Health Insurance Amendment (National Rural Health Commissioner)

I am very pleased to support the establishment of the National Rural Health Commissioner, and I commend the ministers that have been involved in bringing this to this point. It is something that those on the other side have never even considered. Throughout the years of Labor government this was something that the Rural Doctors Association of Australia were constantly asking for. For as long as I can recall going to the Rural Doctors Association of Australia gatherings, the rural generalist pathway is exactly what they have been asking for. It is something that I have heard about for many years, and I commend the minister at the table for taking this particular action. This was something that was very important during the campaign.

We know that the National Rural Health Commissioner will be an independent statutory champion for rural Australia—great words, but greatly needed. Let’s face it: rural Australia needs all the champions it can get, across all areas. The commissioner will work in a broad range of regional, rural and remote areas, and that is where I can see, through listening to the Rural Doctors Association of Australia for so many years, where this particular role for the commissioner will be so important. It will be important for the commissioner to work right across the board with the health sector, the universities and the specialist training colleges, across all levels of government, with the sole aim to improve rural health policy and access for all Australians, no matter where they live. It does not get simpler or more important than that.

Championing the cause of rural health is something the members on this side of the House do on a regular basis. I know that the national rural generalist training program that was suggested by the rural doctors came about because they understood so well the importance of a generalist—that is, the rural GP. I only have to look back into my own history. We had a couple of fantastic doctors who gave historic service in my region, serving the areas of Harvey and Brunswick, which were very small rural communities in those days. I can recall a man by the name of doctor Dr Stimson, who used to do small visits to Brunswick, where I lived. He worked out of the Harvey hospital. Dr Topham and Dr Wu came as well. In those days these gentlemen would do everything. It did not matter what happened in the local Harvey hospital, these doctors were capable of performing in that setting virtually everything that needed doing. They did everything from delivering babies to operations right across the board. It was the one-stop-shop pretty well, except for the very serious cases, which in those days went through to Perth.

We have seen since the establishment in Bunbury of the South West Health Campus, which is now supporting so many specialist services as well as the St John of God hospital, the local public hospital, and the regional hospital. There are so many services, from mental health through to cancer support, right across the board. It also supports our rural clinical school, which again was an initiative of the Howard years of encouraging more young people who were training to be doctors, to be GPs, to actually consider training in a regional area. We have these rural clinical schools operating in Bunbury and in Busselton as well and we get students from all over the state. One of the things they do while there is get for 12 months the experience of living and working in a rural community. What we hope from that is that we get more locally trained, locally sourced kids—whether they are from right around Western Australia or our locals—who go away and do their training and come back and spend some time at the rural clinical schools. We are starting to see some results, where they are making a conscious decision to come back and live and work in our communities. The one thing that does for those who become rural GPs— and I do not mean any disrespect—is that they almost become a god in a small community because they deal with the life and death and the lifetime health issues of complete families. The Dr Wu in Harvey I spoke about before not only delivered my children but has been our family GP all our lives. This is what happens in small regional communities. We rely on those doctors, especially when we are at a distance.

As most people in this House know I am a farmer. In my time as a local farmer I have had everything from a man who had been run over by a tractor rock up at my home to a young man who, after a paddock had been burnt, fell down an ant nest that was still burning and was red-hot. He had basically lost the skin from the lower part of his body. He ran through the diversion drain to get to my home and stood there shaking, completely in shock. I got a moist sheet—I had fortunately done nine years of first aid, which you need out on the farm—and got him on it and told my husband to ring the hospital and to tell the police I am coming, going pretty fast as I needed to get this young man in. My own husband had a close encounter with a tiger snake, and at one point my own son was kicked in the heart by a cow and stopped breathing.

So our reliance in rural, regional and even more remote areas is based around the capabilities of these wonderful general practitioners. Let me tell you that there are countless people in my own community who have relied all their lives on the work of these amazing GPs. They historically have been what is now termed the ‘rural generalist’—they could do anaesthetics, they could deliver babies, and they were operating on people. They did almost every task except for the real specialist work that needed doing. They have done an amazing job and I want to pay tribute to the lifetime of work that so many of our GPs throughout rural and regional Australia have put into their whole communities. I want to say a huge thank you to them, because the lives of our whole community depends on them. They stay in our community and our part and parcel of it. When we walk down the street we can talk to them and if you have a real emergency you can ring them up. That is the way it has worked. And they work with the local St John Ambulance volunteers. These people also, being the first responders, do such an extraordinary job in rural and regional Australia. Often, many of the services provided by St John are in very extreme and remote areas, just as we have the Royal Flying Doctor Service, which comes in and out. So often we rely on the GP and those emergency services, our volunteer St John Ambulance people. I grew up having St John in my home, in a sense, because my mother was a St John Ambulance attendant and first aid teacher. For all my life at home our home phone was the ambulance phone, so even as children we would have to be able to take a call, get an ambulance and get it to the right place, knowing how many people needed treatment.

When I see someone like our National Rural Health Commissioner, who is going to be focusing on and championing the interests of rural Australians, all I can think of is the great need that is out there and the great team of people who work so hard in this place already. As we know, it is so important, because health outcomes tend to be poorer outside of major cities, and that is where all these different parts of this whole health provision come in.

We see that the major contributors to higher death rates in rural and regional and remote areas are coronary heart disease, other circulatory diseases, motor vehicle accidents and chronic obstructive pulmonary disease. And of course in the case of motor vehicle accidents we see so many of them, which is where St John Ambulance volunteers and even our local GPs are so important, because they are often the first people who see these patients when they are taken to a small local hospital.

We see such differences in usage of health services between the metro areas and rural and regional areas. In some instances there are lower rates of some hospital surgical procedures, lower rates of GP consultation and generally higher rates of hospital admissions in rural and regional and remote areas than in major cities. There are also inter-regional differences in risks. For instance, people from regional and remote areas tend to be more likely than their major city counterparts to smoke and drink alcohol in harmful or hazardous quantities, according to the Australian Institute of Health and Welfare. So, there are higher death rates and poorer health outcomes outside major cities.

But in talking about the rural clinical schools, I want to commend the work in my electorate. In November 2016, 60 rural students from 22 country towns, including 17 students from Bunbury, graduated from the University of Western Australia’s medical school. It was the biggest number of rural-background doctors to graduate in a single year. That is a great outcome, because what we are really hoping is that some of those great young people will choose to come back to our part of the world to practise and to become an integral part of a small community. It might be somewhere like Augusta in the south, or it could be Nannup. It could be any one of my small communities where this person will become very much the centre of health provision in that community. And I do hope that more of them do so, as we are seeing throughout the electorate.

This program is now in its 16th year, and the number of UWA medical graduates from country areas has really grown since it was launched in 2000, with 325 rural WA students graduating. It is great news, and there is very good evidence that rural-origin students are three times more likely to return to the country than are their urban counterparts. So, the more young people I see from my electorate and from rural and regional electorates and remote electorates who go off and do their training in the city, where they have to do their training, the more young people I am likely to see coming back.

In the time remaining to me I want to acknowledge the wonderful work of Murray Cowper, who was the member for Murray-Wellington, who I worked with. He did an enormous amount of work to get the $13 million revitalisation of Harvey Hospital and the Harvey Health Service, and he did an absolutely amazing job. We had to be very persistent in this, but the new emergency department that is linked to the procedure room is absolutely amazing. It is going to make a massive difference to a small community—and it is already, and we are seeing a difference in my part of the world. And the money that was put into the Busselton Health Campus was really significant. There was $117.9 million of state government funding that went into the new Busselton Health Campus.

What I am demonstrating is that the rural areas are different, and remote is different again. I am really supporting this piece of legislation and the work of the Rural Health Commissioner. I commend the minister at the desk, and I commend this bill to the House.