Ms LE (Fowler) (16:12): I thank the member for Indi for bringing this significant matter to the attention of the House. The healthcare sector in Australia is in dire need of intensive care, and in south-west Sydney and in my electorate of Fowler, it needs resuscitation. Since last October, the primary health network in south-west Sydney has seen eight GP practices shut down in the Liverpool and Fairfield LGA. For a community like Fowler, this means many of our residents will miss out on accessing the optimum health care they deserve. A constituent, Tom Lieng, a local director of WorkRecover, which provides occupational health services in south-west Sydney, reached out to me recently regarding this very issue. He told me, ‘Practising in south-west Sydney means that we are financially penalised because our patients are poorer.’ He recently had to start charging a $20 gap fee, excluding aged pensioners, healthcare card holders and children. He said: ‘We are surprised that 95 per cent of our patients fall in the excluded group. It reflects the low socioeconomic background of our local community.’ Many GPs are struggling to stay alive and are introducing mixed billing because bulk-billing just can’t pay the bills. The few GPs who are still bulk-billing can’t keep up with demand, with their patients waiting for weeks for appointments.

This system is sick, and people’s lives are at stake, particularly the lives of people with low incomes, who simply cannot afford to pay out of their own pockets to go to the doctor. The South Western Sydney Primary Healthcare Network, or SWSPHN, told me that Australia is producing more med graduates than ever before. That’s supposed to be good news. But the fact is that less than 15 per cent of them are going down the GP route, compared to 40 per cent just 20 years ago. The drastic decline is due to the specialist and hospital sector, where jobs hold more prestige and have higher salaries. Another factor is the decline in the limited options for junior medical officers to do a GP rotation post university, meaning they’re out of the GP network from the start. The SWSPHN has recommended that practical courses mandating that junior doctors do rotations at a GP clinic would inspire, and create pathways for, GP careers instead of specialised medicine. We need practical solutions to encourage medical graduates to come to the south-west as well, including professionals who can engage with a diverse community.

But we’re not only having a GP crisis; we’re also having a mental health one. When I first took office, I held consultations with GPs, pharmacists and allied health professionals of Assyrian and Vietnamese heritage in my electorate to get an insight into the plight of the local healthcare sector for their respective communities.

Local pharmacist Quinn On, from Cabramatta, told our office that while people from CALD backgrounds face mental health struggles, they do not speak up about it, meaning it could be hard giving appropriate care to these patients. However, he has seen a 30 per cent uptake in antidepressant prescriptions since the pandemic in 2020. And while it’s good to see these communities are starting to take their mental health seriously, he said, the lack of psychologists, mental health specialists and counsellors in the area means their treatment options are compromised. There’s only one Vietnamese-speaking psychologist in the Cabramatta area, but he had to stop taking patients because of the months-long waiting list. It’s hard enough to find a psychologist at a moment, let alone one who can speak your language and understand your cultural needs.

The Assyrian Australian Medical Association shared similar insights with me and added that the shortages in south-west Sydney were due to psychologists being incentivised to work out of the area. They asked: why would they work in south-west Sydney when they can charge more per hour in Bondi?

My constituent Tom Lieng said that Medicare indexation was not keeping up with inflation, flagging that this must be remedied in the Medicare reforms the government is planning. He raised that the state government recently announced that those working in group practices are now considered employees rather than contractors and are now subject to a five per cent payroll tax. This will be another unfair cost to our medical practitioners. I call on state and federal governments to collaborate for a fairer tax system as part of the Medicare reforms. This will alleviate the costs being passed on to patients, especially those from a low socioeconomic background. I do not blame the doctors, nurses and allied health professionals who need to charge more for their services. After all, we’re all getting hit by the cost-of-living crisis. We need Medicare reform now. Overall, we need a healthcare sector that guarantees the health and wellbeing of all Australians, regardless of their socioeconomic background, cultural heritage, age or postcode. We all know that health is the real wealth of any country.