National Health Amendment (Cheaper Medicines) Bill 2025

Mr PASIN (Barker) (17:57): The member for Maribyrnong just spoke about a government that is focused on strengthening universal health care. I want to present a slightly different version of what's happening in a community not that far from Maribyrnong, in south-east South Australia in my home town of Mount Gambier. But, before I do, the National Health Amendment (Cheaper Medicines) Bill 2025 commendably, and with bipartisan support, reduces the cost to clients of filling prescriptions.

I say 'commendably', and, of course, it has bipartisan support in this place. But those opposite spent much of the last term telling us it was a real cost-of-living saving, and it is a cost-of-living saving. It's just perhaps unfortunate that, at the same time people were being told about a saving on their prescriptions, their energy bills were doubling and tripling, not to mention their mortgages et cetera.

But let's park that for a moment. Let's talk about the community of Mount Gambier. It's in my electorate of Barker, it's South Australia's second-largest city, and it's not that far from Melbourne—at least in relative terms.

There are four clinics. I received a call this morning from a local journalist from the ABC, saying, 'Mr Pasin, are you aware of the circumstance where all four clinics in Mount Gambier have closed their books?' I don't know if those opposite understand what 'closing their books' in a medical clinic represents, but let me give you a real-world example. Your child is sick.

You're new to our community. Thankfully, our community is strong and vibrant, and people are coming to our community. You pick up the phone and you ring clinic No. 1.

The first question is, 'Are you a client of this practice?' 'No.' 'Well, we can't see you; we're full.' You pick up the phone and ring clinic No. 2. You're presented with the same question—same response, same outcome. You try clinic No. 3.

By this stage, you're probably feeling a bit stressed. But you ultimately get to clinic No. 4, and they say 'Sorry; we've also closed our books.' And those opposite will say: 'That's fine; we've got a solution for communities like yours, Mr Pasin: urgent care clinics. We opened one of those in Mount Gambier.' And, true, you did, those opposite, to much celebration and acclaim for the relevant minister, who himself is a South Australian and who I am sure is aware of the community of Mount Gambier.

But do you know what happened in June of this year? The urgent care clinic in Mount Gambier closed. It's currently closed.

You can get on your device and type 'urgent care clinic Mount Gambier', and it says 'temporarily closed'. It's been temporarily closed since June. The operator that those opposite decided should run that facility fell into administration, and the administrator, after running the troubled urgent care clinic for four months—by the way, this urgent care clinic was never open for the hours that it was meant to be open—ultimately closed it.

So in Mount Gambier, if you are looking to see a GP, you can't go to the four clinics. Their books are closed. You can't go to the urgent care clinic.

It's literally closed. So what do you do? I don't know.

When I was asked that question by an ABC journalist today, I said, 'I don't know what you do right now, but I can tell you how we've got here.' He said: 'How? Why?' I said, 'Obviously, there are issues with the urgent care clinic.' But let me take you back to 2022. A newly crowned Labor government was elected and the Minister for Health appointed, and his very first action as federal Minister for Health—the people of Mount Gambier do want him to help, by the way—was to change the distribution priority area for GPs.

Now, how is that relevant, you might say. Let me put it this way. Our nation determined over the course of this debate around GP shortages—the member for Grey has joined us, and he would know more than most.

This issue is as acute—in fact, it's more acute in his electorate than in mine. When it's becoming an issue in places like Mount Gambier, it's an issue everywhere across regional South Australia. Like I said, Mount Gambier is the second-largest city in South Australia.

Over the course of this debate, we have determined that certain areas in our country and, in the case of the member for Grey and in my case, in our state are in need of special assistance when it comes to attracting a GP workforce. And so we've created these special zones. They mean that foreign doctors could be encouraged to come to Australia on visas, but they would need to practise inside those zones.

As I said, the very first action for the Minister for Health in 2022 in his official capacity was to change that priority area distribution list. What he did was include Adelaide. That is in the priority list.

On the day that came into effect, the office managers of two of the four clinics I mentioned earlier in my contribution rang me and said, 'Tony, we just want to tell you what the read-world impact is of the decision that's just been taken.' I said: 'Don't tell me. Doctors have tendered their resignations.' That was exactly what had occurred. Of course the only thing tying those foreign doctors to our community was the obligation that they practise in those areas.

That was the point of the legislative instrument. If you make it that Mount Gambier, Millicent or any other regional town starting with 'M' that might be in the member for Grey's electorate are treated the same way as Adelaide, of course a number of the small number of GPs that we have relative to our population size are going to make that decision. Mr Venning: Melrose!

Mr PASIN: Melrose—there we go. And do you know where these doctors went? They went to Marion, in Adelaide—that very disadvantaged local community!

I mean, please! But that is the consequence here. Those opposite will get up, as the member for Maribyrnong just did, and give us a fantastic dissertation about universal health care and how important it is and how this was a great Labor legacy.

What the member for Maribyrnong didn't say is that, over the term of the last government, bulk-billing rates actually went down. Now, I'm loath to mention bulk-billing rates in my contribution because almost no-one in my electorate is able to access a bulk-billed GP consultation; they're very difficult to get hold of. The reality is that the majority of people pay gaps, and, in some cases, very substantial gaps.

Personally, I think it's a real flaw in this system that I could be a well-heeled individual living in a well-heeled suburb of Adelaide and could drive 15 minutes to a bulk-billing clinic, and yet I could be one of the poorest South Australians, living in a very marginalised community a long way from services otherwise, in a community like Mount Gambier where the urgent care clinic is closed, and I could have to fork out a $40, $50, $60 or $70 gap.

Someone needs to explain to me the equity of that, because it doesn't feel that equitable to me. Far be it from me to be that member of parliament who grumpily points out all the problems. I'm going to suggest a solution, and that is to undo what the Minister for Health and Aged Care did in 2022 when he stripped Mount Gambier of its special status, and, as a result, GPs left that community—a community that, as I've said previously, is the second largest in South Australia.

But I'd remove Adelaide from that distribution priority area designation. A capital city shouldn't be in that category. It is unfair to ask communities like mine to effectively compete with a city of 1.4 million people.

That's the first thing the minister for health could do. The second thing the minister could do is to expedite the reopening of the urgent care clinic in Mount Gambier. As I said, it has been closed since June.

There is a tender process going on, but let's get it done and get it done quickly. As an aside, I should tell you that, as to the local PHN, when they told me that they were going to allocate it to a particular individual, I warned them that I thought allocating it to an existing GP practice with limited doctor numbers would lead to challenges, and indeed that's what happened.

But he could expedite the reopening of the urgent care clinic in Mount Gambier. The final thing is this—and this is directed at everyone in this place. There are so many young people studying in regional South Australia.

I'm sure the member for Grey knows some brilliant young students in his communities; I certainly know some in mine. I know how passionate they are about health and health related studies. But too many of them, even with high ATARs, are culled away from the process of studying medicine because they're subjected to subjective testing: 'interviews', the GAMSAT testing for aptitude and these things.

Having grown up in a regional community and having left it to study because the degree I wanted to pursue wasn't available in the community I grew up in, I can tell you that the strongest links are those familial and friend based relationships that draw you back to a community. The member for Grey's one example. I'd suggest to you, the member for Barker's another.

Having got my degree, I was working in Adelaide. All my friends were living in the regions. At one point I simply walked into the law firm I was working in, sat down with the partner I was working for and said, 'I'm off home.' He said, 'For how long?' I said, 'Forever.' He said, 'Don't be silly.

You'll be a partner in this law firm one day.' I said, 'That's not where I want to be, champ. I want to be home, with my people.' I give that example, not dissimilar to the member for Grey's experience, because young people who grow up in a regional community are much more likely to return to it after their studies. I appreciate that we're doing our best to educate our young people in medicine and other health disciplines in regional communities, and that is admirable and we should do more of it.

But the very first thing you need to do if you want more rural generalists practising in the country is to give the opportunity to country kids. Give the opportunity to more country kids. I'm not saying that every single one of them will return and become a local GP or, even better, a specialist living in and operating their practice in regional South Australia.

But I'm confident you'd massively increase the chance of that taking place. I think it's something that we need to do more of. There's no paucity, can I tell you, of young people who are smart, with the right attitude and aptitude, living in regional communities, who want to do this.

So it's incumbent on all of us. We can't solve this problem long term without more GPs. I end my contribution with what I said at the beginning: cheaper medicines have bipartisan support.

I don't want to end up in a situation where the only health care available in some communities is from the local pharmacist, but that is the case right now. I began by talking about that new arrival to Mount Gambier with the sick child, ringing around the four clinics and being told there was no room at the inn. Right now, the only place they could go is their pharmacy.

I'm glad they can, but it's not good enough.