Mr PETER DRAPER (Tamworth) [5.54 p.m.], by leave: Most people in the north-west were not surprised when the Australian Medical Association recently released its Public Health Report Card 2007, which said that Australia-wide public hospitals were in crisis and that more funding, better management and improved Commonwealth-State cooperation was needed to turn this situation around. Health consumers are acutely aware of this crisis and the disadvantage that country people in particular face. They do not require reports to realise we require better management plus Federal- State cooperation. What they do want to know is whether any government is capable of delivering a successful model, one where interdependence works in the consumers' favour rather than against them.

Our health system relies on interdependence. State Emergency Service or Rural Fire Service volunteers in isolated areas are trained to use defibrillators to help keep people alive until an ambulance arrives. Community nurses play an important role in places like Premer and Nundle, and these services dovetail through hospitals like Barraba, Werris Creek, Manilla and Boggabri, in conjunction with ambulance services, to feed to the Tamworth Rural Referral Hospital. This, in turn, feeds to Newcastle and Sydney for serious cases. Our hard-working health professionals dovetail these services so that if anyone in Tambar Springs requiring open-heart surgery is treated at the most appropriate facility. The community expect governments to provide appropriate funding and staffing so our health professionals can deliver their vital services.

Yet as the Federal election looms, health issues are being raised to buy votes in marginal electorates with piecemeal, big-ticket promises that simply will not fix the national crisis. The Nationals candidate for the Federal seat of New England even surveyed constituents and seemed surprised to discover that the health system was a major issue of concern to local people. Surprise, surprise—what a revelation! He failed to tell the electorate that his Federal colleagues have overseen a billion dollars a year reduction in the proportion of funding provided to health, despite their record budget surpluses. Recently it has been suggested that by 2037 the entire New South Wales State budget will be required merely to fund the health system. If that does not spur Federal-State authorities to develop cooperative interdependence of health provision urgently, the crisis will only deepen.

Yet another new report by Tony McMichael from the Australian National University says that climate change will also cause a rise in deaths, especially from heart attacks and strokes. Rates of asthma will rise, and gastroenteritis and food poisoning will become major problems. In additional, extreme climatic events will cause even more mental stress and depression. In the next 30 years, the number of people aged over 65 years is expected to rise from 13½ per cent of the population to 23 per cent, including 1.1 million aged 85 years and over. This will place massive additional stresses on our health system. When the entire national health system is under stress, the problems become exponentially worse in rural and regional areas. Over the last 20 years Federal governments of both persuasions have failed to fund sufficient training places for new doctors, leading to the critical shortages we are facing today. Australians are angry that not only have we failed to train our own kids to fill these roles, but also we have plundered overseas countries' limited resources to meet our own needs.

The latest Medicare Australia Annual Report indicates a government scheme to attract young doctors to work in rural areas has failed to realise its potential, with less than half the funds allocated to the Higher Education Contribution Scheme being spent during the 2006-07 year. The scheme offers doctors working in rural and remote areas an opportunity to claim back one fifth of their Higher Eduction Contribution Scheme fees for each year of service in these areas, but just $2.7 million of an available $5.95 million was spent. The Rural Doctors Association and the Australian Medical Association are urging the Federal government to commit to a major rescue package of rural-specific support incentives to get more doctors working in country areas. These include a rural isolation payment to be paid to all rural doctors, including general practitioners, specialists and registrars, to reflect the isolation associated with rural practice.

A rural procedural and emergency on-call loading is also suggested to better support rural procedural doctors, including procedural specialists, who provide obstetric, surgical, anaesthetic or primary emergency on-call service in rural communities. Next year students will commence their studies through the medical school at University of New England in Armidale. An important part of that program is the students gaining experience and on- the-job training at Tamworth Rural Referral Hospital. At the recent March State election Premier Morris Iemma promised to redevelop the hospital in Tamworth to meet the needs of these students. Many constituents have expressed their concerns to me that pressures on funding to drag the health system out of its current quagmire may mean this project will be delayed.

The people of the New England and north-west are truly sick of the health blame game. There are many reports and recommendations but, most importantly, people want action and true interdependence that results in a properly funded health system that can meet the community's needs and expectations. The Governor of the Reserve Bank has warned that large tax cuts will drive inflation. The feedback I am receiving very strongly from my electorate indicates that people are looking for leadership on the issue. The message is they do not want superficial tax cuts; they want budget surpluses invested in fixing the health system to benefit all Australians.