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Legislative Assembly for the ACT: 2003 Week 1 Hansard (19 February) . . Page.. 147 ..

MS TUCKER (continuing):

There were a couple of comments in the paper that I would like to question. In the paper, the government said that the restriction of provider numbers has exacerbated a shortage of GPs in the ACT. It says that benchmarks used by the Australian Medical Work Force Advisory Committee indicate that the ACT has a shortage of 50 to 60 full-time equivalent GPs. The shortage of GPs reduces competitive pressures between individual practices and reduces pressures on GPs to bulk-bill.

I am not sure about that argument-I think it could be seen to be a dangerous presumption. I am interested to know whether this is the result of coordinated research into the question. For instance, when the Interchange General Practice closed last year, the people who provided that service were unhappy that they had to change, but felt they had no choice. The Medicare rebates did not cover their costs and they were bulk-billing 70 per cent of their clients. They noted too that, between 1985 and 2000, the CPI rose 95 per cent but the Medicare rebate for general practice rose by only 45 per cent.

In the debate in November, I suggested that the government should look at options such as community health centres, which were scrapped by the Carnell government in the third Assembly.

I am not going to move my amendment because I understand the argument from Simon Corbell. However, I just want to get on the record the measures we have suggested-that any strategy must ensure that every person in the ACT, regardless of income, has adequate access to the services of a general practitioner; that we do want to see the government consider options such as mechanisms to support general practitioners to provide bulk-billing, and that we want them to look at the re-establishment of community health centres with salaried medical officers and other health practitioners.

That leads me to Mr Smyth's amendment, which we will probably get to, where he asks specifically for facilities at Tuggeranong and Gungahlin. I do not want to support that. I know it was an election commitment, but I do not know that they are the only places I want to specifically say need some kind of community health centre or salaried medical officer. The need could be broader than that.

I am making the point for the record in this debate that, if my amendment had got up, it would have stressed that we need these community health centres with salaried medical officers, or some other model which ensures that people have access to a general practitioner.

In the paper in response to my November motion, there were some initiatives listed by the government, but there was no time line. From the government, I would be interested to hear results of the working group of GP work force issues with the ACT, the AMA, CAHMS, the ACT health department and the Commonwealth health department, among others.

I am interested in progress towards independent midwifery practice being re-established in the ACT by auspicing through community care, or an association as mentor or preceptor through the Canberra midwifery program. That would take pressure off the hospital system as well.

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