The Bonded Medical Program (the Program) is a critical component of the Government's Stronger Rural Health Strategy to ensure that the Australian trained medical workforce is well-distributed, flexible and targeted to areas of workforce shortage particularly in regional, rural, remote and communities.
The department is continuing to resolve cases for individuals impacted by issues that arose during the implementation of the Program in 2020.
As highlighted in our October/November 2021 newsletter working through these cases involves understanding the affected individual’s personal circumstances since they were not correctly bonded in 2020, including assessment of both recent and historic actions taken.
What progress has the department made?
The department continues to make steady progress. We appreciate your patience as we carefully work through each case. As previously advised, the department has consulted stakeholders and prioritised affected individuals as follows:
- Individuals who thought they were bonded, had completed their obligations and had exited the Program;
- Individuals who thought they were bonded and still need to complete their Return of Service Obligation (RoSO); and
- Individuals who had expressed their interest to opt in and await a response.
The department has now finalised 159 of the 176 cases of those individuals who thought they were bonded, had completed their obligations and had exited the Program (Group 1 above). The remaining 16 cases sit with the participant awaiting their decision.
We are working through cases where the affected individual thought they were bonded and still needs to complete their RoSO (Group 2 above). We have finalised 205 of 407 cases.
We have commenced allocating the cases of affected individuals that had expressed their interest in the Program and await a response. We have finalised 88 and allocated 378 more.
Further detail is outlined in the table
|1) Opt-in and Exit
|2) Opt-in and Stay
|3) Waiting to opt-in
Amendments to the Health Insurance Act 1973
On 13 December 2021, the Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021 received the Royal Assent.
The amendments to the legislation provide additional flexibility to support the ongoing administration of the Program. The proposed amendments, once commenced, will address unintended consequences in the interests of participants and will also support achievement of the Program's objectives.
The amendments to the legislation are significant as they:
- allow a person to cease to be a bonded participant, and exit the Program, in the event of their death. This rectifies the unintended consequence where a deceased person could breach Program conditions and incur a debt to the Commonwealth;
- provide more appropriate administration in some circumstances by allowing a bonded participant, or a person on behalf of a bonded participant, to apply to the Secretary for an ‘exceptional circumstances determination’. If granted, the subject would no longer be a bonded participant and would not be subject to the consequences if the exceptional circumstance lead to the subject breaching their obligations or any of the Program conditions;
- provide greater flexibility to provide some legacy scheme participants – who would otherwise not be able to complete their RoSO in the 18-year period allowed – to apply to the Secretary for an ‘extended compliance determination’. Having considered the required evidence – including a plan of how the person would propose to complete their RoSO and the amount of time required to do so – the Secretary can choose to grant the determination, and in so doing, determine the amount of additional time (up to 6 years) that the person would have to complete their RoSO, should they become a bonded participant.
- reduce the administrative penalty that applies if a person does not comply with the requirements to provide necessary information – as outlined in the Program rules – from $10,000 to $1,000.
NB: The four amendments outlined above require supporting amendment to the Program rules and/or further development of the Bonded Return of Service System (BRoSS) and will commence on ‘Proclamation’ or six months after the Royal Assent (~13 June 2022).
- [Commencing on the Royal Assent ~13 December 2021] additional flexibility for administration of inadvertent and minor breaches of Medical Rural Bonded Scholarship (MRBS) Scheme contracts that might otherwise have resulted in the MRBS Scheme participant being banned from Medicare and possibly accumulating a debt to the Commonwealth.
Further information about the amendments can be found in the Bills Digest no. 19 (2021-22) - Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021 (aph.gov.au).
Program Update Webinar
On Tuesday 14 December 2021, the department hosted a Program update webinar for all affected individuals, including those that expressed their interest to opt in and await a response.
The webinar slide deck provides the key information that was covered including how the department is progressing cases, information on the opt in process and what affected individuals can do to prepare. The webinar slide deck also includes frequently asked questions and answers.
During the webinar, the department advised that it is working towards finalising all remaining cases of affected individuals by 30 June 2022.
If you are still waiting, once your case is allocated, a case manager will contact you to understand your personal circumstances, and work through any decisions or actions you have taken since 2020, to finalise your case on a ‘no disadvantage’ basis.
Program Information Webinars and Information Booklets
The department has recorded an information webinar for prospective students considering applying for/accepting a bonded place in the Program. The webinar is available on the department’s website at Bonded Medical Program – Information for Prospective Students.
The department has also finalised the Prospective Student Information Booklet.
Both the webinar and the booklet provide important information on the Program including: how to apply for/accept a place, conditions, requirements and obligations, RoSO, eligible work, using BRoSS, consequences of not meeting obligations, and where to go for support.
Further information webinars and booklets will be available shortly, including:
- Bonded Medical Program – Information for Legacy Scheme Participants
- Rural Workforce Agencies – Support for bonded participants
BRoSS – Roll out and User Demonstration Webinar
The Bonded Return of Service System (BRoSS) is the department's online system which assists bonded participants to plan, monitor and manage their obligations under the Program. Other users of BRoSS include universities, Rural Workforce Agencies and departmental staff.
BRoSS continues to be developed and released in stages. The next BRoSS release is on track to be delivered in coming months and will provide enhanced functionality for all users.
To support those individuals whose cases have been finalised and are now bonded participants, the department has published a Bonded Return of Service System (BRoSS) Webinar on its website. The webinar includes a live video demonstration of BRoSS and frequently asked questions and answers.
Higher Education Loan Program (HELP) Debt Reduction for Rural Doctors and Nurse Practitioners Initiative
Participants of bonded programs may be eligible for the Australian Government’s new HELP debt reduction for rural doctors and nurse practitioners initiative.
The initiative encourages eligible doctors and nurse practitioners to live and work in rural, remote and very remote communities, by reducing their outstanding HELP debt.
The department has recently published information about the initiative, including a fact sheet, frequently asked questions and prospective participant case studies on its website.
Whilst eligibility for the initiative commenced on 1 January 2022, legislative amendments to the Higher Education Support Act 2003 are required. It is intended the amendments will also enable secondary legislation in the form of 'guidelines' that will govern the administration of the program (in the same way that the Bonded Medical Program rules support Part VD of the Health Insurance Act 1973). The proposed guidelines will outline the processes for participants to follow in order to realise the benefits of the Program.
The department will provide further information, including updates on progress – for example, when the necessary legislative amendment bill is introduced into the Australian Parliament – at the website above.
The team can be contacted by emailing: HELPforRuralDoctorsandNursePractitionersInfo@Health.gov.au