2CC Canberra - GP Senate Inquiry

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29 September 2021


RADIO INTERVIEW – 2CC – Afternoons with Leon Delaney

Thursday 28 September 2021

SUBJECT: GP Senate Inquiry

LEON DELANEY, PRESENTER: Submissions to the Senate inquiry into rural and regional health services will close on Thursday. Federal Member for Eden-Monaro Kristy McBain says she's collected more than 500 signatures for her petition to improve access to GPs in rural and regional areas. Joining me now, Kristy McBain Good afternoon.


DELANEY: We've spoken about the challenges facing healthcare in regional and rural areas many times before. Obviously, we already know there's a critical shortage of doctors, what are you expecting this Inquiry will actually achieve?

MCBAIN: I hope it achieves some concrete recommendations that will lead to action because I think the last thing anyone wants is another inquiry which doesn't result in anything. I've been out talking to community members, we've done a community zoom and had multiple discussions with individual GPs across the electorate, all of whom have come up with ideas, incentives and put forward solutions of things that could be done to end this crisis in rural and regional GPs. And so those are all including as part of my submission to the inquiry itself.

DELANEY: It's not just GPs, though, is it because there's also a shortage of specialists isn't there?

MCBAIN: Well, across the region, there is a shortage of actual access to specialists, we are still so heavily reliant on access to specialist doctors and tertiary healthcare outside of our region, especially, into the AC T and Wollongong and beyond. The Rural Health Alliance has estimated that there is a $4 billion a year saving to the government because regional rural people don't access primary health care. But then because people haven’t received that early intervention through GPs we see additional presentations at hospitals.

DELANEY: And speaking of hospitals, will the inquiry also consider the issues that are affecting hospitals? Because obviously, they're run by states, but the interaction between primary health care and hospitals is a very important one, isn't it?

MCBAIN: Yeah, look, it's obviously paramount. And I think that there has been over many years a lack of understanding in our communities about primary health care networks in GPs, being regulated through the Commonwealth Government, and hospitals through the state government. And obviously, there's an interaction. But there hasn't ever been a look at holistically what we need. We're in a good position at the moment, because New South Wales Government is also holding its own inquiry into regional and rural access to health care, the same time that we are holding this inquiry into GP shortages. So hopefully, there will be some interaction between the two committees, because there is obviously a role to play in interacting between the two levels of government to make sure that we're not short at the early intervention stage, but also not let down in our hospital stages, either.

DELANEY: Yeah, because obviously, if things are not working well, in the primary healthcare sector, that has an impact on the demand for hospital services.

MCBAIN: That's exactly right. And we see more people presenting to emergency departments when they aren't able to access a GP in their local community. And in this region, we have GPs practicing our community, and then also doing shifts at local hospitals, because we don't have additional doctors to work in our hospitals. So we are also fighting, GP fatigue across the regions where they are seeing community members during the day, and then all are also backing up and working at our local hospital. You can see why some GPs decide that they might end up with a better lifestyle if they don't live in a regional area, because they won't have the two types of health care to keep the local hospital running.

DELANEY: Now, there are a number of factors involved here. But surely, some of the answers are pretty obvious, like increasing the basic rate of the Medicare rebate.

MCBAIN: Yeah, that's right. I mean, the freeze on the Medicare rebate, for some regions had a significant impact. There's been a small increase this year to regional areas. And I've spoken to a lot of our GPs across the region and asked whether that will make a difference. And they've basically said, it will not make up any significant difference. The amount of compliance and regulation on our GPs at this point in time is so significant, that most of them actually have practice managers to deal with the compliance side of things. So that's paying a non-income earner to sort out all of the regulation for them. It can be quite complex. I was chatting to a GP in Cooma and in the middle of the vaccine rollout, they were hit with an audit from the regulator, which means they not only had prepare to deliver immunizations, but they were also required to go through all their paperwork and deal with the audit request. So there are significant compliance issues that are taking up a lot of our GPs time.

DELANEY: That Medicare rebate, though is something that's been a long standing fault in the system, it's now pretty much a built in floor you walk on, that undermines the whole pyramid of the health system, isn't it?

MCBAIN: Yeah, look, there's significant issues, obviously, in it. I'm hoping that the inquiry will look at a whole range of sectors. I know the submissions that I've received, which I'll be sending includes submissions from GPs, that will talk about issues directly with Medicare. These issues also include the cost of actually sitting your GP exam, which is in the order of $10,000, the incentives framework, which could be better how we actually attract more GPs from the regions to go and train and come back to the regions. So there are a whole range of issues that GPs have put forward as part of this submission, Medicare being a huge one of those.

DELANEY: And if somebody wants to make a submission, that deadline is Thursday. Can I get in touch with your office and just do it that way?

MCBAIN: Yeah, that's right, they can contact my office or simply go to my website, which is KristyMcbain.com.au. And under the Have your say tab, there's a link to where you can make a submission. You can also make one directly to the to the committee itself and ask for your name to be redacted if you have a personal story that you don't wish your name to be published as part of. And we do have a number of people who have stories that need to be on the record and haven't felt comfortable attaching their name to it. And they can do it that way.

DELANEY: Now both New South Wales and the ACT have outlined their pathways out of lockdown. What does this mean for businesses in your electorate?

MCBAIN:  Look, it's fabulous that we're getting to a stage where we're when zeroing in on that target of 70 to 80% people being double vaccinated. The New South Wales roadmap commences on the 11th of October. And unfortunately for many people across this region, that means that they will start to lose some freedom. After the 11th of October, we've got a lot of people across the region who have wanted to get vaccinated and have not yet been able to do so. We have people that have heeded the call and gone out and got AstraZeneca as soon as they can. And obviously there's a lag time between you being double vaccinated. So there are going to be some changes and they are can be quite complex. But look, we are looking forward to some freedoms and hopefully headed towards a summer which is a little bit more normal for everyone. We want to make sure our local businesses can get back to some form of trading very, very soon.

DELANEY: Are you concerned that business owners and operators in your area will effectively be required by the New South Wales state government to act as COVID policemen and turn away people who can't prove that they've been double vaccinated, even though they can't afford to turn anybody away at the moment?

MCBAIN: I am hugely concerned that that it sets up our small businesses to be the police in a time period where after 20 months of continued interruption to trade, they should be focusing on trying to get back to business as usual. And this two month period, they are the ones that are that are meant to check whether everyone's vaccinated or not. I think it is really damaging for communities to be put in that situation. We know that there are people in our community, who wanted to be vaccinated and have not yet had the advantage of being double vaccinated. We know that there are people in our community that cannot receive a vaccination for medical reasons. And we know that there are there are people that are still on a waiting list trying to get it done. So what I'm really concerned about is the impact this is going to have on small businesses and especially in small communities.

DELANEY: Meanwhile, the New South Wales state member for your area Andrew constants yesterday threatened or at least indicated he's prepared to quit the front bench if he's not allowed conscience vote on the question of voluntary assisted dying in the state Parliament now, I presume, as his constituent you would support his position.

MCBAIN: Look, I think it's really important that we have a discussion on voluntary assisted dying laws, it'd be great if the territories were allowed to have that same discussion as well in their parliament. It is obviously a matter for each individual to decide on how they want to vote. And that should not be a party line that should be very much based on an individual's conscience, after consultation with their electorate.

DELANEY: And that question about the territories rights and of course there is the bill being put forward by Senator Sam McMahon. Is there anything you can do to help that argument along in the federal parliament?

MCBAIN: I think you've got a very strong advocate in senator Katie Gallagher, who is very much behind getting this right back for territories. It is shameful that in 2021 we have a difference between our state now territory governments and what they can and can't legislate for.

DELANEY: And thanks very much for chatting today.

MCBAIN: Thank you very much.

DELANEY: Thank you Kristy. McBain, the Federal Member for Eden-Monaro on 2CC Canberra live.