Mr ELLIS (Narungga) (10:37): I move:
That this house—
(a) recognises the serious shortage of doctors and other medical staff in regional South Australia;
(b) acknowledges that regional South Australians are just as worthy of access to quality health care as those in the metropolitan areas;
(c) notes that incentivising doctors in regional South Australia has not worked and that it is time to guarantee it;
(d) calls on the state government to ensure the equal distribution of general practitioner doctors around regional South Australia, now and in the future; and
(e) calls on the state government to establish a dedicated department of regional health to support access to quality health care across South Australia.
Mr PEDERICK (Hammond) (12:23): I rise to support this motion by the member for Narungga and commend him for it. Regional health: where do you start? We certainly need to see what we can do to make sure that we have the right conditions—and to attract doctors and other medical workforce not just to work in the regions but also to live there—and we must make sure that we look after the ones that are in place. As time goes on, and we have seen it over and over again in recent times, doctors nearing retirement age fear for the communities that they have lived in. They have loved to be there and, when they are about to retire, they wonder what will happen next.
Certainly, I have been lobbied by local doctors at Murray Bridge assisting with running the emergency department there to make sure that we can get enough on-call doctors. I note that it is operated by a private service, the Bridge Clinic. They have been doing it for decades as a service contracted to governments of all colours. They do a great service, but they would certainly like more support. I know when we were in government, until recently, there was some support supplied there as well, but it is contracted to those private clinic doctors, as it is in a lot of areas across South Australia, and they certainly would, as I said, appreciate more support.
I note that in the town of Murray Bridge, which is my biggest town in the Rural City of Murray Bridge, there are two other clinics. They operate as day clinics, which is great, to service the needs of the ever-growing population of Murray Bridge and the surrounding districts. It being a popular town only an hour south-east of Adelaide, a lot of people, a lot of farmers, from right around the state retire there. They do not want to live in the city amongst all the concrete and bitumen, which I appreciate, but they want to be within reach of good services.
We do get this issue, though, that not just any doctor these days can turn up and work in emergency departments. They have to be credentialled and that is another level of training that must take place. I have been meeting with the doctors at the Mannum health services as well, talking about the needs not just of the doctors there but of the nurses, whether they be at Karoonda, which used to be in my electorate, or Mannum, which still is in my electorate, and the shortage there.
Also, as I indicated, we must make sure that we retain doctors, make sure everything is in place, whether it is the right conditions or whether it is the structure of how they get paid and supported. It is very much a different world in country South Australia. The difference in what happens if you land in emergency, for instance, is brought up at times. Some people cannot get their head around it, but in most places in the country, because they are on-call doctors for the emergency units, if you do not get admitted to hospital there is a gap fee.
One thing the gap fee does—apart from infuriate some people, because they have to pay a gap fee for this kind of service in the country, and I acknowledge that—is it does keep people out of emergency. It does keep people out of emergency, so they attend their own doctor if they do not need to address an urgent situation. But the issue, and it would be an issue that the health minister in the new government would be well aware of, is that it would be well north of $40 million annually to fund that service not having a gap fee. It was interesting that in the city two years ago, in Adelaide, numbers dropped heavily in emergency attendance, by about 70 per cent, which was probably (not probably; I am sure it was) because people were scared of the risk. They thought hospitals were full of COVID.
There are obviously strategies that we put in place. We put in rural generalist training, which can take up to 12 years—that is up at Berri in the Riverland—to get doctors used to working in regional conditions. It is tough. I have been around a while, but when I was young the local doctors would do the operations, they would do all the childbirth work, they would deal with the accidents and they would see their patients. I do not know when they slept, and I think that is the issue.
There are a lot more doctors on the scene now, and I commend those doctors for what they did. We are now more heavily reliant on overseas-trained doctors, but their credentials do not match up with the requirements of the South Australian health service or the Australian health services when they come in from overseas. They are a much-valued group who come in to support our communities in regional South Australia, but when they come here they have to retrain. A lot of them work in aged care and other fields while they are doing that training to get accredited to be a full-blown, accredited doctor in South Australia.
It is not without its issues. Some people cannot work out why the place is so isolated when they come from overseas, and it takes a while to get used to the lifestyle. It does not matter what you do. I know that, as a community, we fixed up the nurses' quarters in Tailem Bend for a doctor but, as the demands and needs of that family grew and they needed to be in Adelaide for education, university and other matters, they left.
I guess it is the beauty of the bush, and sometimes it can be the tyranny of the bush. The bush is a great place, I love it, but obviously for a lot of education needs, as well as professional needs, people want to be in the city areas. I have never forgotten a speech that a former member for Kaurna, the Hon. John Hill, gave here one day. I just about fell over when he said that they were having trouble attracting doctors in Reynella. I thought, 'Wow! If they're having trouble at Reynella no wonder I'm having trouble getting a doctor to Pinnaroo.' That speech in the house has always stuck in my mind.
We must do all we can, as we did. We put in the rural generalist training. I was proud to deliver, as part of the Marshall Liberal government, a new $7 million emergency department in Murray Bridge combined with $3 million to update the operating theatres there, which is going very well. Obviously, we have seen the commissioning of a new ambulance station under us at Strathalbyn as well. In recent times a new five-bay station was built in Murray Bridge. I note that under our watch we instigated the 36-bed aged-care and dementia ward that was opened in Strathalbyn, and I see that it is still in the budget.
The future of Kalimna might be fleshed out a bit in estimates. It was shut down by the previous Labor government before the 2018 election, and those residents were essentially kicked out in the cold. However, it is pleasing to see that an aged-care centre of some kind will be built there into the future. I will be watching that as time goes on as the new local member for Strathalbyn as the member for Hammond, because as the population ages we certainly need to look after them.
There are so many things that we need to do to make sure that we get health care right, not just in city areas but across the state, and make sure that we can put in place the right programs to attract not just doctors but other healthcare workers. I commend the motion by the member for Narungga.