Healthcare in Macquarie

I'm very happy to speak on this private member's motion, and I want to highlight the challenges of peri urban areas like mine, which sit in a bit of a no man's land between urban and regional. In fact, the region I represent is a mix of urban, regional, rural and remote in its character and geography, with small towns, hamlets, villages and large properties that mean it is not a one-size-fits-all place. No single model of primary care is going to suit my constituents, and that means we really need to break down the issues area by area. Remember that this is something that the Minister for Health and Aged Care has described as a crisis. We have a crisis because of the failure to invest in this very key part of primary care for so many years.

The first region I want to focus on is the Blue Mountains, which sits anywhere from 60 kilometres to 120 kilometres from the Sydney CBD. I recently held a roundtable with consumers in Katoomba, towards the top of the mountains, about their experiences, and then I held a separate roundtable with GPs and practice managers. Both of these groups provided enormous insights into their experiences and their challenges. I'm really grateful to all those who participated, and I also want to thank the Nepean Blue Mountains Primary Health Network representatives who were there, given their role as an agent for distributing Commonwealth funding to primary health care at a local level. There are a range of issues, and they include the constraints of the Modified Monash Model that the previous government brought in. It applies only to the very top of the mountain. That's the bit that gets incentives. Yet a few kilometres down the road, the town of Katoomba does not attract those incentives. That is our key population base, but the model really constrains the services. There are a whole range of challenges that we face locally and nationally that I'm going to continue to work on.

What has emerged is the issue of access for those with a chronic illness or chronic condition who are experiencing problems in getting ongoing continuity of care. The steps we're taking are to look at the health system as a whole, to look at the role that nurse practitioners can have and to look at the role that pharmacies can have, so that people are working to what we call the top of their scope, the top of their ability, and getting extra training where it's needed. That might mean giving these people Medicare item numbers to deliver certain things. It's making sure that, whether it's contraceptives, treatments for UTIs or immunisation, pharmacists are able to service that part of the healthcare system. These are all things that take the pressure off GPs so that they can see the people that only they can see.

I'm very pleased to see that, in 2025, a record 1,750 offers are likely to be made to junior doctors to begin government funded GP training and that a huge chunk of those have already been taken up. We've certainly seen bulk-billing rates turn around with, in the 2023 budget, the biggest investment in bulk billing in that 40 year history of Medicare, and in the last two years we've delivered the two largest increases to Medicare rebates in 30 years. In our two-and-a-bit years, we've increased rebates by more than those opposite did in nine long years.

One of the things that are helping in the lower part of the mountains is the opening of the urgent care clinic in Penrith, and, while it's not ideal for lower-mountains people to travel down off the mountain, it is understood that that does provide more options for them compared to those higher up the mountains. I know parents of young children have been particularly grateful for that Medicare urgent clinic down in Penrith, which I opened the year before last.

I want to talk about why one is needed so badly in the Hawkesbury. The Hawkesbury desperately needs a Medicare urgent care clinic because people don't have the same access to the existing ones. This would be a walk-in mini-emergency clinic for urgent but not life-threatening conditions, with radiology there open seven days a week, 365 days a year, usually from eight in the morning till eight at night, so that everybody knows where to go when something urgent but not life-threatening happens. I know my community wants this, because 1,600 people have already signed my petition in support of this. I will keep advocating this as something that can be a real life-saver for parents who don't want to be in the emergency department and want to get good, urgently needed care for their kids.