People in western Victoria are being diagnosed with serious illnesses later, and sometimes too late to save their lives, because of the region's medical workers' shortage, the Rural Doctors Association of Australia president Megan Belot says.
Government data compiled by the Western Victoria Primary Health Network shows the number of general practitioners in the electorate of Mallee is well below the Victorian and national averages.
There are 76 general practitioners for every 100,000 people in the electorate compared to 91 on average across Victoria and 97 across the country.
The numbers per patient are worse for dentists (39 per cent below the Victorian average) and much worse for psychologists (82 per cent lower).
"The consequences are huge," Dr Belot, a general practitioner and anaesthetist working in Cohuna, Echuca and Kerang, said.
"Not only will you have more acute presentations to your emergency departments ... but you're also seeing people coming in with cancer diagnosis much later, needing much more further intervention [including] further surgery, more intense chemotherapy or radiotherapy.
The shortage of GPs and specialists across the medical profession are nothing new in the region.
But Dr Belot said COVID had made the problem significantly worse.
The ABC asked each Mallee candidate what they would do to improve local healthcare and medical staff shortages if elected.
Candidates are listed in the order they appear on the ballot paper.
Dr Anne Webster, National Party
Nationals MP Anne Webster is the incumbent in Mallee.
She said being a member of the government had enabled her to secure a series of healthcare outcomes for the electorate.
Among them, she listed the retention of Medicare-funded telehealth; increased hospital funding, including $30 million for the Swan Hill hospital; 80 new Commonwealth-supported places at regional universities; and the reimbursement of university fees for medical degrees in the region.
Dr Webster said she had been working with hospitals, and with La Trobe and Monash universities, to deliver a tri-state training hospital for Mildura.
She also said a returned Coalition government would spend $3.3 million on facilities for an undergraduate biomedical course in Mildura.
"Research shows if we do this, [medical students] are 75-80 per cent more likely to stay local," she said.
Dr Webster noted aged care "received a boost in the federal budget with 15,000 training places for upskilling".
"The delivery of regional MRI's with MBS rebate has been welcomed also," she said.
"If the Coalition is returned to government we will also deliver $35 million in new funding to significantly expand the successful Innovative Models of Collaborative Care program across rural and regional Australia from 1 January 2023.
"The program will attract, support and retain rural health professionals to deliver care on the ground.
"I will fight for Mallee to be a site for this program."
Sophie Baldwin, independent
Sophie Baldwin argued Mallee needed a "flexible model of care to suit the country" where telehealth and nurse practitioners could help take pressure off local GPs.
She is also in favour of incentives for GPs to practice in the region and investment in housing and daycare.
"It's also a catch 22 if a town only has one doctor, the burnout factor is high and GPs soon move on.
"Doctors need to be better supported in the country whether through financial/HECS incentives and appropriately paid multi-skilled staff to help take the pressure off."
Ms Baldwin argued for a "templated approach, to be fine-tuned from community to community".
"[To] achieve those goals, Mallee needs a committed member."
Claudia Haenel, independent
Claudia Haenel said she would "ensure GPs weren't ripped out of the bush".
"We need to keep and retain medical staff, having them train here," she said.
"After kids finish year 12, if they could be here and train through local TAFE or uni, and we can make use of our tertiary education facilities here in Horsham, then we can keep them.
"We need to ensure we get more services in the bush rather than less.
"For people to have to travel ... down the road to Ballarat for a 10-minute appointment which could be done in our local area, particularly when our roads aren't adequate, it's very dangerous."
Ms Haenel also argued for National Disability Insurance Scheme reform.
"We need to ensure ... that when people are given services or their NDIS is able to pay for services for recipients, that those services can be accessed here, to enable the health service funding," she said.
Christopher Lahy, Australian Citizens Party
Christoper Lahy called for a "dramatic increase" in medical staff across specialties and across the national health system.
He argued that "decades of ideologically driven under-resourcing, profiteering, and outsourcing to management consultants" had caused the public health system to become overwhelmed, even before the pandemic.
Mr Lahy said better conditions in health facilities would encourage medical professionals who have left their job to return.
He argued a key method for attracting and retaining young people in the local medical profession would be to pursue better funding for Monash School of Rural Health and the development of the La Trobe University Mildura hospital training precinct.
Mr Lahy said these policies would be funded through a publicly-owned Commonwealth Postal Savings Bank or National Infrastructure Bank.
Carole Hart, Labor
Carole Hart did not respond to requests to comment for this story, but her party has made several promises that it says would make it easier to see a doctor if it wins government.
In its health policy document, Labor has pledged to "boost workforce incentives for rural and regional GPs to support the engagement of nurses, allied health and other health professionals and provide multidisciplinary team-based care".
Labor has detailed plans to expand the Innovative Models of Collaborative Care program across rural and regional Australia "to attract, support and retain rural health professionals".
It also has plans to expand the John Flynn Prevocational Doctor Program to more than 1,000 placements in rural Australia per year, and "strengthen rural generalist and GP registrar training".
The party has vowed to "change the rules to allow regional and outer metro communities to recruit more doctors of their choosing", expand the newborn screening program, and improve pandemic preparedness and response by setting up an Australian Centre for Disease Control.
Labor also pledged to deliver 50 Medicare urgent care centres, which would bulk bill, for conditions like a broken bone or an insect bite.
Sam McColl, the Greens
Sam McColl says his experience working as an operations officer with St John Ambulance helps him understand the importance of what he describes as "a properly funded health care system".
"Healthcare is getting more and more expensive, and too many people can't afford to access dental or mental health care," he said.
Mr McColl cited the Greens' national platform in response to questions about how he would improve healthcare and the medical staff shortage in Mallee.
He says the party's policies are to add dental and mental health care on to Medicare and make telehealth a permanent feature of the scheme.
Other initiatives include reinvesting "the billions paid in private health insurance rebates back into the public system" to reduce out-of-pocket costs, to fund hospitals and clear public hospital surgery waiting lists and spend an extra $8 billion by legislating equal funding of hospitals between the Commonwealth and states.
Asked whether he or his party had any health policies specific to the region, Mr McColl said the Greens did not have specific policies for individual seats.
"All our policies are for the many, not the few."
Stuart King, United Australia Party
Stuart King argued the key to attracting and retaining medical professionals was better quality health facilities and financial incentives to practice in the regions.
He said the United Australia Party’s plan for healthcare involved a 20 per cent regional tax concession, $40 billion for hospital infrastructure, abolishing fees for university and TAFE and forgiving existing HECS debts.
"This will bring direct benefit to Mallee healthcare infrastructure and service delivery by providing better facilities and higher wages to attract and retain healthcare professionals in the Mallee," Mr King said.
"We will [also] invest in education and community facilities which will also support existing residents and attract new ones including healthcare professionals."
The United Australia Party has proposed a 15 per cent licence fee on Australian iron ore exports to fund the repayment of government debt.
The savings on interest payments, Mr King said, would directly fund the proposals.
Vanessa Atkinson, Pauline Hanson's One Nation
Vanessa Atkinson did not respond to the ABC's attempts to contact her for comment.
She is among about a dozen "ghost" candidates running for Pauline Hanson's One Nation this election who have not been seen or heard actively campaigning in the electorates they are contesting.
EDITOR'S NOTE: Candidates' responses have been edited for brevity and clarity.
