ADJOURNMENT: Rural Doctors Association Parliamentary Breakfast

'If rural practice was a patient, I would say that its condition would be critical.' Those were the words of Dr Maxine Percival as she addressed the third annual Rural Doctors Association of Australia parliamentary breakfast on 29 February.

Rural practice, Dr Percival maintains, 'needs urgent resuscitation with appropriate funding'. Dr Percival would know better than most the seriousness of the situation. From Moree in northern NSW, Dr Percival has spent more than 25 years working hard specialising in rural birthing services and Indigenous health. A general practitioner and obstetrician, she was recognised for her dedication and skill in 2009 when she was deservedly named National Rural Doctor of the Year. 

Dr Percival gave an impassioned and informed speech to the breakfast which was attended by rural doctors from across the nation as well as, for the first time, a health minister—and I appreciate the fact Tanya Plibersek turned up, at least for the first part of the event. It is important the new health minister, as part of her brief, appreciates and understands the unique challenges faced by rural doctors and the strains of regional health in general. There is no better way of getting a handle on the demands and expectations of a GP than by hearing about it firsthand, particularly from someone with the experience of Dr Percival or the President of the Rural Doctors Association of Australia, Dr Paul Mara, from Gundagai in my Riverina electorate. Dr Mara has headed the national rural doctors' body for two years and is an outstanding advocate for country doctors and country health services. He cleverly and appropriately took the opportunity at the recent breakfast to include among the handout material a photocopy of the front page of his local newspaper, the Gundagai Independent, from 6 February 2012. In doing this, Dr Mara brought a Riverina perspective to a frustrating problem which is a burden on the provision of decent health services in regional areas. The article was headed 'Hurdles keep doctors away from bush'. It told of how technicalities in the way doctors are counted mean areas such as Gundagai do not qualify for the medical support they both deserve and need. 

The text was accompanied by a photograph of Dr Barb Cameron, who is passionate about regional health yet might not be able to use up her bond in many small country towns due to the rules of her bonded position. Bonded students have to work off their bonds in an area which is counted as a district with a workforce shortage. This system has some merit and I am the first to argue that there must be rules in place, and enforced, to ensure places where doctors are difficult to come by receive the resourcing and personnel they so desperately require. 

There is an argument for all small country towns with a population of under 15,000 to be automatically classified as a district of workforce shortage. The market will set the limit. However, as Dr Cameron said: 'Because of the way they count things, Gundagai isn't classed as district workforce shortage—but it clearly is.' That is notwithstanding the fact that Gundagai has only two fully qualified doctors providing services 24/7. I am pleased the member for Bowman, the shadow parliamentary secretary for regional health services and Indigenous health, Dr Andrew Laming, is at the table. He knows all too well the health challenges of the Riverina, having practised at Gundagai in 1992. 

Dr Cameron continued: 'It is a major problem. There is not just a shortage of doctors; there is a distribution problem. Just because we have all these medical graduates doesn't mean we can get them in the country, which is where we need them.' An area is considered a district of workforce shortage if it falls below the national average for the provision of medical services for the speciality, based on the latest Medicare billing statistics, but the portrayal of this is less than transparent. Dr Cameron said the problem with the statistics is that they class junior doctors, such as herself and the Gundagai registrar, as full doctors, but they both still require the supervision of trained specialists. When these junior doctors do the rounds of the hospital they require supervision, as per the rules. This places some pressure and commitment requirements on the town's husband and wife doctor duo, Paul Mara and Virginia Wrice, who are already run off their feet and it limits where a doctor such as Dr Cameron can go to work off her bond. 

Dr Cameron said, 'The fact is that GPs, especially in rural areas, are getting older and they're going to retire. In 10 or 15 years, Dr Mara and my father's generation will retire and country areas will be in real trouble.' Dr Cameron's father, Dr Ian Cameron, is the long-serving chief executive officer of the New South Wales Rural Doctors Network based at Newcastle which, in conjunction with the Rural Doctors Association of Australia, is lobbying hard to get the situation rectified. There could be no better organisations working to make things happen. Both are representative groups of some of Australia's finest professionals: country doctors. 

This year marks the 25th anniversary of the Rural Doctors Association movement. It is a quarter of a century since the New South Wales rural doctors' dispute, which was the catalyst for the formation of the state rural doctors associations and the RDAA itself. According to Dr Percival, back at that time seeing a patient went from $22 to $13.85 per consultation, regardless of the time of day or length of consultation. This obviously left doctors demoralised and undervalued and many wanted to leave the rural doctors' practices. I congratulate all rural doctors for their perseverance and the wonderful care they provide and wish the Rural Doctors Association of Australia all the very best in all of its future endeavours. (Time expired)

Cristy Houghton