rebate in 30 years.

This will transform our health care system.

In our major cities, it means a 30% increase in what the government pays for your bulk billed visit.

In rural areas and regional centres like Devonport, it is a 50% increase.

But we are not stopping at bulk billing.

We announced a comprehensive package of measures to rebuild Medicare. This includes, supporting health professionals to work at top of scope, expanding the nursing workforce, improving access to after-hours primary care, introducing MyMedicare to support wrap around care for patients registered with their local GP, providing flexible funding for multidisciplinary team-based models to improve quality of care, and investing in digital health including initiatives to support the digital sharing of pathology and diagnostic imaging information across the entire health sector.

Through these Strengthening Medicare measures, the Government is demonstrating its commitment to reforming primary care.

We are developing the MyMedicare system, which will come online from 1 October 2023.

It will strengthen and formalise the relationship between patients and their primary care teams improving their quality of care.

Building on this, in the Budget the Government announced an investment of $98.9 million to introduce an incentive and model of care that connects frequent hospital patients who have chronic conditions with a general practice.

This means these patients will receive comprehensive care in the community and keep them out of hospital.

Under this initiative, Primary Health Networks will work in partnership with Local Hospital Networks to identify patients with chronic conditions who are attending hospital more than 10 times a year.

This measure will result in more appropriate care and reduce pressure on hospitals.

This program will be scaled up to all 31 PHNs over 3 years from 1 July 2024, covering all regional, rural and remote areas in Australia.

This holistic care is vitally important for the people being treated as well as the health professionals working together. The patient will be the centre of their care.

There are 450,000 registered nurses and midwives in Australia, and we want them to be at the forefront of reforms to primary care. 

But, at the moment, Medicare does not do enough to encourage or enable them – or many other health professionals – to provide care.

Even if they have the training and expertise to deliver the care that a patient needs, they may be held back by a complex regulations and funding programs.

The Government will commission a Review of Scope of Practice.

We cannot build a more collaborative primary care system, or support practitioners to work autonomously, unless we are prepared to get rid of the red tape and outdated silos that prevent team-based care.

Australia’s nurses and midwives play a pivotal role in multidisciplinary care and we are doing more to support the primary care nursing workforce.

We are investing $1 million over 4 years in the Nurse Supervised Practice program to attract 500 registered nurses and enrolled nurses, who were previously registered, back to the nursing workforce.

We are also helping more nurse practitioners who are training and working in primary care.

This Budget will unlock the potential of Australia’s highly educated nurses and midwives to use their skills to provide more primary care. It funds, 6,000 clinical placements to provide nursing students with practical experience of primary healthcare nursing, 1,850 postgraduate scholarships to train more nurse practitioners and endorsed midwives, and $1 million in incentives to get 500 nurses back into the workforce.

And I’m pleased that the Nurse Practitioner Workforce Plan will be published soon.

It provides a set of actions to address nurse practitioner workforce issues and enhance the delivery of nursing care to the Australian community.

We are a Government committed to innovation and reform in the delivery of health care in rural and regional areas.

We have heard how GP and Rural Generalists Registrars moving between general practice and hospital rotations during their training often end up losing their entitlements.

This can result in many junior doctors opting to stay within the hospital system rather than taking up a career in general practice.

That’s why we are supporting the expansion of Single Employer Model across the country, including here in Tasmania.

Single Employer Model trials allow GPs, Rural Generalists and GP Registrars to be employed by a Local Health Network or other entity for the duration of their training.

The Tasmanian trial will support 20 GP Registrars throughout their training, providing a pathway to strengthen the long term general practice workforce across Tasmania.

We are also establishing more than 50 Medicare Urgent Care Clinics across the country.

As part of the Budget, 4 clinics will open right here in Tasmania.

Two will be in Hobart, one in Launceston and one in the North West region.

The new clinics will provide access to urgent bulk billed services and help reduce demand on our hospital system.

It will support greater access for Tasmanians to get the right care, in the right place, at the right time.

We know that our health care system is only as good as its workforce.

Educating, and training health practitioners outside of major cities is the first step towards a stronger regional workforce.

By maximising rural clinical training, students are far more likely to choose to practise in rural and regional communities.

When you spend an extended period of time in rural and regional communities, like I did as a pharmacist, then very often people choose to stay.

Rural training does more than just provide improved health care to those Australians most in need – it also improves the educational, economic and social outcomes of communities.

And to encourage more rural generalists, the Government is wiping the university debt of graduates that live and work in rural and regional areas.

We are experiencing increased demand for mental health services, driven in large part by the hardships we have faced over the past few years.

GPs are feeling this increase in demand in their practices as the first point of contact for many Australians seeking mental health care.

In this Budget the Government will provide over $91.3 million over 4 years to address bottlenecks in the psychology training pipeline and increase the number of registered psychologists moving into practice while we explore longer term reform. This will support over 5,000 postgraduate psychology places including 500 new places, fund 500 one-year internships for provisional psychologists, and deliver 2,000 fully subsidised psychology supervisor training places.

We have also provided $17.8 million in the Budget to upskill GPs and the broader health workforce in mental health. This includes a review of mental health training and CPD for GPs to ensure they reflect new evidence and emerging ways of delivering health care.

We also know that many of your patients come to you for referral to more specialised mental health care – often these Medicare-subsidised mental health sessions are not being accessed by those who might need it most, or because they live outside of a city or do not have enough money.

We are working through solutions to address the gaps in mental health services and as part of our response to the Better Access evaluation.

These solutions will be developed in close partnership and consultation with the sector and people with lived experience. This will men future arrangements are robust and well-considered.

Thank you to everyone here for your commitment to improving the health of people living and working in rural, regional, and remote communities.

Thank you to everyone for engaging in the reform process, your goodwill and expertise will make Australia’s health system stronger.

It is my aim, and the Australian Government’s aim, to see better access to healthcare around Australia, and that means having the right practitioners in the right place at the right time.

Quality training in rural communities will improve the supply and distribution of the medical workforce and enormously rewarding careers.

Thank you again for inviting me to speak today and I look forward to hearing about the outcomes of this conference.

Thank you.

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