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27 May 2016
Medical Deans, the peak body for entry level medical education, again calls for the Federal Government to invest in viable, regional post graduate training programs to address rural medical workforce shortages.
Medical Deans President, Professor Nicholas Glasgow said he was pleased to see Minister Ley’s comments in the Bendigo Advertiser which showed the Government understood that simply increasing the number of medical school training places will not provide regional and rural Australia with the medical workforce they need.
Bendigo Advertiser 20 May 2016
Health Minister Sussan Ley said the government had been advised against creating any more medical training places.
“We will go on talking about it, but at the moment my experts and the Australian Medical Association are telling me we don’t need any new medical training places in Australia,” she said.
She said the number of student undergraduate medical training places doubled between 2008 and 2016.
Professor Glasgow said “More post graduate training opportunities are needed so medical graduates can stay in rural areas for their specialist training. We have more than doubled the output of our medical schools over the last 15 years and there are now significant numbers of medical students and interns in rural and regional areas.
However the path to becoming a fully fledged doctor is a long one and many young doctors end up back in our cities in order to complete their specialist training”.
Professor Glasgow said that scarce resources needed to be allocated across the training pipeline where they could make the most difference. He noted that the proposed University of Newcastle Central Coast medical school involved a transfer of Commonwealth supported places from the University of Newcastle campus.
“The growth of rural clinical schools means medical students can experience high quality rural placements. They have been successful in increasing the number of medical students with a rural background – since 2003 the number of medical students from a rural background has increased from 20% of commencing students to nearly 26% in 2015. It is now time to address the next disconnect in the rural training system by enabling graduates interested in rural medical careers to stay in rural areas while they finish their training” .
Contact: Carmel Tebbutt, CEO Medical Deans, 02 8084 6557, 0437 476 267 or firstname.lastname@example.org
There are few new initiatives in the Health portfolio, beyond what was announced prior to the delivery of the Budget.
Expenditure – Investment in health, aged care and sport in 2016-17 is $89.5 billion, an increase of 4.1% on 2015-16. This includes a $71.4 billion investment in health, a 3.2% increase on 2015-16.
The major initiatives are:
+ The April COAG new funding arrangements for public hospitals which provides an additional $2.9billion over three years to commence in 2017-18
+ The Health Care Homes trial of coordinated primary care (announced 31 March 2016) will cost $21.5 million and is to be funded by redirecting fee for service payments for Chronic Disease Management Medicare items for participating patients. (The Government will redesign the Practices Incentive Program (PIP) to introduce a new quality incentive from May 2017, which will achieve savings of $21.2m)
+ The Child and Adult Public Dental Scheme – $1.7 billion over four years
+ General practice registrars training on the Australian College of Rural and Remote Medicine Independent Pathway to claim a higher level of Medicare benefits rebate for the services they provide while training ($8 million over four years but from within existing resources of the DoH)
+ The Rural and Regional Training Infrastructure Grants Program will be redesigned and renamed the Rural General Practice Grants Program to provide a broader range of infrastructure grants to teach and train rural health practitioners (existing funding of $20.7m from the DoH will be redirected for this purpose)
+ $63.8million to be provided for new or amended PBS listings including for treatments such as melanoma and breast cancer
There are a range of saving measures, with funds redirected to health policy priorities. They include:
+ The pause on indexation of the MBS fees will continue until June 2020 saving $925m over two years. There has been a strong response to this measure with concerns being raised about its impact on bulk billing and the AMA saying “the poorest, the sickest and the most vulnerable will be hardest hit”
+ Pausing indexation on the Health Flexible funds for a further two years from 2018-19 (savings of $182.2m over 3 years). Flexible funds will be combined into a new funding structure from 1 July 2016 with eleven outcomes streamlined to six
+ Enhancing the Medicare compliance program is to achieve efficiencies of $66.2m over four years from 2016-17
+ $5.1m will be saved over four years from the recommendations of the first stage of the MBS Review
+ GP training positions continue at 1500 per year
+ STP continues with 900 in 2016 and then reflects the MYEFO Rural Integrated Pipeline announcement for subsequent years.
+ Commonwealth Medical Internships program continues to provide 100 places a year.
+ The Medical Research Future Fund (MRFF) board will develop national medical research priorities to guide where future funds will be allocated.
+ Integrated Rural Training Pipeline Initiative is as announced in MYEFO in December 2015
Funding for Higher Education is $12.3 billion for 2016 – 17, a 0.9% increase.
The Government has released a higher education reform discussion paper “Driving Innovation, Fairness, and Excellence in Australian Higher Education”. New reforms are not budgeted to commence until 2018 (there are still savings in the forward estimates). The Government plans to work with stakeholders to finalise the package in 2016 and legislate for commencement in 2018. The Government has said it will not be implementing deregulated course fees as proposed in the 2014-15 Budget. The discussion paper raises alternative models of flexibility for institutions to set fees for a small cohort of students enrolled in courses of clearly defined excellence or “flagship courses”.
A range of other measures are raised in the paper including reforms to the allocation of postgraduate places, enhancements to QILT surveys, options to adjust subsidy and student contributions and changes to the HELP repayment thresholds and rates.
The paper also flags seeking the views of the sector on the relativities between disciplines of funding clusters and to work with Universities Australia to investigate the relative cost of delivery of higher education.
An Expert Advisory Panel has been established and written submissions on the paper can be made up until 25 July 2016.
The Higher Education Participation Program has had $152m cut over four years and the Promotion of Excellence in Learning and Teaching in Higher Education has had $20.9m cut over four years
Three existing programs (Commonwealth Scholarship Program, Indigenous Support Program and Indigenous Tutorial Assistance Scheme) will be consolidated to create a new program to improve completion rates for Indigenous higher education students. This is to provide greater flexibility for universities to implement responses to meet the needs of individual students.