The National Health Amendment (COVID-19) Bill 2021 amends the National Health Act to facilitate the purchasing of COVID-19 vaccines, including boosters, consumables and COVID-19 treatments.

This bill shows more of what living with COVID might mean beyond the immediate political cycle. I’m relieved that planning is underway to flesh out the health details of the national plan. The Prime Minister has said over and over that this is a safe plan. By asking us to believe it’s safe, he’s asking us to take a great leap of faith. I support the national plan, make no mistake. I, like so many other Australians—most Australians—want to find myself in a situation of certainty, rather than continuous uncertainty.

But I and my rural and regional constituents want reassurance too about how it will work in practice. And here’s what I’d like to know: what does 70 to 80 per cent look like for rural and regional Australia?

Are our unique circumstances of higher disease burden and inequitable healthcare access being considered?

How will our chronically underfunded health services respond to three, a dozen, hundreds of cases?

Will our under-resourced workforce’s response be supported and equipped to deal with what comes next?

Can we guarantee that our family members, our friends and our neighbours can still get elective surgery, can still see a specialist?

Can our health infrastructure handle the requirements of COVID-safe isolation?

My electorate has been largely COVID-free since the pandemic began. There have been a few scares, which were expertly handled by our health services, but the disease itself has largely existed somewhere else.

This doesn’t mean, of course, that we’re unscarred. We’ve borne the economic cost of lockdowns and seen our small businesses contract. We’ve worked hard and followed the rules, and we’ve also benefitted from protection. The ring of steel around Melbourne was introduced last year because our small rural health services are not equipped to deal with large COVID outbreaks.

My constituents are turning out in record numbers for vaccination, even though we’ve had little exposure, and, in spite of the many blunders of this vaccine rollout, we’re still showing up. Country people are used to going the extra mile to get medical care. We’re used to waiting a long time. But it’s usually months, not hours, like it is in some COVID queues, and this rollout has been no exception.

I am so proud that the health district of Hume, which is approximately the footprint of Indi, was the fourth-highest in our state for first doses. The LGAs on the first-dose leaderboard are: Indigo shire, at 68 per cent; Towong shire, at 67.4 per cent; and Alpine shire, at 67.1 per cent. Of fully vaccinated LGAs, the gold goes to Benalla, at 43.8 per cent, then Strathbogie, at 40.1 per cent, and Wangaratta, at 39.7 per cent. On Friday Albury Wodonga Health administered 708 vaccine doses, and that’s a record for them. We’re showing up because we’re desperate to return to a life where we can work, study and travel.

The Doherty institute says that, with higher vaccination rates, there will be less transmission of COVID-19, fewer people with severe illness and fewer hospitalisations and deaths. That’s good news. But, for rural and regional Australians, the reality is that, when we open up at 70 to 80 per cent, our health services will experience something they have never grappled with before, and that’s COVID-19 circulating in the community. This means it will get worse for them and it will get harder. It’s not a possibility; it’s a certainty. And of course the vaccination rates are key to that, to make sure that, as it’s circulating much more broadly, people don’t get as sick as they could do if they were not vaccinated.

Before I became an MP, I worked in rural and regional health care for over three decades, and I know there’s simply no give in our system. On a normal day, our health services are at capacity, and it’s very common for there to be nowhere near enough staff. Like the bushfires exposed how brittle our regional infrastructure is from years of neglect, COVID has magnified the weaknesses of our regional health systems. That’s why I’m calling on the government to explain, please, how we will transition from zero COVID to the place where we need to go with the national plan.

The situation playing out in Shepparton, in the neighbouring electorate to mine, Nicholls, is a case in point. Shepparton has experienced the worst regional Victorian outbreak since the pandemic began. In tight-knit regional towns, lives overlap, and in Shepparton this has resulted in one-third of its population in isolation. People have struggled to access essential services such as groceries. Over the weekend, the Red Cross delivered 600 food parcels to families isolating at home. I know they’re on top of it now, and that’s because they’re an incredible community. And the health service has responded valiantly, but of course it has to buckle under so much pressure. By Sunday, 500 Goulburn Valley Health staff had been furloughed due to the growing list of exposure sites, and that’s having flow-on effects to services in Numurkah and Kyabram. The remaining doctors still working are focused on rolling out vaccines and dealing with critical emergencies.

I’m told that everything that could be done is being done to support the community and its health services, but it’s still not enough. What we’re seeing in Shepparton is how little it takes to completely swamp our rural and regional health systems.

And this is just one regional town. Just think about it. If it’s a dozen across Victoria, then what? If our metro hospitals are struggling with increased demand like we’re seeing in New South Wales, no-one will be spare to lend a hand in the country. And what’s playing out in New South Wales is instructive. The New South Wales Premier says the worst is yet to come, in October, still a whole month away. The New South Wales Deputy Premier said that the health system is ready to repivot and recalibrate, but, goodness me, this is a claim that has been rebutted conclusively by doctors and nurses on the front line, who say that, on current trends, it’s not long until the system is overwhelmed.

The government had been warned of a looming COVID disaster in Wilcannia 18 months ago, and we find ourselves here—too little and too late. It’s the people on the front line I’m most concerned about. As I said, I’ve worked in rural and regional health services for 35 years. Before I came to the chamber this afternoon, I was speaking to the director of medicine at Northeast Health Wangaratta, and she was telling me, too, about the burnout, about the exhaustion, about the uncertainty that so many of the workers there face. After a year and a half of this pandemic, despite this burnout, they’re still showing up and they are trying to be strong, but it takes its toll. Wearing PPE is oppressive. The working conditions are hard. Many are exhausted. And, as she told me this afternoon, many are burning out.

Many health services survive only through overseas trained locum doctors, but closed borders mean this supply has dried up. With some medical specialist exams cancelled just weeks out from exam day, it’s not just a sunk cost of months and months of study for these doctors; it’s fewer skilled medical workers when we most need them.

It has come to a point where some of the most passionate healthcare workers are actually questioning their career choice, and this is a terrible shame. We can’t afford to lose a single worker, not now, and we need to support them. We need a pipeline of medical professionals and we need confidence that plans are being made ahead of time, not just on the fly. This government needs to have the backs of our health professionals for the long haul.

We need a dedicated focus on vaccinating rural and regional Australians. The New South Wales Chief Health Officer, Kerry Chant, said we’re only as safe as the protection of our most vulnerable. It doesn’t escape my attention that the people she identified as vulnerable should have been vaccinated months ago. People with underlying health conditions, First Nations people, people with mental ill health, prisoners, aged-care workers and people with disabilities should have been at the front of the queue. With higher disease burden and greater barriers to accessing health care, our regional communities must be a priority.

In my electorate, one of these priority groups is our culturally and linguistically diverse community in Albury-Wodonga. With government resources focused on the Sydney outbreak, our local CALD communities have really struggled to find adequate, local public health information about vaccination, about their questions, about how the testing process works or about how to manoeuvre through the complex border permit system, particularly in the languages of Swahili, Kinyarwanda and Nepali, which are spoken by our refugee community. Our sector has now begun to meet regularly to coordinate these resources and support. I want to thank our community leaders, volunteers, local settlement, community services and health services staff, who work so hard on this response in Albury-Wodonga. I especially want to thank Lucy Wallace for pulling meetings together of these key groups.

I represent an electorate which has endured the repeated closure of the New South Wales-Victoria border. This has and continues to have detrimental impacts on access to health care. When the border first closed in 2020, it prevented the region’s only two infectious diseases doctors from getting to work. It stopped up to 80 frontline Northeast Health Wangaratta staff getting to work. It disrupted surgery and cancer care—and the list goes on. Every day we live with the cruel consequences of rules made in metropolitan cities without understanding the reality of life in rural and regional centres.

And now we have hundreds of Victorians, many grey nomads in their 60s, 70s and 80s, stranded in limbo in caravan parks just north of the Murray River. They’re barred from getting home through no fault of their own because there is no permit that allows them to enter Victoria. Anecdotally, there may be thousands of Victorians further into New South Wales in the same position. This is a public health crisis within a public health crisis waiting to happen. Ironically, one of the few reasons they can cross back into Victoria is to get medical treatment. They should not have to get sick enough to need medical attention before they have a legitimate reason to return home. It’s a disgrace.

Our community has fought for over a year for the protections in the border bubble. I was pleased to hear in my meeting with the New South Wales border commissioner yesterday that New South Wales is planning for specific arrangements for border communities once the 70 to 80 per cent vaccination targets in the national plan are met and restrictions are being eased. It’s only because of the sustained advocacy for our border bubble that the interests of the hundreds of thousands of people who live on the New South Wales-Victoria border are taken seriously at all.

Again I say as a long-term health worker, and one of only two nurses in this parliament, that I welcome this bill and the forward planning it foreshadows. But here’s what else we need to see: our essential workers, our frontline health professionals—the nurses, doctors, allied are workers—need reassurance that they will have the resources to be safe and supported for the long haul.

We need modelling done on a local level for projected patient numbers so that we can plan ahead.

We need a long-term plan for properly staffing the administration of vaccinations, including these booster shots that we’re legislating for today. We can’t keep redeploying specialists from the front line into the vaccination line.

We need our multipurpose services in regional Australia. They need capital funding from the Commonwealth for modifications to make them COVID safe. We need a national cabinet approach to resolving workforce shortages across the country.

And, just for good measure, by golly we need a new hospital at Albury-Wodonga Health. Let’s see this as an opportunity, because we can do two things at once. We can equip our rural and regional health sector to respond to COVID, and properly resource it to deal with whatever the future will bring.

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