NADIA MITSOPOULOS, HOST: Well, do tell me this morning how hard it is to get a doctor or a nurse in your town and how that impacts on your ability to get timely healthcare, 1300 222 720. But I also want to know what incentives are needed to get them out there. I do want to hear from you about this, because the Federal Government is going to have another go at trying to fix what has been a problem for many, many years. I want to get more from the Federal Health Minister, Mark Butler. Minister, good morning.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, Nadia.
MITSOPOULOS: How dire is the situation become in regards to the shortage of medical staff in regional WA and really regional Australia?
BUTLER: Across regional Australia it is pretty dire and it's been dire for some time and this is not just an Australian issue. This is something that countries across the world are facing as we come out of COVID, there really is a very serious global health workforce crunch. We're finding a lot of people retiring earlier, particularly those areas that were hard hit by COVID. People are exhausted, they're often traumatised and if they were approaching retirement age anyway, they've often across the world, taken a couple of years earlier to retire. We are dealing with a bit of a legacy out of COVID but this is not a new issue for rural and regional Australia. For many years we've been trying to find ways in which we can incentivise people to go out and build a career in rural and regional Australia, not just fly in and fly out, although that sometimes is the last resort that we have to rely upon - to have locum GPs or locum medical officers going into rural communities - but finding the right incentives is something that governments of both political persuasions have been trying for a very long time. What we're finding out of COVID is that things have changed. The way in which doctors are working has changed, particularly GPs and psychiatrists.
MITSOPOULOS: In what way - changed how?
BUTLER: We've seen the work from home phenomenon sweep the whole economy. It's changing a lot of industries in terms of the way in which people want to work, and medicine and health broadly is not immune to that. A lot of the medical officers who do some of the consultant work, so GPs and psychiatrists are just changing the way in which they work, the number of hours they want to work as well. Increasingly we're finding them going into locum work, which is sort of fly in, fly out from cities like Perth - we know fly in, fly out is a very common concept over in the Western Australian economy. But we're seeing it now across Australia with doctors in particular taking up fly in and fly out jobs from the major cities into rural communities, which does fill a gap to some degree, but it doesn't give you the continuity of care you get from a GP who settles down and builds a career and a practice in a local rural community. There's a range of issues that we're confronting, which is why we've got a couple of pieces of work underway now, some of which we're doing at the Commonwealth level and some of which we're doing in concert with state governments, because this is obviously a shared responsibility we have.
MITSOPOULOS: You've got a review into this, the Working Better for Medicare Review, which is one of the things. What will this look at? What are the policy levers that you have that can get more doctors and nurses into regional areas? What are the ideas?
BUTLER: Some of the policy levers we have are essentially just financial incentives. In the October budget last year, we lifted the financial incentives for doctors to work in more remote parts of Australia quite considerably particularly if they had some more specialist skills as GPs. So not only their specialised skills as general practitioners, but if they had some additional skills in emergency medicine or mental health or obstetrics, for example, they got additional incentives on top of that. We also passed legislation a few months ago now to effectively wipe the university debt of graduating doctors and nurse practitioners if they went and did several years in a rural community, working in a rural community. That's only just passed the Parliament recently, but we're hoping that will make a difference as well.
The review I announced yesterday looks at essentially quite an old system we've had in Australia, which allows communities to recruit overseas trained doctors, so from other countries that are allowed to come in to Australia, practice and charge Medicare. But for a very long time now, as long as I can remember, there's only been certain parts of the country where you can do that, and that's essentially been rural Australia. So, communities outside of our big major cities. That has become a little contentious over the last several years because you've got, for example, rural communities that are on the fringe of a major city. You've got some of the outer suburbs of our big cities that are experiencing really the same level of GP shortage in particular that you see in some rural communities. Often, I'm being lobbied, I'm sure the State Minister, Amber-Jade Sanderson, is being lobbied by some of the peri urban areas of Perth. Certainly, we're getting in Sydney and Melbourne and Brisbane.
MITSOPOULOS: So you're talking about sort of the outskirts the sort of the fringes?
BUTLER: Yes. the outskirts. We're hearing them say our shortage is just as bad as towns two or three hours away from the major cities so why can't we recruit overseas trained doctors to fill those gaps? I think it's been quite a while since we had a good look at that system about where you can employ overseas trained doctors and where you can't. That's the review I announced yesterday.
MITSOPOULOS: So that could change those boundaries or add more areas?
BUTLER: That's right. Those boundaries were put in place five or six years ago. As I said, I think COVID has changed things quite a bit. This has been an area of real contention now for several years. There was a big Senate Inquiry into it under the former government, which led to a lot of analysis about who was effectively being short-changed on this and who wasn't. I thought it was time for a big, strong independent review to give us some advice about a system going forward.
On top of that, I've been working with ministers like Amber-Jade Sanderson at the direction of National Cabinet, so this is something the Prime Minister and the Premiers told us to do, to just try and smooth the path for overseas trained doctors and nurses coming into Australia because what we're finding is, whether it's hospitals or general practices recruit someone, for example, from the UK to come over and work here in Australia, too often they spend months unable to actually get on the floor and do health work because of a whole lot of regulatory hurdles and hoops they have to jump through. They might spend months working in a cafe or working as an Uber driver for just so they can get through that system instead of getting straight on to the floor and relieving some of that health workforce shortage we have.
MITSOPOULOS: Mark Butler is my guest this morning. He's, of course, the Federal Health Minister. And then people on the text line immediately when I talk about this, they talk about, you know, high cost of rents and, you know forcing people out of medical school to go and do three years a little bit like what you used to do with teachers, I guess forced them to go out and do those two or three years in regional areas as a condition, I guess. Can you do that?
BUTLER: We're not doing it as a condition, we're doing it as an incentive.
MITSOPOULOS: So it's about money at the end of the day, paying them more?
BUTLER: That's right, there's positive payments but there's also, as I said recently, we passed legislation through the Parliament to forgive their university debt, which is pretty substantial when you do medical degrees. These are long degrees. So, doctors are nurse practitioners if they go and work for a certain number of years in a rural or remote area, we'll look at how long they work and how remote it is and we'll knock off potentially all of their university debt. Now that can amount to tens and tens of thousands of dollars. We're trying a range of those things as well.
MITSOPOULOS: And allowing nurses to do more?
BUTLER: Yeah, that's right. That really is one of the ongoing challenges we have in our health workforce system. There's still a lot of glass ceilings, particularly for nurses. What I've said at a time where demand for healthcare is, you know, soaring, we're getting older, we've got more complex chronic disease, we've got the legacy of COVID, at a time where people really need healthcare, and we're struggling to get a supply of workers, doctors and nurses and allied health workers it doesn't make sense not to have everyone working to the full extent of their training and their experience, and that's not the case in Australia. At the risk of saying we've got another review going, we do have work going to make sure that nurses and pharmacists and physiotherapists, all of those things, and GPs for that matter, are allowed to work at what we call in health the “top of their scope of practice.” So, all of their training, all of their experience is able to be deployed for the care of patients rather than having these artificial limits which particularly often constrain the work that nurses can do. Nurses are the biggest part of our health workforce, almost half a million across the country. They're incredibly well trained, incredibly well experienced. We have some of the best training of nurses anywhere in the world, but too often they can only do a whole lot of work if a doctor is looking over their shoulder and so on and so forth. So, better utilising the skills of all of our health workers is another way to deal with this shortage.
MITSOPOULOS: Finally, Minister, just before I let you go, if I can just touch on COVID, because we here in WA are going through a wave of COVID like pretty much the rest of the country. And there is some new some updated vaccines that will be made available in a couple of weeks. Are you concerned about people's attitude towards COVID who seem to have moved on and are treating it just like another cold or a flu and the low booster rates?
BUTLER: Right across the world, including here in Australia, we've moved out of the emergency phase of the pandemic. The World Health Organization has withdrawn its declaration of an international emergency. In most countries, including ours, have done the same. To an extent, the community is reflecting what governments and health experts have decided in terms of a new phase of the pandemic. But we have also been very clear it hasn't gone away. We're seeing pretty regular waves every four or six months, a new omicron wave. Each wave is a little bit smaller than the one before it. We're better managing it. We're getting better every single time at how we manage it in hospital systems and in aged care facilities. But I am concerned, and I've said this publicly a few times, that the booster rate is not what we saw in the first few years of the pandemic. I'm particularly concerned that older Australians get out there and get their booster. They are more vulnerable to severe disease from COVID than the general population. We’ve got new vaccines coming through. They're the cutting edge, most up to date vaccines. But frankly, the vaccines that are currently in pharmacies and in general practice are also, our technical advisers reinforced a couple of days ago, are also very, very effective at protecting you from severe disease or death. Being up to date with your booster, particularly if you're over 65 or if you're younger than that and have some compromise to your immunity is very, very important.
MITSOPOULOS: I'll leave it there. Appreciate your time. That is Mark Butler there, the Health Minister.