Vote 07: Healthcare focus

If the opinion polls stack up healthcare will be a decisive issue for voters on November 24.

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Health professionals, desperate to see reform, are hoping the major parties will produce a comprehensive solution to one of the country's most demanding public policy areas.

The failing state of healthcare in Australia is most acute in the bush, where there's a massive shortage of doctors, nurses and midwives.

“Across rural Australia we need another 1000 rural doctors to supply health services in rural & remote Australia. We also need over 5 and a half thousand nurses, 600 midwives and over 6- thousand allied health professionals,” Dr Peter Rischbieth, Rural Doctors Association President told SBS.

Health professionals say the everyday pressures experienced in city hospitals and practices are amplified in rural areas.

“We have in this very wealthy country of ours – and it seems to be wealthier every day of the election period – we have to face the fact that in the outer western suburbs of Sydney & Melbourne you're five times more likely to die prematurely of preventable illness than if you live in a wealthy suburb like the lower north shore of Sydney,” says Professor John Dwyer of the Health Care Reform Alliance

“If you are white and live in a country town you're eight times more likely to die prematurely than if you live in a wealthy Sydney suburb. And of course, if you're Indigenous, it's 20 times more likely,” Prof Dwyer says.

'Not enough'

The policies put forward by the two major parties so far in the election campaign have been described as inadequate.

On the back of its decision to takeover the Mersey Hospital in the marginal northern Tasmanian seat of Braddon the federal government spear-headed its election health policy with a plan for Local Community Boards.

Prof Dwyer says local boards for hundreds of hospitals would be a health reformers nightmare.

There are concerns that neither the Coalition nor Labor has produced a comprehensive solution for the crisis in Australia's public hospitals.

The Coalition is offering a $2.5-billion Health and Medical Infrastructure Investment Fund, plus $444 million to train 900 GPs and 300 specialists, and to subsidise home visits by nurses to elderly patients. It also includes $433 million for 50 Emergency Clinics.

Labor has put forward a $2.5-billion Health and Hospital Reform Plan including $220 million for GP “Super Clinics” and a proposal to take over the finances of public hospitals if the states haven't made improvements by mid-2009.

Labor has also pledged $600 million to reduce public elective surgery waiting lists, a $290-million Dental Health Program and $81 million for 9250 more nurses over five years.

“Our plan isn't just for one hospital in one marginal seat, It's about shifting the debate in health care – addressing the issues for future decades,” Labor's health spokesperson Nicola Roxon said during the health debate in Canberra.

Federal Health Minister Tony Abbott emphasised the government's policy of a federal takeover of public hospitals.

“You've seen what we've done with Medicare, you've seen what we've done with the PBS, you've seen what we've done with aged care. Let us do the same good job for public hospitals that the

Australian people need and deserve.

More needed

But both parties fall far short of what the health experts say is necessary.

The AMA has called for a $3-billion top up funding initially and then indexed increases from the current 5 percent up to 9 percent.

But for rural practices all the attention being given to big city hospitals is a diversion when, for example, 50 percent of country maternity units have closed down over the last ten years.

“Our outcomes for rural health are so abysmal compared with metropolitan patients, that something needs to be done now by our political parties to rescue rural health,” says president of the Rural Doctors Association, Dr Peter Rischbieth

In the past decade less than 5 percent of medical graduates have gone to work in rural areas and more than 40 percent of rural doctors are now overseas trained.

“We have to recognise that unfortunately 10-15 years ago the decision was made not to increase the number of graduates coming out of our medical schools and so we're basically 10-15 years behind in having the appropriate numbers of graduates coming out of our Australian universities,” Dr Rischbieth says.