Wednesday, 29 June 2016

Students grill Bendigo member on medical school policy

Federal member for Bendigo, Lisa Chesters, took questions from students about  the proposed new medical school and Labor health policy.
Medical students concerned about a proposed new medical school in Bendigo took their questions directly to local federal member, Lisa Chesters, on Monday night.

Students have been campaigning for more postgraduate training places rather than an increase in undergraduate places in rural and regional areas. Ms Chesters agreed that the major issue in retaining doctors in rural areas was lack of specialist training places outside metropolitan Melbourne.

The argument for establishing a new medical school rests on evidence that students with a rural origin who train in a rural and regional areas are more likely to stay and practice. But medical students must complete up to six or seven years of further training after graduating and there are few opportunities to train in specialities outside Melbourne. So students are forced to go to Melbourne to train in their chosen specialty.

Ms Chesters acknowledged that the evidence was “compelling” around training nurses and allied health students in regional areas, but the statistics don’t reflect the reality for medical graduates who have to return to Melbourne.

“This is a time of life when you’re likely to be settling down and if your partner has a job in Melbourne, then you’re likely to stay there as well,” she said.

Evidence about medical students is lacking, said Ms Chesters, and is a good reason that a body like the Australian Institute of Health and Welfare which used to conduct research into health and welfare but was dissolved in 2014, should be refunded.

“There is a need for long-term public health research. We need to invest in rural and regional areas because there are real issues there,” she said. “But it needs to be properly funded and to do that you need the research.”

Closer to home, Ms Chesters wanted to focus on Bendigo’s strengths. “It’s unrealistic to expect that we’ll be able to offer every specialty, but there are many that could build on existing community needs,” she said.

Students suggested opportunities might exist in Bendigo for graduates to train as general surgeons, or as physicians specialising in renal medicine or oncology.

Ms Chesters said expanding postgraduate training into regional areas would need support from a range of stakeholders. “We need to start conversations with the specialist colleges,” she said. “And it’s not just a federal issue, the state government is a big stakeholder.” She emphasises that it also needs long-term strategies drawing together the education and health portfolios.

Students raised concerns about the “attacks” on general practice through issues like the Medicare freeze. The continual attention on GPs was making it a less attractive career prospect. They were also worried about the effect of Medicare funding on general health. The threat of GPs charging fees due to an ongoing freeze would see the burden on hospital emergency departments increase as poorer people avoided seeing a doctor until a health issue became urgent.

Ms Chesters agreed and said the debate needs to be turned around. “GPs are an easy cut in a debate focussed on waiting lists and emergency departments. We need to turn that around. We have a brilliant primary health care system – there needs to be less emphasis on hospitals.”

Although pressed by students, Ms Chesters did not make a commitment that there would be no new medical schools. But she did repeat that her priority was to ensure medical students have options after graduation.

Head of Monash Rural Health, Professor Robyn Langham, quickly outlined a proposal by a partnership between Deakin University, the University of Melbourne and Monash University for a state-wide postgraduate training network which aims to support specialty training in regional areas by building on existing medical school capabilities.

“I’m keen to read that paper about next steps,” said Ms Chesters. “I’m keen to have it funded.” But she said it needs to wait until after the election, so it gets the non-political respect it needs.

“I’m serious about ongoing dialogue with students,” she said. “Changes need to happen otherwise we’ll just keep spinning in this space.”

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