Doorstop interview at the Bilateral Regional Health Forum
Read the transcript of Minister Coulton at the Bilateral Regional Health Forum in Wagga Wagga.
The Hon Mark Coulton MP
Assistant Trade and Investment Minister, Minister for Regional Services, Decentralisation and Local Government
Okay. So, good morning everybody. It gives me great pleasure to welcome you today for this bilateral Commonwealth-State roundtable on health. A number of Ministers. First of all, let me welcome the Deputy Prime Minister Michael McCormack and the Minister for Rural Health Mark Coulton from the Federal Government. And can I also welcome Minister Brad Hazzard and Minister Bronnie Taylor as well as Parliamentary Secretary Natasha Maclaren-Jones from the State Parliament. This is a great opportunity to tackle some real issues in rural health.
And with no further ado, I'd like to hand over and introduce the Deputy Prime Minister, Michael McCormack.
Well, thank you, Joe. And certainly, welcome to my parliamentary colleagues and it's fantastic having both New South Wales and Federal Ministers - people who are absolutely committed to making sure that rural health is what it should be; that the investment rural health is absolutely critical to making sure that we get the best healthy outcomes. And we know that, as Ministers in Liberals and Nationals Government, we know just how critical it is to make sure that we get the right investment. To that end, I absolutely commend the New South Wales Government for what it has done since returning to government in 2011 for the fact that they have invested so much in country health, so much in regional areas. Certainly, they've done that with the Commonwealth's backing since 2013 and we have made absolutely certain that we've got the right investment for the right outcomes.
Just yesterday, Mark Coulton and I were in Orange with the parliamentary colleagues, making sure that we turn the first sod on the first rural medical school under the Murray-Darling Network, and that is such a critical juncture in that rollout of funds to get more doctors in the bush. More doctors, in fact, starting their training and finishing their training in regional areas because Mark Coulton and I, our Nationals colleagues, know, and Liberals too, that if you train doctors in regional areas, the likelihood is that they will stay in regional areas when five years of their degree is completed.
And to that point too, Joe McGirr and I were at a very important meeting today with the Riverina Medical School. Something that I have fought for since getting into Parliament in 2010, and progress on the Riverina Medical School for UNSW is very well underway. And so, we're looking to make some more announcements and some sod turnings and that sort of thing in 2020, in the early stage of next year.
But look, it's been great to have actually a good look through this particular facility with the Parliamentary Secretary of New South Wales Health, with my colleague Bronnie Taylor, who of course has been a champion for mental health services in rural and regional areas. And I know how important this is. I know how important it was that we open a new facility not far from where we're standing, just a few- just a couple of years ago and what a difference it has made to the mental health outcomes. And it's great to be here, of course, with Brad Hazzard. No stranger to Wagga Wagga, he understands the importance that rural health is.
But also, with the Liberal-Nationals governing New South Wales, in conjunction with the Commonwealth, we've made a significant investment with the new Wagga Wagga Base Hospital. And this, of course, is the latest stage in that magnificent building. So anybody who drives down Docker Street, anybody who drives down the highway, knows that the investment, the critical investment, that we're needing to make is being made, not just with the first stage, but with ongoing stages. And so, I commend the New South Wales Government and certainly, it's great to have the ministerial team here from New South Wales to look at the progress of works on this latest stage.
And with that, I'll ask Mark Coulton to add to my remarks and then Brad Hazzard can also make a few remarks about the wonderful progress of rural health here in Wagga Wagga.
Thank you, Michael. It's certainly good to be in your patch here in Wagga Wagga with my state colleagues. Look, we are witnessing now the infrastructure that's being constructed to service the people of western and southern NSW, and infrastructure is so important. But later on today at the roundtable, we're also going to be discussing workforce issues between State and Federal, working out how we can combine better, break down the silos, make sure that [inaudible]… absolute best use of taxpayers' dollars because what we need is rural workforce. Rural workforce need to be able to come to an area where they're supported not only with the infrastructure but with mentoring, financially renumerated. And we need to explain to the young graduates coming through, and those that will be actually trained in this area, that rural Australia is a great place to work. It's a place where your services are really appreciated. You're dealing with complex cases for people who need it the most. And you are working in communities that will support you and nourish you and care for you, and that's the message. And we need to put the structure in place at government level to provide an environment that's going to be conducive for health professionals to want to come and live and work and grow their families in regional Australia.
So it's fantastic to be here and I'll hand now to New South Wales Minister Brad Hazzard.
Well, thank you to the Deputy Prime Minister and to Mark Coulton, my senior colleagues. Of course, Joe McGirr, and my most excellent Minister for Mental Health Bronnie Taylor.
Can I just say, we're standing in the last stage, the third stage of the magnificent $431 million redevelopment of Wagga Wagga Base Hospital. And this is a little bit of health magic for the community of Wagga Wagga but also the region. This particular stage, third stage is $171 million. But what we expect of course is that by the end of this year, 2020, we'll have the building work finished in about 2021. The commissioning will occur and we'll actually have staff working in here and getting them ready to welcome patients and others into the hospital. I have to say, as the Health Minister here in New South Wales, I have the best job being able to come to the magnificent regional rebuilds like Wagga Wagga Base Hospital. This is driving a lot of the local economy. There are lots of jobs here onsite today - when full, we're close to hundred workers. And over the last 12 months or so, there's been many hundreds of workers on the site, and it has flow on economic benefits. So, the State Liberal and National Government is delighted to be here. I mean, Gladys Berejiklian has visited this area. She loves the fact that we're building new regional hospitals, and Wagga Wagga is just a great place to have such a [indistinct] facility. This hospital, of course, has new mental health facilities as well, and I thought Bronnie Taylor might just like to say a few words about the importance of mental health, particularly in these difficult times that we're experiencing with drought, and so on and so forth. So, Bronnie Taylor.
Thank you very much. It's really exciting to be here with my colleagues and the Deputy Prime Minister, our Nationals Senator in the Federal Parliament, Mark, Brad, Jo, Natasha - terrific. I'm particularly excited. I spent 20 years of my life as a registered nurse working for the Southern Local Health District, so I knew the old Wagga Base and I know the new Wagga Base, and it is a really exciting time for health services in rural and regional New South Wales. We know people can work in environments that are really conducive to good care, that we're going to get better outcomes. That's what this is all about today. Really excited as the Mental Health Minister to be able to have new facilities, more facilities for the people that need it. We are in challenging times at the moment. We know that the drought is presenting lots of issues. But with facilities like this, we have great opportunity. And as an old nurse, I think it's just fantastic. And I'm really, really excited about it. I think it will bring people into our communities, strengthen our communities, make people want to live here, and that's exactly what we want. So it couldn't be a better day, really, for rural health care in New South Wales.
So, happy to take any questions. Before I take them though, can I just say thank you to CPB, the builders, and Health Infrastructure. You guys are doing an incredible job, and thank you for employing so many people in the local community. Thanks for making sure there are so many add-on jobs, because that's what really is driving so much of the economy in this area at the moment. So thank you.
Any questions or comments either about this? I don't think there's another press conference later at the regional [indistinct]. If you want to ask any questions about that, happy to take some [indistinct].
What's your best [indistinct] coming out of this meeting? Is it the [indistinct] or will we see something [indistinct]?
Each of the Ministers who've come today, Federal and State, including our Deputy Prime Minister, I think show the significance of why this meeting is occurring today. It is the first ever of such meetings to try and work through, at a Federal and State level, how we use the billions of dollars that are already going into the regional areas, how we use those best. And there are some challenges. State Governments could build new hospitals. Federal Governments have to actually make sure that they can provide the necessary general practitioners. But together, we can do it far better. So it makes a lot of sense to have this discussion today. I'm hoping it'll be the first of a number of these discussions over the next few years to make sure that taxpayers' dollars are used as wisely as possible to get the best possible outcome. Sensible use of Federal State money, and providing the best possible services in the regions.
[Indistinct] if the Federal Government though, as regards with making the possibility of getting rural GPs working in special [indistinct]? I know there's worker [indistinct]. What do you want the Feds [sic] to do more, if anything?
Our Federal colleagues are every bit as committed as the State Government to trying to make sure that we get the best outcomes for patients. But I know as the State Health Minister, as I travel around places- I won't name them, but there are particular regional communities, some in this particular locality, but all across New South Wales, we're finding it really, really tough to get GPs particularly, medical staff into our hospitals. And we come today to have a discussion to see if there's some more innovative ways that perhaps- we can break whatever these barriers are that are stopping GPs working in regional areas.
I think that there are some issues that both the State Government probably needs to address, and our Federal colleagues need to address, particularly as we have this difference with- State Government generally provides funds for hospitals and doctors employed in hospital; Federal Government normally employs and pays for through Medicare GPs. And somehow we have to be really, really, really smart about how we make that work best for regional areas. I'm absolutely confident that these discussions will actually have a positive outcome.
As the Deputy PM has already indicated, and he's very committed to this, he's been driving- trying to get regional training for doctors. Obviously, the University of New South Wales and Notre Dame already have capacity here at Wagga Wagga Base Hospital, but what can we do to expand those training programs for trying to attract young people from the regions, preferably, to stay in the regions that we train, and love that lifestyle.
But it's not that simple. My view is we need to be doing a lot more for the state [indistinct], and once we get there, how do we support them? Is it a job only for health, or is it a job for local government and a job for the community? There's no one group here that could actually deliver the outcomes. So today's a really positive opportunity for discussions about this.
And Brad, a lot of these results seem to be long-term training doctors [inaudible]… but regional New South Wales is at a crisis point with the lack of doctors. Places like Leeton have no doctors; Cootamundra has no doctors. People are literally- you walk down the street, and people think, you know, people are dying in these communities if they don't have access to [indistinct]. That's what we're saying. Is there an immediate result from that?
From the State Government's point of view, we're doing everything possible to try and get doctors into smaller regional communities. I think [indistinct] Federal Government, but I'm also trying very hard, and that's what [indistinct] discussion is doing. The great challenge we have, I think, right around New South Wales is we have a lot of doctors are over 50 [indistinct]. The younger doctors, males and females, are not necessarily as keen to live in the regions. The challenge for us is to make it a really attractive option for doctors to be there. And I've got to say, as Health Minister, it's a struggle. Every day I have a report from another hospital somewhere that there's been a couple of retirements in the local town. Generally, local hospitals are smaller, are actually staffed by GPs that have a practice in town, and then work in the hospital. So that might be one of the opportunities for us to have discussions today. How do we make it more attractive to those people who- if they're down in their general practice on the main street in a country, get paid through Medicare, but then they come through the hospital and they get paid through the State Government. What can we do? What are the obstacles to making sure it's more attractive for them? And they just don't- I am so excited- I can tell you, I am really excited to have my Federal colleagues here, to have the Deputy Prime Minister of Australia here - he's also a lot like me, he gets it because he's a regional MP. How much more positive could we get than to have a really positive outcome? So I'm really looking forward to today. I've been to Wagga Wagga numerous times, but I've got to tell you, I'm loving today. With that-
Doctors today are expressing their deep concern about the links between climate pollution and [indistinct], and saying the serious health effects are urgent. [Inaudible]…
I think- look, there's no doubt about it at the moment. There is obviously climate effects, particularly we see a lot of effects coming just from the bushfires. So, climate always has an impact on health, but it's part of the parcel of what we do every day in our health system in New South Wales.
[Interrupts] Are you comfortable with this air pollution- [indistinct] air pollution at the moment, though. I mean, do you [indistinct].
[Interrupts] I don't think anybody's comfortable with air pollution, but you know what, that's the great challenge we have right across the world. I was in Scandinavia last year, and they were certainly talking about climate impacts on health, I think we all know that's a big issue. But do you know? When the Federal and State Governments are working well together, and we have a Liberal-National Government in Canberra, we have a Liberal-National Government in New South Wales - we're going to do miracles, and we're going to. Today's one of them. Thank you very much.
Minister McCormack, a question, sorry, from the ABC in connection with the concerns that have been raised about air quality being at hazardous levels, incredibly hazardous levels, and doctors saying we're concerned for the Federal Government that this is business as usual. Is that what you're doing?
It's not as business as usual. We're meeting and beating our climate action responsibilities, our climate action targets, we're more than beating those and we will continue to ensure that we do just that. And yes, there is very much an inconvenience at the moment for people throughout New South Wales, and indeed Queensland as well and elsewhere with the smoke caused by the fires. But look, let's spare a thought for those people who've lost their homes. Let's spare a thought more for those people who've lost family members in these fires. The smoke will blow away. It always does.
Let's spare a thought for those people who are out on the fire front putting them out rather than worrying too much about those people who are going to be inconvenience for a day, or a week, or so as these fires rage. I think the concern more should be on those people who've lost their homes and lost their family members than those people who will, yes, be inconvenience. And will yes, have to present themselves to hospital because of respiratory problems. But- and that is of course something that we are very concerned about. But these fires, we're doing our very, very best.
Yesterday, we announced another $11 million for aerial bombing of these fires. And we will continue to work with State Governments to ensure that we've got the right resources, that we've got the right people with the right training to put these fires out. And I commend again, not just the full time firefighters, but indeed those volunteers, those volunteers who are risking themselves, and indeed their own homes while they go and fight the fires for other people in other nations. They're the ones we should be commending, they're the ones who we should be really [indistinct] for being on the frontline to put these fires out.
Minister, a report about today on the option of nuclear energy in Australia. Certainly wouldn't be causing pollution like what we're seeing now. What are your thoughts about it and would you support nuclear in your own backyard, in your city?
Well we've got a parliamentary committee looking at that right at this point in time. Headed up by Ted O'Brien, looking at what we can do as far as not just nuclear, but other energy alternatives, but certainly nuclear is one of them. And that- we'll certainly be having discussions and having meetings and taking the best scientific advice, as well as local community engagement next year.
Michael, I just want to turn back to the [Indistinct]… from overseas shorten the process so they can get them over here quicker. [Indistinct]
Well when you say shorten the process, they need to still go through the necessary protocols. We can't just take international doctors who may well, yes be trained and having reached their proper necessary requirements in whatever country they may reside in at the moment. But they have to meet Australian standards. They have to make sure that their doctor's degrees and that their qualifications overseas are met here in Australia.
And so yes I appreciate the Cootamundra, it's not just Cootamundra that are desperate for doctors, its other areas as well. Fact is, we are doing a lot in this regard. In conjunction with the New South Wales Government, we will continue to do that. We'll continue to make the right investments. It's great to have New South Wales Minister Brad Hazzard here today to look at one of the great infrastructure investments, and we will continue to work with the New South Wales Government as we have since we returned to government in 2013.
The health options for people in New South Wales, particularly New South Wales regional areas, are far better now than what they were when we had 16 years of sorry Labor, who did not invest in infrastructure, who did not invest in health services. And when the New South Wales Liberals and Nationals returned to government in 2011, what a difference that made. And of course, when we returned to government in 2013 in conjunction, in collaboration, in cooperation, with the New South Wales Government, we are doing a lot of investment, we are making and building a lot of hospitals, MPSs, and we're also providing the sort of services that you would expect us to. I mean, the amount of drugs and people who been put on the Pharmaceutical Benefits Scheme is quite incredible.
When Labor were in power, they had to actually stop funding some of those PBS drugs, and those drugs which were recommended by the independent body the PABC - were not, in fact put on the PBS because Labor had run out of money. Well that hasn't happened under us. We're getting the budget back into surplus. We're doing that. When you've got an economy with a surplus budget, you can invest in even more lifesaving drugs, life extending drugs and that is exactly what we're doing.
Can I just add to that. The Federal Government is funding a Rural Generalist Pathway. And that's to give doctors that are coming to regional areas a broader range of skills. Those- a lot of those doctors that are retiring now had a broader range, where they could deliver babies, they're emergency accredited. That's one of the things we're doing. We're also funding educational training in the regional areas, and there'll be a press release coming up later today where there have been identified locations in this area where funding will go to local practices to enable medical- junior medical officers to come and work in those areas. Because it is shown that if they get a medical experience in the regions, they're more likely to stay there. So Brad Hazzard was correct. The State Government funds the doctors in our hospital system with associated with the ones in the broader community. But in those smaller communities, a greater opportunity for overlap, for a combined model where those doctors can work under both systems, and that's one of the things that will be discussing today.
So you're talking outside of Wagga like small towns?
Yes. Sure we are. Yeah. So it's a- the real issue we are having are in the smaller communities. We are seeing that there's doctors now not far from here who have been in the town for 38 years. My own doctors, two weeks ago who celebrated husband and wife, 30 years there. They have been the true heroes of regional Australia. But that's not what's coming through now. The younger generation are looking for a different model. And we need to make sure that we can provide them with the support that [indistinct].