Radio interview with Assistant Minister McBride and Leon Compton, ABC Radio Tasmania - 22 April 2024

Read the transcript of Assistant Minister McBride's interview with Leon Compton on Medicare Urgent Care Clinics; bulk billing; funding for regional health doctors.

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

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LEON COMPTON, ABC RADIO HOBART: It's a pretty simple idea. If you train GPs in regional Tasmania, they're more likely to stay in regional Tasmania to work. The federal government putting some more money into a project to train future doctors in places like Burnie in Tasmania, in the hope that they'll stick to the north west of Tasmania or somewhere else in regional Australia in the long term. Emma McBride’s Assistant Minister for Rural and Regional Health and Mental Health and Suicide Prevention, and joins us on Mornings. Emma McBride, good morning to you.

EMMA MCBRIDE, ASSISTANT MINISTER: Good morning Leon, good to be with you.

LEON COMPTON: You've been listening to this conversation. It's the challenges of ramping at Tasmania's hospitals and the fact that it's gone on for so long that now the government have said to paramedics, okay, 60 minutes, you can drop them off pretty much whatever the situation and get back out on the road. Do you think that is ultimately going to be helpful to making patients safer in our health system?

EMMA MCBRIDE: I understand that this was an election commitment of the Tasmanian government, and we know that ambulance ramping is a problem in Tasmania and right around the country and different jurisdictions have tried- introduced different measures to try to reduce wait times safely. I wish the Tasmanian Government well with this approach. From the Commonwealth perspective, we're trying to- we're investing strongly in primary care, particularly general practice to try to make sure that people can get primary care so that they don't end up in crisis and needing to be transferred by ambulance to an emergency department. And that also includes the introduction of Medicare urgent care clinics, where someone can present without an appointment or a referral for urgent but not life threatening care. And we know and I visited the urgent care clinic in Hobart, and we know that it's already starting to take- to ease some of the pressure on that emergency department. But understanding there is a lot more to do.

LEON COMPTON: And so the state health minister, Guy Barnett, has said on this program on a number of occasions, if your government and previous federal governments had done a better job our state funded hospital system would be better able to cope. Do you accept that there needs to be greater responsibility taken by the feds in funding GPs and other health services to keep people out of hospital in the first place?

EMMA MCBRIDE: And this is something that has been the strong focus of our incoming government. We knew that when we came to government that there was a- Medicare was in freefall, that, you know, doctors had their books closed and people were unable to get appointments for weeks at their local GP, which is why we've tripled the bulk billing incentive. And it's encouraging to know in the latest data that we've seen a five per cent increase in bulk billing across Tasmania, which is the biggest statewide increase that we've seen since that was introduced on 1 November.

We're also working, as you mentioned in your introduction, to grow the rural workforce. And we know the most reliable pipeline of health workforce - and me being a pharmacist myself, who ran a department in a regional hospital - the most reliable pipeline of health workforce are regional students trained in regional university cities because they're much more likely to stay and work in those communities. So I'm pleased that I'll be at Burnie where we'll be announcing an extra 20 medical students a year training locally. And we know this will make a genuine difference to the health workforce here in the north of Tasmania.

But we're also doing a number of other things at the same time: wiping the HECS debt of doctors and nurse practitioners choosing to live and work in the regions, having more prevocational scholarships, because we know a placement- a quality placement in a regional or rural community is much more likely to make a doctor or allied health student likely to be open to working in the regions. We've also introduced across the whole of Tasmania the single employer model. So doctors in training in your state hospitals can then transfer with one employer across to working, doing all of their prevocational training as a GP in the community.

LEON COMPTON: Okay. And so the situation that we see as an audience here on mornings is that a growing number of GP clinics that are critical in local communities are closing. It's a story that happens all too often. Let's touch on upping or wiping the HECS debt for doctors in Tasmania. So specifically, how many HECS debts have you wiped for doctors in regional Tasmania under this plan?

EMMA MCBRIDE: So this was introduced as of 1 February last year. And we know that the health department estimated at the time nationally that several hundred doctors may take up this opportunity. In terms of the north west of Tasmania, I know, UTAS has a number of regional clinical schools, and I'll be visiting them and I can get the most up to date figures. But we know that this is something that is likely with the pressures of cost of living- when someone is making a decision about where they're likely to practise, that wiping the HELP debt will be a strong incentive for them if they're open to practise in a rural and regional community.

LEON COMPTON: And sometimes Tasmania misses out on these schemes. So my question specifically is if you're wiping the HECS debt for doctors training or working- agreeing to work in regional Tasmania, how many times has that been used? How many actual doctors are benefiting from that and being drawn to the regions that might otherwise not have been there?

EMMA MCBRIDE: As I said, this programme started at the beginning of last year, and doctors training, as you would be aware and your listeners would know, takes more than five years. The department estimated that several hundred doctors are likely to benefit from that and we’ll see that through the pipeline of their training. And so I’ll be able to give you some firmer figures as the program progresses.

LEON COMPTON: It's coming up now to six minutes to news at nine. Emma McBride's our guest this morning, Assistant Minister for Regional and Rural Heath in Australia. Emma McBride, you say that you're funding ten new Commonwealth supported places, and is it the University of Tasmania are chipping in for another ten - what does that actually mean? Is, that cheaper for the students or does it just mean money for the university to create more training spaces for them?

EMMA MCBRIDE: So what it means is that- and the government is contributing $8.5 million to the university, and there's two streams of this funding. One is for the universities to be able to invest in new infrastructure. So medical classrooms, equipment, the right kind of first class facilities to train doctors now for the future. The other part of that is supporting the universities to be able to provide those places, and as they're Commonwealth supported, then it means that student would be able to access them through HECS-HELP. So it creates them better facilities and expanded facilities for the universities to be able to accommodate these additional places at regional and remote universities. And we know that the most reliable pipeline of a future health workforce is training local students or regional students, at regional campuses. And I'm very excited to see what this will mean in Burnie and for North West Tasmania.

LEON COMPTON: On Mornings around Tasmania, you can join us too. A couple of doctors texting in. Staffing won't improve until the pay rates approach parity with the mainland, says a listener this morning via text. Lots of people texting in on the issue of ramping. And Beth in Glenorchy says we need more bulk billing and emergency doctors’ clinics so that people only go to the hospital emergency in an emergency, not just because they can't afford a doctor's visit. That's from Beth in Glenorchy. So a question to you, Emma McBride, have you got enough of these emergency critical care clinics in Tasmania? You promised us four, what about ten? Would that make things better for Tasmanians and better for our hospitals?

EMMA MCBRIDE: What we know is and what we've seen in Tasmania and across the country, is that the urgent care clinics are- and there's now a 58 up and running across the country- what they're doing is achieving the two primary objectives. One, making sure that people can get urgent but not life threatening care when they need it so they don't end up in crisis and presenting to an emergency department, and at the same time reducing the pressure on our already stretched emergency departments, including in Tasmania. At the national cabinet last year, the Prime Minister committed to expanding the network of urgent care clinics. And we are- and we know that the Commonwealth is working with the states and territories, including Tasmania, to work on the locations of future additional urgent care clinics because they are providing affordable, completely bulk billed healthcare close to home and reducing pressures on the emergency departments.

LEON COMPTON: If we just put paid GP’s more through Medicare, would that solve a problem of the lack of GP’s in regional Tasmania?

EMMA MCBRIDE: We understand that there are many drivers, many sort of enablers, and barriers in terms of the health workforce more broadly, but including general practice. So there is a review at the moment about the distribution levers, to look at both what incentivises and what limits GPs being able to practise in more regional or remote parts of Australia. And we did, as I mentioned, triple the bulk billing incentive. And we have seen, for example, in Bass where we are today, an increase of more than 3 per cent in bulk billing. But across the whole of Tasmania, an increase in 5 per cent of bulk billing. All GP practices last year were also eligible for a GP practise payment that could go towards their infection prevention control or their IT. So we're working ongoing with general practice and with their peak bodies, including the AMA and the Rural Doctors Network, to make sure that we're pulling the right levers to be able to boost that health workforce, because everybody should be able to have quality healthcare close to home. And as a pharmacist myself who lives and works in a regional community, I know just the difference it makes to be able to have quality primary care affordably when you need it.

LEON COMPTON: Your Mornings around Tasmania. My guest this morning, Assistant Minister for Rural and Regional Health. Emma McBride, while we've got you there, let's talk about a story that you may have seen in today's news. You're a federal member for an electorate outside of Sydney. Lucy Bradlow and Bronwyn Bock are political candidates. They want to win the seat of Higgins, but they want a job share it. Could that work? You've spent some time in federal parliament, is there any chance that it could work as a job share deal?

EMMA MCBRIDE: It's exciting to see people being interested and putting their hand up for parliament, and we need to see more people willing to be able to take on those responsibilities. I understand the way that the Constitution stands at the moment that I don't think this is possible. But I think it's exciting to see two younger women - I think one's an investment banker and one's a lawyer - who are childhood friends who have put forward this proposal. But as the Constitution stands at the moment, this would not be possible. And as an MP myself, I'm not sure how it could work in practice. But it's- but we do need to see an environment that encourages more people from all walks of life to be able to contribute. Because the more that our Parliament reflects the community, the more we're going to be able to make better decisions for everybody.

LEON COMPTON: Hey, good to talk to you this morning. Thanks for coming into our studios. Emma McBride, Assistant Minister for Rural and Regional Health and Mental Health and Suicide Prevention.

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