In my role as the shadow assistant minister for regional health and the member for Mallee, I am pleased to speak about regional Australia and my home electorate of Mallee in this debate on Appropriation Bill (No. 1) 2023-2024. I am passionate and committed to improving healthcare services for every person living in regional, rural and remote communities, who are too often unable to access even basic health care that people in the cities take for granted.

My electorate of Mallee is home to over 155,000 people and covers an area of over 83,500 square kilometres. The electorate covers 36 per cent of Victoria, making it the largest in the state. Yet, despite its size, population and economic significance to the state and the nation, Mallee is plagued by the inadequate provision of health services. Issues faced in Mallee are, sadly, common in a range of regional and rural settings. For example, in a recent health survey I facilitated amongst Mallee residents, to which nearly 2,000 people responded, 30 per cent of respondents said they do not have a regular GP. Forty per cent of respondents put off seeing a GP because it’s just too hard to get an appointment. Thirty-three per cent presented to their local hospital because they couldn’t see their GP. And that says nothing about the regional communities that are entirely reliant on fly-in fly-out locum services and agency nurses because there is no doctor in their region.

A 2022 Grattan Institute report shows that for every 100,000 people there are 123 full-time equivalent GPs in inner metropolitan cities but only 83 per 100,000 people in rural towns. The situation shows no sign of abating, since there are nearly 3,000 GPs needed nationally and a shortage of 100,000 nurses. So, even if Labor had taken measures in their budget to attract healthcare workers to the regions, where they are so badly needed, where would they come from? The minister has failed dismally to address this glaring issue, which is leaving people in precarious states, literally, of life and death.

Given this dire situation, you would expect that Labor would have announced a raft of new measures in their May budget aimed at improving access to health care in regional Australia. But, no, there is not one single new measure specifically for regional health services in their budget, apart from a few much-needed measures aimed at improving the health of First Nations people, some of whom live in regional Australia. It seems the government are in denial about the healthcare crisis facing the region, and you can’t fix a problem that you are not even willing to acknowledge exists.

One simple measure the government could take right now is to reverse the absurd decision to expand the distribution priority areas directing international medical graduates to specific regions. Under the new criteria, metropolitan suburbs are now eligible, and directly compete, with rural and regional areas. This completely undermines the reason for implementing this policy in the first place, because we now have evidence that IMGs, international medical graduates, are choosing to live and work in the outer suburbs rather than in the regional communities where they’re so desperately needed.

A delegate at the Mildura health summit, which I hosted recently in March, told us that, as soon as the DPAs changed, three of the six international medical graduates in Swan Hill left. As I’ve heard repeatedly, Swan Hill spent over $40,000 to get an overseas trained doctor—who made a commitment to stay for at least two years—to work in Swan Hill. But as soon as the distribution priority area was expanded, the doctor left and went south towards Melbourne.

I have called on the Minister for Health and Aged Care, Mark Butler, to reverse this perverse decision so the DPA can do what it was meant to do—provide healthcare professionals to regional and remote communities that are crying out for them. If he continues to refuse then he needs to tell the nine million people who live and work in the regions what his solution is for our dire health workforce shortages.

We now know that the Minister for Health and Aged Care implemented this change to the 60-day medicine dispensing without once consulting the Pharmacy Guild, the Pharmaceutical Society of Australia or any other pharmaceutical body. If he had done, he would have learned of the devastating impacts this decision will have on pharmacy businesses, especially in regional communities, where economies of scale will not protect small businesses from the huge losses they face. It seems that Labor are intent on destabilising regional communities and are risking further closures of primary care services. While this policy will halve some dispensing costs, it appears Labor has no ability to join the dots and understand that if regional community pharmacies are forced to shut their doors because they are not financially viable, patients will not be able to access medications at all. How does that help anyone? Consequently, I express my deep concern for the repercussions of this policy that it will have on our small regional pharmacies and the people they serve.

Dedicated pharmacists across Mallee fear for the future of their businesses. They have told me they are at risk of closure due to the implementation of this urban-centric policy that fails to appreciate the unique challenges faced by regional communities. Take pharmacist Taren Gill from Maryborough in Mallee, who expects to be insolvent due to losses in excess of half a million dollars when this policy is initiated. She also expects that more than 1,000 of her patients will face medicine shortages due to the measure.

Alexander Look, a pharmacist from Ouyen, is concerned with the precarious state of the medication supply chain. There are already shortages of common medications, including those used for infection, diabetes, blood pressure and mental health conditions. This policy will only exacerbate the problem, leading to hoarding, potentially, and an increased risk of overdoses, particularly among vulnerable groups such as children and seniors. Mr Look’s pharmacy is the sole provider within a nearly a 100-kilometre radius, making access to basic medications an arduous journey for some of his customers. Where will they go if this business is forced to close down because of this reckless policy? It is not as though regional people can simply drive to the next suburb and find another chemist; it may well be a 200-kilometre round trip. Kobie McIvor from Cohuna shared her concern about the risk of medication mismanagement this policy brings. For vulnerable older Australians who heavily rely on the guidance of support of pharmacist, regular monthly check-ins will not take place, potentially leading to poorer health outcomes.

If pharmacies are forced to reduce their hours and staffing levels, the consequences will be dire for the wellbeing of constituents. Natalie Hutchison, a pharmacist from Nhill, proposes an alternative solution—go Natalie!—that prioritises patient safety by reducing the co-payment to $19, and allowing doctors to write prescriptions for 12 months would ensure that patients maintain regular support and contact with their trusted pharmacist. These professionals serve as vital links between patients and comprehensive care, safeguarding the health of regional communities.

Let us not overlook the invaluable human connection that local pharmacies provide as a source of support and interaction, particularly for vulnerable older people. The comfort of walking into a pharmacy, your local pharmacy, and asking questions and receiving guidance from a familiar professional face fosters a sense of trust and community that just cannot be replaced. Many people in my electorate wholeheartedly oppose this policy that threatens to sever these essential bonds. A pharmacist from the Riverina wrote to me warning that the changes to dispensing times will burden regional emergency departments when patients inevitably run out of medication due to shortages. The increase from 30 to 60 days for over 300 medications will place additional strain on already stretched healthcare resources. This policy fails to consider the consequences it will have on emergency departments, GPs and other vital services.

The Prime Minister and his health minister must address the pending crisis in health care and ensure that medications remain accessible and affordable for all Australians. I call on the government to ensure that the implementation of this policy does not jeopardise the viability of community pharmacies or impede patients’ access to essential services. The government must explain to the Australian public how it will prevent stockpiling. How will they guarantee an adequate supply of medications to regional and rural community pharmacies? What policy solutions are they enacting to ensure the viability of those pharmacies, including mitigating the risk of job losses, reduced trading hours and closures?

Our regional communities deserve better. I implore the Labor government to reconsider this ill-advised policy and engage in meaningful dialogue with the stakeholders and the experts who understand the unique challenges faced by regional areas. I assure you that I will continue to fight tirelessly for the people of Mallee and advocate for the needs of regional communities across this great nation. It is now up to the Labor Party to step up and demonstrate their commitment to the welfare of all Australians, including regional Australians.

I now turn to the related issue of insufficient access to childcare services in regional Australia. As with all services, child care is either non-existent or in short supply in regional communities. This means that parents who could be working in the healthcare system, as we desperately need them to do—such as nurses—are prevented from doing so for the lack of access to child care. It’s a perverse situation when you consider how badly these workers are needed. What is the Minister for Early Childhood Education going to do to address the pressing issue of childcare deserts in Australia? Childcare deserts are areas where families face limited or no access to quality childcare services.

The Community Child Care Fund was established by the coalition government with the purpose of addressing this very issue, ensuring that families in regional areas have access to the vital support they need so that parents who want to can get back to work. However, the Charlton & District Kindergarten in my electorate of Mallee is not eligible to apply for the fund—who knew? Charlton is a small town of approximately 1,000 residents, with only the Charlton & District Kindergarten to service it. It needs access to this fund to provide child care to the local community so that more parents can get back to work. If Charlton doesn’t qualify as a childcare desert then it’s hard to imagine which town does.

Exacerbating this issue is the absence of alternative childcare options nearby. The next-closest childcare facility would see a gruelling 120-km daily round trip, a journey that is simply unfeasible for parents living in Charlton. As a result, these parents find themselves in a deeply distressing situation in which they are unable to return to work because of the lack of accessible and affordable childcare services. I implore Minister Anne Aly to act on the glaring inequity faced by the parents of Charlton and other regional towns in Mallee, like Donald, Horsham and Nhill, and take swift action to rectify this situation.

It is unjust and unacceptable that families in regional communities like Charlton are excluded from accessing the support provided by the Community Child Care Fund. The dearth of accessible childcare options not only affects parents’ ability to rejoin the workforce but also hinders the recruitment and retention of essential professionals in regional areas. Without reliable childcare services, healthcare workers—who are already in short supply—are unable to pursue employment opportunities in the regions, where they’re desperately needed. We cannot ignore the far-reaching consequences of this injustice. Families are burdened by the inability to access child care, leading to financial strain and diminished career prospects for parents.

The time for action is now. I call on the government to urgently review the eligibility criteria of the Community Child Care Fund and ensure that it reflects the pressing needs of regional communities across Australia. We must address disparities in childcare access, with parents being unjustly denied the opportunity to participate in the workforce because they cannot access it.